下颌阻生第三磨牙分段切割拔除术的选择

中国口腔颌面外科杂志 ›› 2015, Vol. 13 ›› Issue (3): 245-248.

下颌阻生第三磨牙分段切割拔除术的选择

庄浩^*, 沈海平^*, 王惠娟

嘉兴市市立三一医院口腔科,浙江嘉兴 314051

收稿日期:2014-09-17 修回日期:2014-11-17 出版日期:2015-05-20 发布日期:2015-06-18
通讯作者: 沈海平,E-mail: shp516@126.com
作者简介:庄浩（1968-）,女,学士,副主任医师,E-mail: zjzh729@163.com;沈海平（1957-）,男,学士,主任医师,E-mail: shp516@126.com。*并列第一作者

Selection of segmental cutting methods for extracting impacted mandibular third molars

ZHUANG Hao, SHEN Hai-ping, WANG Hui-juan

Department of Stomatology, Jiaxing Sanyi Hospital. Jiaxing 314051, Zhejiang Province, China

Received:2014-09-17 Revised:2014-11-17 Online:2015-05-20 Published:2015-06-18

摘要/Abstract

摘要： 目的探讨用涡轮机分段切割法拔除下颌中、低位阻生的第三磨牙的效果及适应证。方法对481例675颗曲面体层片显示中、低位阻生的下颌第三磨牙用涡轮机分段切割法拔除。其中327颗实施二段切割法;348颗实施三段切割法。结果下颌阻生第三磨牙均完全拔除;手术时间5~20 min（平均16 min）;术后发生短暂下唇麻木症状3例（3颗）,发生术后感染15例（15颗）。结论二段切割法适用于中位近中阻生的下颌第三磨牙,三段切割法适用于中/低位近中、水平阻生的下颌第三磨牙。

关键词: 下颌阻生第三磨牙, 牙拔除术, 分段切割法

Abstract: PURPOSE：Use of segmental cutting methods with high speed turbine for extraction of mesially impacted mandibular third molars. METHODS: Six hundred and seventy-five mesially impacted mandibular third molars in 481 persons were extracted with high speed turbine. Three hundred and twenty-seven teeth were extracted by two-segment method; three hundred and forty-eight teeth were extracted by three-segment method. RESULTS: Impacted mandibular third molar were extracted entirely; the operation time was 5-20 minutes(average 16 minutes); temporary lower lip numbness occurred in 3 teeth of 3 cases; postoperative infecting occurred in 15 teeth of 15 cases. CONCLUSIONS: Two-segment method can be applied for mesially impacted mandibular third molars, while three-segment method can be applied for mesially and horizontally impacted mandibular molars.

Key words: Impacted mandibular third molar, Tooth extraction, Segmental cutting method

中图分类号:

R782.11

庄浩, 沈海平, 王惠娟. 下颌阻生第三磨牙分段切割拔除术的选择[J]. 中国口腔颌面外科杂志, 2015, 13(3): 245-248.

ZHUANG Hao, SHEN Hai-ping, WANG Hui-juan. Selection of segmental cutting methods for extracting impacted mandibular third molars[J]. China J Oral Maxillofac Surg, 2015, 13(3): 245-248.

参考文献

[1] 杨擎天, 胡开进, 薛洋, 等. 阻生下颌第三磨牙2种拔除方法的比较 [J].实用口腔医学杂志,2010,26(1): 71-74.
[2] 邓天阁, 李永锋, 丁宇翔, 等. CBCT分析下颌阻生第三磨牙牙根与下颌管的解剖关系[J]. 牙体牙髓牙周病学杂志,2013,23(2): 111-115.
[3] 徐光宙, 杨驰, 范新东, 等. 以下颌神经管为参照的下颌阻生第三磨牙的分类及临床意义 [J]. 中国口腔颌面外科杂志, 2014, 12(2): 131-135.
[4] 陈全, 柳登高, 张刚, 等.下颌阻生第三磨牙与下颌管位置的曲面体层X线片和锥形束CT观察 [J].中华口腔医学杂志, 2009, 44(4): 217-221.
[5] 李涛, 江莉婷, 陈玉华, 等. 两种手术径路在水平阻生牙拔除中的选择 [J]. 口腔颌面外科杂志, 2007, 17(2): 149-152.
[6] 钱文涛, 樊林峰, 徐光宙, 等. CBCT观察影像重叠的下颌第三磨牙与下颌管的位置关系 [J]. 口腔颌面外科杂志, 2010, 20(6): 398-403.
[7] 马绪臣. 口腔颌面锥形束CT的临床应用 [M].北京: 人民卫生出版社, 2011: 95-109.
[8] Nakagawa Y, Ishii H, Nomura Y, et al. Third molar position: reliability of panoramic radiography [J]. J Oral Maxillofac Surg, 2007, 65(7): 1303-1308.
[9] Palma-Carri&#x0dbc0;&#x0dda9; C, García-Mira B, Larrazabal-Mor&#x0dbc0;&#x0dda9;n C, et al. Radiographic signs associated with inferior alveolar nerve damage following lower third molar extraction [J]. Med Oral Patol Oral Cir Bucal, 2010, 15(6): e886-890.
[10] 钱文涛, 张瑛. 下颌管及其分支与下颌第三磨牙关系的影像学观察 [J].口腔颌面外科杂志, 2013, 23(1): 32-36.
[11] Ghaeminia H, Meijer GJ, Soehardi A, et al. Position of the impacted third molar in relation to the mandibular canal. Diagnostic accuracy of cone beam computed tomography compared with panoramic radiography [J]. Int J Oral Maxillofac Surg, 2009, 38(9): 964-971.
[12] Tantanapornkul W, Okouchi K, Fujiwara Y, et al. A comparative study of cone-beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars [J]. Oral Surg Oral Pathol Oral Radiol Endod, 2007, 103(2): 253-259.
[13] 楚德国.下颌第三磨牙阻生类型同体两侧对称性研究 [J].现代口腔医学杂志, 2013, 27(6): 325-327.
[14] 周宏志,胡开进,秦瑞峰,等.下颌阻生第三磨牙拔除难度预判 [J]. 口腔医学研究, 2009, 25(3): 327-329.
[15] Susala SM, Dodson TB. Preoperative computed tomography imaging in the management of impacted mandibular third molars [J]. J Oral Maxillofac Surg, 2007, 65(1): 83-88.
[16] Yuasa H, Kawai T, Sugiura M. Classification of surgical difficulty in extracting impacted third molars [J]. Br J Oral Maxillofac Surg, 2002, 40(1): 26-31.
[17] 郭斐, 叶丽娟, 康非吾, 等. 锥形束CT中下颌第三磨牙与下颌管的关系及其与阻生类型的相关性分析[J]. 口腔颌面外科杂志, 2013, 23(3): 186-191.
[18] 戈旌, 杨驰, 何冬梅, 等. 4种超声骨刀去骨法在高难度下颌阻生第三磨牙拔除术中的应用[J]. 中国口腔颌面外科杂志, 2014, 12(5): 425-429.
[19] 康非吾,薛中秀.下颌第三磨牙截冠留根法的临床研究进展 [J]. 口腔颌面外科杂志, 2014, 24(3): 165-169.