中国口腔颌面外科杂志 ›› 2018, Vol. 16 ›› Issue (1): 48-51.doi: 10.19438/j.cjoms.2018.01.010

• 论著 • 上一篇    下一篇

微创拔除压迫下牙槽神经的第三磨牙方法分析

汪湧1, 徐颖2,*, 杨驰1, 戈旌1, 池政兵3,*   

  1. 1.上海交通大学医学院附属第九人民医院·口腔医学院 口腔外科,上海市口腔医学重点实验室, 上海市口腔医学研究所,国家口腔疾病临床研究中心,上海 200011;
    2.上海交通大学医学院附属瑞金医院 口腔科,上海 200025;
    3.上海交通大学医学院附属第九人民医院·口腔医学院 儿童口腔科,上海 200011;
  • 收稿日期:2017-08-21 修回日期:2017-09-15 出版日期:2018-01-20 发布日期:2018-02-11
  • 通讯作者: 徐颖,E-mail:dtww1@126.com;池政兵,E-mail:zbchi120966@sina.com。*共同通信作者
  • 作者简介:汪湧(1966-),男,学士,副主任医师, E-mail: wangyong@126.com
  • 基金资助:
    上海市浦东新区卫生和计划生育委员会资助项目(PW2014D-6); 上海市卫生和计划生育委员会资助项目(201440401)

Minimally invasive extraction of impacted mandibular third molar compressing the inferior alveolar nerve: a comparison of three techniques

WANG Yong1, XU Ying2, YANG Chi1, GE Jing1, CHI Zheng-bin3   

  1. 1.Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology. Shanghai 200011;
    2.Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200025;
    3.Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology,Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2017-08-21 Revised:2017-09-15 Online:2018-01-20 Published:2018-02-11

摘要: 目的: 应用牵引拔牙、截冠和超声骨刀微创拔牙技术拔除压迫下牙槽神经的第三磨牙,观察术后产生下唇麻木等并发症的发生情况。方法: 选择60例全景片和锥形束CT(CBCT)显示下颌第三磨牙牙根压迫下牙槽神经的患者,分别采用3种方法拔牙各20例,术后检查下唇麻木情况。结果: 应用牵引拔牙技术和截冠方法拔除压迫下牙槽神经的第三磨牙,术后无人发生下唇麻木,而应用超声骨刀微创拔牙的患者中有1例出现轻微的下唇麻木症状,经用药1个月后好转。结论: 牵引拔牙技术、截冠和超声骨刀3种方法均可有效避免智牙拔除后下唇麻木的并发症。

关键词: 牵引拔牙, 截冠, 压迫下牙槽神经, 埋伏阻生牙

Abstract: PURPOSE: Extraction of impacted mandibular third molar compressing inferior alveolar nerve(IAN) is highly related to inferior alveolar nerve injury. The aim of this study was to compare the incidences of IAN injury in orthodontic traction, coronectomy and piezosurgery for the impacted mandibular third molar removal. METHODS: After examination of panoramic radiography and cone-beam computed tomography(CBCT), sixty patients with impacted mandibular third molar compressing the IAN were enrolled in this study. Orthodontic traction, coronectomy and piezosurgery were carried out in 20 patients, respectively. Signs of postoperative neurosensory impairment were recorded. RESULTS: No sign of neurosensory impairment was observed in patients undergoing orthodontic traction or coronectomy. One patient (5%) undergone piezosurgery had postoperative lower lip numbness, and recovered within 1 month after drug treatment. CONCLUSIONS: Orthodontic traction, coronectomy and piezosurgery can reduce the incidence of nerve injury during removal of impacted mandibular third molar compressing IAN.

Key words: Orthodontic traction, Coronectomy, Compressing inferior alveolar nerve, Impacted mandibular third molar

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