社区医生使用高速涡轮机在拔除下颌阻生智齿中的临床应用(1)
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[摘要] 目的:对比高速涡轮钻法与传统的劈冠法在中、低位下颌阻生智齿拔除术中的临床效果,评价涡轮钻法的临床可行性和优越性。方法:对232例中低位水平或近中阻生的下颌阻生智齿,随机采用高速涡轮钻法(实验组)或劈冠法(对照组)去除阻力两种方法拔除,进行临床观察,记录智齿拔除时间、术后患者疼痛程度、张口受限程度及干槽症的发生情况。结果:实验组手术时间明显短于对照组(t=8.33,P<0.05)。两组患者术后疼痛程度和张口受限程度比较有非常显著性差异(χ2值分别为14.27、23.90,均P<0.01)。两组干槽症的发生率实验组明显低于对照组,两组比较有显著性差异(χ2=3.98,P<0.05)。结论:高速涡轮钻法拔除下颌阻生智齿能显著缩短手术时间,减轻患者术后并发症,值得临床推广。
[关键词] 高速涡轮钻法;劈冠法;下颌阻生智齿
[中图分类号] R782.11 [文献标识码]A [文章编号]1673-7210(2010)06(b)-028-03
Clinical application of high-speed turbine drill in extraction of impacted mandibular third molars by community doctors
ZHANG Jianru, CHEN Jingjing
(The Community Health Service Center of Qiaozi Town in Huairou District, Beijing 101402)
[Abstract] Objective: To compare the effects of high-speed turbine drill and traditional chisel in the extraction of impacted mandibular third molars and to evaluate the clinical feasibility or superiority and the high-speed turbine drill. Methods: 232 impacted mandibular third molars to be extracted were randomly divided into two groups: one (test group) by high-speed turbine drill, and the other (control group) by traditional chisel. Then the duration of the extraction, opening of mouth, incidence of dry socket were observed and recorded. Results: The average surgery time of test group was shorter than that of control group (t=8.33, P<0.05), there were significant difference about the degree of postoperative pain and restriction of mouth opening between two groups(χ2 valuses were 14.27 and 23.90, all P<0.01), and there was a significant difference about incidence of dry socket between two groups (χ2=3.98, P<0.05). Conclusion: High-speed turbine drill when applied in the extraction of impacted mandibular third molars, could efficiently cut down duration of extraction, reduce the incidence of complication and is therefore recommendable in clinical practice.
[Key words] High-speed turbine drill; Traditional chisel; Impacted mandibular third molars
人类的进化过程导致了咀嚼器官的退化,其中颌骨退化的进程略快于牙齿,因而产生牙量、骨量不调,现代人第三磨牙的阻生的情况较常见[1-2]。下颌阻生智齿拔除术是众多口腔颌面外科门诊复杂牙槽外科手术之一。传统锤凿劈冠法手术时间较长、创伤往往较大,且术后常伴发颞下颌关节紊乱、开口受限、干槽症等并发症,给患者造成较大的痛苦。高速涡轮机气钻已经广泛应用于口腔内科、修复科等很多年,在解决了消毒和散热等问题后现在已经越来越多地应用于阻生智齿的拔除,其便利性已受到较多学者的重视和肯定。本文中笔者对120例中、低位水平或近中阻生的下颌阻生智齿采用高速涡轮牙钻去除骨阻力和牙阻力的方法进行拔除,并和另外112例采用普通劈冠法拔除的具有相似难度的下颌阻生智齿法进行对比及临床分析,现报道如下: ......
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