颊侧角形瓣转移缝合对下颌阻生第三磨牙拔除术后愈合及并发症的影响

doi:10.19438/j.cjoms.2026.02.007

中国口腔颌面外科杂志 ›› 2026, Vol. 24 ›› Issue (2): 139-143.doi: 10.19438/j.cjoms.2026.02.007

颊侧角形瓣转移缝合对下颌阻生第三磨牙拔除术后愈合及并发症的影响

高常乐¹, 刘锟^1,2,*, 雷荣昌^1,2,*, 蒋智升^1,2, 廖骏¹, 柴安^1,2

1.湖南中医药大学口腔医（学）院,湖南长沙 410208;
2.长沙市口腔医院口腔颌面外科,湖南长沙 410006

收稿日期:2025-05-29 修回日期:2025-07-16 出版日期:2026-03-20 发布日期:2026-04-02
通讯作者: 雷荣昌,E-mail：leroch@163.com;刘锟,E-mail：391144470@qq.com。^*共同通信作者
作者简介:高常乐（1999—）,女,在读硕士研究生,E-mail: 2859820235@qq.com

Effect of buccal triangular flap transfer and suturing on postoperative healing and complications following mandibular impacted third molar extraction

Gao Changle¹, Liu Kun^1,2, Lei Rongchang^1,2, Jiang Zhisheng^1,2, Liao Jun¹, Chai An^1,2

1. School of Stomatology, Hunan University of Chinese Medicine. Changsha 410208;
2. Department of Oral and Maxillofacial Surgery, Changsha Stomatological Hospital. Changsha 410006, Hunan Province, China

Received:2025-05-29 Revised:2025-07-16 Online:2026-03-20 Published:2026-04-02

摘要/Abstract

摘要： 目的: 探讨颊侧角形瓣转移缝合法用于部分萌出下颌阻生第三磨牙（mandibular impacted third molars,MITM）拔除术后创口修复的有效性与安全性,提出个性化缝合方案,为临床选择缝合方法提供参考。方法: 选取2024年1月—2025年1月长沙市口腔医院需拔除近中/水平阻生（冠部分萌出）MITM 的患者90例,随机分为试验组（n=47,颊侧角形瓣转移缝合）与对照组（n=43,原切口对位缝合）。比较两组患者术后创口一期愈合率、食物嵌塞发生率及术后并发症发生情况。结果: 两组基线资料（性别、年龄、阻生类型）无显著差异（P>0.05）,但试验组龈瓣最大缺损宽度>5 mm的比例更高（P=0.043）。试验组一期愈合率（82.97%）显著高于对照组（32.55%）,二期愈合率（17.02%）显著低于对照组（67.45%,P<0.001）。亚组分析显示,龈瓣缺损宽度≤5 mm 时,两组愈合率均为100%（P>0.05）;缺损宽度>5 mm 时,试验组一期愈合率（81.82%）显著高于对照组（14.71%,P<0.001）。试验组食物嵌塞发生率较对照组降低 50.4%（P<0.001）。术后第3天,试验组面颊部肿胀程度略高于对照组（P=0.025）;但术后第1天、第7~10天,两组无显著差异（P>0.05）。两组术后各时间点疼痛指数、开口度无显著差异（P>0.05）。试验组术后出血发生率显著低于对照组（P<0.01）,两组均未发生干槽症。结论: 尽管基数中两组龈瓣最大缺损宽度分布不均衡,但颊侧角形瓣转移缝合法可显著提升 MITM 拔除术后创口一期愈合率（尤其缺损>5 mm 时）,有效降低食物嵌塞及术后出血风险,安全性高,值得临床推广应用。

关键词: 颊侧角形瓣, 龈瓣转移缝合, 下颌阻生第三磨牙, 一期愈合, 食物嵌塞

Abstract: PURPOSE: To explore the efficacy and safety of buccal triangular flap transfer and suturing for wound repair after extraction of partially erupted mandibular impacted third molars(MITM), and to propose a personalized suturing scheme for clinical reference. METHODS: A total of 90 patients with mesially/horizontally impacted MITM (partially erupted crowns) treated in Changsha Stomatological Hospital from January 2024 to January 2025 were randomly divided into two groups: the experimental group(n=47, buccal triangular flap transfer and suturing) and the control group(n=43, primary approximation and suturing). The primary wound healing rate after surgery, the incidence of food impaction and the occurrence of postoperative complications were compared between the two groups of patients. RESULTS: There were no significant differences in baseline data (gender, age, impaction type) between the two groups (P>0.05), but the proportion of patients with maximum gingival flap defect width >5 mm was significantly higher in the experimental group (P=0.043). The primary healing rate was significantly higher in the experimental group(82.97%) than in the control group (32.55%), while the secondary healing rate was significantly lower (17.02% vs 67.45%, P<0.001) in the experimental group. Subgroup analysis showed that the primary healing rate was 100% in both groups when the defect width ≤5 mm(P>0.05), but significantly higher in the experimental group (81.82%) than in the control group (14.71%) when the defect width >5 mm (P<0.001). The incidence of food impaction in the experimental group was 50.4% lower than that in the control group(P<0.001). Facial swelling in the experimental group was slightly more severe than that in the control group on postoperative day 3 (P=0.025), but no differences were observed on day 1 or days 7-10(P>0.05). There were no significant differences in pain scores or mouth opening between the two groups at any time point(P>0.05). The incidence of postoperative bleeding was significantly lower in the experimental group than in the control group(P<0.01). No dry socket osteitis occurred in either group. CONCLUSIONS: Despite more severe gingival flap defects at baseline, buccal triangular flap transfer suturing significantly improves the primary healing rate of MITM extraction wounds (especially when the defect width>5 mm), effectively reduces food impaction and postoperative bleeding, and has high safety, which is worthy of clinical promotion.

Key words: Buccal triangular flap, Gingival flap transfer and suturing, Mandibular impacted third molar, Primary healing, Food impaction

中图分类号:

R782.1

高常乐, 刘锟, 雷荣昌, 蒋智升, 廖骏, 柴安. 颊侧角形瓣转移缝合对下颌阻生第三磨牙拔除术后愈合及并发症的影响[J]. 中国口腔颌面外科杂志, 2026, 24(2): 139-143.

Gao Changle, Liu Kun, Lei Rongchang, Jiang Zhisheng, Liao Jun, Chai An. Effect of buccal triangular flap transfer and suturing on postoperative healing and complications following mandibular impacted third molar extraction[J]. China J Oral Maxillofac Surg, 2026, 24(2): 139-143.

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颊侧角形瓣转移缝合对下颌阻生第三磨牙拔除术后愈合及并发症的影响

Effect of buccal triangular flap transfer and suturing on postoperative healing and complications following mandibular impacted third molar extraction

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