陈芳川++陈雅瑜++关比扬

[摘要] 目的 比较两种方法（传统法、气动式外科专用切割手机拔除法）拔除下颌阻生第三磨牙的临床效果。 方法 将福建医科大学附属第二医院2013年4月—2015年5月间收治的80例下颌阻生第三磨牙患者随机分为观察组及对照组，每组40例。观察组采用气动式外科专用切割手机拔除，对照组采用传统拔牙法拔除。比较两组手术时间及术后并发症，采用SPSS 21.0统计学软件对数据进行统计学分析。结果 观察组下颌阻生第三磨牙患者的手术时间为（26.35±3.21）min，对照组下颌阻生第三磨牙患者手术时间为（35.21±8.43）min，两组比较观察组用时明显较短，差异有统计学意义（P<0.05）。观察组患者的术后张口受限、面部肿胀、疼痛等情况显著低于对照组患者，差异有统计学意义（P<0.05）。结论 使用气动式外科专用切割手机拔除下颌阻生第三磨牙相比较传统方法而言，操作简便，效率高，创伤小，术后反应轻，因此值得临床推广。

[关键词] 拔牙；传统方法；气动式外科专用切割手机；下颌阻生第三磨牙

[中图分类号] R782 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0082-04

[Abstract] Objective To compare the clinical effect of traditional method and atmospheric surgical special cutter method in extraction of impacted mandibular third molars. Methods 80 cases of patients with impacted mandibular third molars admitted and treated in our hospital from April 2013 to May 2015 were selected and randomly divided into two groups with 40 cases in each， the observation group adopted the atmospheric surgical special cutter method， while the control group adopted the traditional extraction method， and the operation time and postoperative complications were compared between the two groups， and the data were statistically analyzed by the SPSS 21.0 software package. Results The operation time in the observation group was obviously shorter than that in the control group[（26.35±3.21）min vs （35.21±8.43）min]， and the difference was statistically significant（P<0.05）， and the postoperative mouth-open limitation， facial swelling and pains in the observation group were obviously lower than those in the control group， and the differences were statistically significant（P<0.05）. Conclusion The operation of atmospheric surgical special cutter method in extraction of impacted mandibular third molars is easier than the traditional method with high efficacy， small wound and mild postoperative reactions， therefore， it is worth clinical promotion.

[Key words] Extraction； Traditional method； Atmospheric surgical special cutter； Impacted mandibular third molars

拔除下頜阻生第三磨牙在临床中较为常见，同时因为下颌阻生第三磨牙的位置靠后且解剖变异大，邻牙及骨阻力大导致拔除难度大、时间长、创伤大。传统的拔牙方法包括凿骨劈冠法和敲锤增隙法，拔除阻生牙需要凿劈、敲击、撬挺等暴力操作，由于力量难以控制，操作性差，往往造成比较严重的术中及术后并发症。近几年随着各种新型拔牙手术器械的出现，微创拔牙理念及技术正被越来越多的临床医师所接受和应用[1-2]。该研究观察了气动式外科专用切割手机在下颌阻生第三磨牙拔除术中的应用情况，并与传统的拔牙方法相比较，为临床相关工作提供参考，该研究以福建医科大学附属第二医院2013年4月—2015年5月间收治的80例患者为研究对象，现报道如下。……