中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2025, Vol. 23 ›› Issue (4): 355-360.doi: 10.19438/j.cjoms.2025.04.007

• 论著 • 上一篇    下一篇

部分牙冠切除术拔除侵及下颌神经管的阻生第三磨牙的效果评价

闫威风1,2, 陈志方1,2,3, 陆璐云1,2   

  1. 1.安徽医科大学合肥口腔临床学院,安徽 合肥 230001;
    2.安徽医科大学第五临床医学院,安徽 合肥 230032;
    3.合肥市口腔医院 西区口腔外科,安徽 合肥 230601
  • 收稿日期:2025-02-20 修回日期:2025-03-15 出版日期:2025-07-20 发布日期:2025-08-04
  • 通讯作者: 陈志方,E-mail: czf-1973@163.com
  • 作者简介:闫威风（1998-）,男,硕士,E-mail: 3181969676@qq.com
  • 基金资助:
    2024年合肥市口腔医院院级科研项目（院级教[2024]25号）

Clinical evaluation of partial odontectomy for the removal of impacted third molar invading the inferior alveolar nerve canal

Yan Weifeng1,2, Chen Zhifang1,2,3, Lu Luyun1,2   

  1. 1. Hefei Clinical School of Stomatology, Anhui Medical University. Hefei 230001;
    2. The Fifth Clinical Medical College, Anhui Medical University. Hefei 230001;
    3. Western Stomatological Surgery Department of Hefei Stomatological Hospital. Hefei 230601, Anhui Province, China
  • Received:2025-02-20 Revised:2025-03-15 Online:2025-07-20 Published:2025-08-04

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摘要： 目的：探讨部分牙冠切除后再行二次手术拔除牙根侵及下颌神经管的阻生第三磨牙的临床效果。方法：选择2023年1月—2024年12月在合肥市口腔医院西区口腔外科就诊的近中或水平阻生第三磨牙64例,所有阻生牙经CBCT确诊牙根侵入下颌神经管。患者随机分为2组,每组32例。试验组采取先部分牙冠切除,3或6个月后再完全拔除;对照组采取常规一次性拔除。观察试验组部分牙冠切除术后随访期间的不良反应,并比较两组牙完全拔除术后下牙槽神经损伤、感染、干槽症的发生情况,以及术后第1、3、7天的疼痛及肿胀情况。结果：试验组患者在部分牙冠切除后,仅2例出现轻度疼痛,1例轻微肿胀,1例阻生牙术后萌出发生冠周炎,无牙髓症状,其余未见异常。在两组牙完全拔除术后,试验组下牙槽神经损伤发生率显著低于对照组（P<0.05）,术后肿痛程度也较对照组显著减轻（P<0.05）。结论：部分牙冠切除术可显著降低下牙槽神经损伤风险,减少手术创伤,且术后反应更轻,是一种更安全有效的拔牙方法。

关键词: 部分牙冠切除术, 下颌阻生第三磨牙, 下颌神经管, 下牙槽神经损伤

Abstract: PURPOSE: To explore the clinical efficacy of performing a second surgical extraction of impacted third molars with roots invading the inferior alveolar nerve canal after partial crown resection. METHODS: A total of 64 cases of mesially or horizontally impacted third molars with roots invading the inferior alveolar nerve canal, which were diagnosed by CBCT and treated in the Department of Oral Surgery at Hefei Stomatological Hospital West Branch from January 2023 to December 2024 were selected. The patients were randomly divided into two groups, with 32 cases in each group. The experimental group underwent partial crown resection first, and then complete tooth extraction was performed 3 or 6 months later. The control group underwent routine one-time tooth extraction. The adverse reactions of the experimental group were observed during the follow-up interval after partial crown resection, and the incidence of lower alveolar nerve injury, infection and dry socket after complete tooth extraction, pain and swelling at 1, 3 and 7 days after surgery were compared between the two groups. RESULTS: After partial crown resection, only 2 patients in the experimental group experienced mild pain, 1 patient had slight swelling, and one impacted tooth developed pericoronitis after eruption. There were no pulp symptoms, and no other abnormalities were observed. After the complete extraction of tooth in both groups, the incidence of inferior alveolar nerve injury in the experimental group was significantly lower than that in the control group(P<0.05), and the degree of postoperative pain and swelling was also significantly milder than that in the control group(P<0.05). CONCLUSIONS: Partial odontectomy can significantly reduce the risk of inferior alveolar nerve injury, minimize surgical trauma, and result in milder postoperative reactions. It is a safer and more effective method for impacted tooth extraction.

Key words: Partial odontectomy, Impacted mandibular third molar, Inferior alveolar nerve canal, Inferior alveolar nerve injury

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