不分冠法在特定类型近中高位下颌阻生第三磨牙拔除中的效果评价

doi:10.19438/j.cjoms.2026.03.014

摘要/Abstract

摘要： 目的: 评价不分冠法在特定类型近中高位下颌阻生第三磨牙拔除中的效果。方法: 选择2023年7月—2024年7月苏州口腔医院收治的近中高位下颌阻生第三磨牙患者92例,随机分为试验组和对照组,每组各46例。对照组接受传统分冠法拔除治疗,试验组采用不分冠法拔除患牙。比较两组手术时间,术前焦虑程度,术中牙根折断、牙龈撕裂、舌侧骨板骨折等术中并发症,术后疼痛、肿胀、张口受限、出血、干槽症、颞下颌关节疼痛等术后并发症,以及术后邻牙状态。结果: 试验组手术时间显著短于对照组,术前焦虑程度显著低于对照组（P<0.05）。两组牙根折断、牙龈撕裂及舌侧骨板骨折比例均无显著差异（P>0.05）。试验组术后1 d和3 d疼痛评分及张口受限程度显著低于对照组（P<0.05）,但术后7 d时两组无显著差异（P>0.05）。两组术后肿胀程度及邻牙松动、出血和干槽症的比例无显著差异（P>0.05）。试验组颞下颌关节疼痛比例显著低于对照组（P<0.05）,但术后邻牙咀嚼无力出现比例显著高于对照组（P<0.05）。结论: 对于特定类型近中高位下颌阻生第三磨牙,不分冠法拔除具有手术时间短、术前焦虑轻、术后早期疼痛及张口受限轻、颞下颌关节疼痛少等优点。

关键词: 不分冠法, 分冠法, 阻生牙拔除术, 近中高位下颌阻生第三磨牙, 并发症

Abstract: PURPOSE: To compare the efficacy of no crown-amputation technique versus the traditional tooth-division technique in the extraction of specific high-positioned mesioangular impacted mandibular third molars. METHODS: A total of 92 patients with high-positioned mesioangular impacted mandibular third molars admitted to Suzhou Stomatological Hospital from July 2023 to July 2024 were selected and randomly divided into the experimental group and the control group, with 46 cases in each group. The control group underwent extraction using the traditional tooth-division technique, while the experimental group was treated with no crown-amputation technique. The following parameters were compared between the two groups: operation time, preoperative anxiety level, intraoperative complications (including root fracture, gingival laceration, and lingual plate fracture), postoperative complications (including pain, swelling, trismus, bleeding, dry socket, and temporomandibular joint pain), and the status of the adjacent tooth. RESULTS: The operation time in the experimental group was significantly shorter than that in the control group, and the preoperative anxiety level was also significantly lower (P<0.05). There were no significant differences in the incidences of root fracture, gingival laceration and lingual cortical plate fracture between the two groups (P>0.05). The pain scores and the degree of trismus in the experimental group were significantly lower than those in the control group at 1 and 3 days postoperatively (P<0.05), while no significant difference was found between the two groups at 7 days postoperatively (P>0.05). No significant differences were observed between the two groups in the degree of postoperative swelling, nor in the incidences of adjacent tooth mobility, bleeding and dry socket (P>0.05). The incidence of temporomandibular joint pain in the experimental group was significantly lower than that in the control group (P<0.05), whereas the incidence of masticatory weakness of adjacent teeth postoperatively was significantly higher (P<0.05). CONCLUSIONS: For specific types of mesioangular high-position mandibular impacted third molars, extraction via the crown-non-separation method has the advantages of shorter operation time, milder preoperative anxiety, less early postoperative pain and trismus, and a lower incidence of temporomandibular joint pain.

Key words: No crown-amputation technique, Tooth-division technique, Impacted tooth extraction, Mesioangular high-positioned mandibular third molar, Complications

中图分类号:

R782.1

赵立媛, 陈冲, 张晨欢. 不分冠法在特定类型近中高位下颌阻生第三磨牙拔除中的效果评价[J]. 中国口腔颌面外科杂志, 2026, 24(3): 296-301.

Zhao Liyuan, Chen Chong, Zhang Chenhuan. Evaluation of the efficacy of no crown-amputation technique for the extraction of specific mesioangular high-positioned mandibular third molar[J]. China J Oral Maxillofac Surg, 2026, 24(3): 296-301.

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