中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2025, Vol. 23 ›› Issue (5): 450-456.doi: 10.19438/j.cjoms.2025.05.004

• 论著 • 上一篇    下一篇

刚体力学法拔除高危下颌第三磨牙对下牙槽神经功能的影响

匡世军, 刘湘奇, 吴家顺, 冯细妹, 杨辛   

  1. 中山大学附属口腔医院 口腔颌面外科,广东省口腔疾病临床医学研究中心,广东 广州 510055
  • 收稿日期:2025-07-03 修回日期:2025-08-05 发布日期:2025-10-10
  • 通讯作者: 杨辛,E-mail: yangxin7@mail.sysu.edu.cn
  • 作者简介:匡世军（1969-）,男,博士,副主任医师,E-mail: kuangshj@mail.sysu.edu.cn
  • 基金资助:
    国家自然科学基金（81902778）; 广州市科技项目（2023A04J2167）

Application of geostatics on the extraction of high-risk mandibular third molars : a prospective randomized controlled study on inferior alveolar nerve function

Kuang Shijun, Liu Xiangqi, Wu Jiashun, Feng Ximei, Yang Xin   

  1. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-sen University; Guangdong Provincial Clinical Research Center of Oral Diseases. Guangzhou 510055, Guangdong Province, China
  • Received:2025-07-03 Revised:2025-08-05 Published:2025-10-10

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摘要： 目的: 探讨刚体力学法拔除高危下颌第三磨牙（mandibular third molar,M3M）对下牙槽神经（inferior alveolar nerve,IAN）功能的影响,为临床降低IAN损伤风险提供参考。方法: 采用前瞻性单盲随机对照设计,纳入263例患者的270颗高危M3M,随机分为试验组与对照组,每组各135颗。试验组采用刚体力学法拔除,对照组采用传统力学法拔除。术后1周复诊拆线,记录两组IAN损伤发生情况,分析组间及性别间的差异。结果: 两组患者在年龄、性别、M3M的Pell-Gregory分类及Winter分类方面均无显著差异（P>0.05）。对照组IAN 损伤发生率为11.1%（15/135）,试验组为3.0%（4/135）,组间差异有统计学意义（P=0.009）。性别分层分析显示,男性IAN损伤发生率为1.7%（2/121）,女性为11.4%（17/149）,性别间差异有统计学意义（P=0.002）。结论: 刚体力学法可有效降低高危M3M 拔除后IAN损伤的发生率,为临床上避免IAN损伤提供了新的思路。女性患者拔除高危M3M时,需更关注IAN的保护。

关键词: 刚体力学法, 下颌第三磨牙, 下牙槽神经, 神经损伤, 术后并发症

Abstract: PURPOSE: To evaluate the effect of geostatics on inferior alveolar nerve (IAN) function after extraction of high-risk mandibular third molars (M3Ms), and to provide a clinical reference for reducing IAN injury risk. METHODS: A prospective single-blind randomized controlled trial was conducted, including 270 high-risk M3Ms from 263 patients. The M3Ms were randomly divided into two groups (135 M3Ms each): the experimental group (extracted via geostatics) and the control group (extracted via traditional mechanical methods). One week after operation, the stitches were removed during the follow-up visit. The occurrence of IAN injury in both groups was recorded, and the differences between the groups and between genders were analyzed. RESULTS: There were no significant differences in age, gender, Pell-Gregory classification and Winter classification of M3Ms between the two groups (P>0.05). The incidence of IAN injury was 11.1% (15/135) in the control group and 3.0% (4/135) in the experimental group, with significant difference (P=0.009). Stratified analysis by gender showed that the incidence of IAN injury was 1.7% (2/121) in males and 11.4% (17/149) in females, with significant difference (P=0.002). CONCLUSIONS: Geostatics can effectively reduce the incidence of IAN injury after high-risk M3M extraction, providing a new technical approach for clinical IAN protection. More attention should be paid to IAN protection in female patients during high-risk M3M extraction.

Key words: Geostatics, Mandibular third molar, Inferior alveolar nerve, Nerve injury, Postoperative complications

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