李永吉+宋阳+孙拓褀

【摘要】 目的 比较应用微创技术与传统拔牙方法在拔除儿童病灶乳磨牙的临床效果。方法 60例（患牙64颗）需拔除病灶乳磨牙的患儿， 按就诊顺序分成试验组和对照组， 各30例。试验组采用微创技术拔牙， 对照组采用传统技术拔牙， 比较两组术中断根情况及术后水肿、痛疼、发烧等并发症情况。

结果 试验组患儿术后断根发生率为3.33%， 低于对照组的20.00%， 差异有统计学意义（P<0.05）。试验组水肿发生率为6.67%、疼痛发生率为3.33%、发烧发生率为0， 均低于对照组的33.33%、23.33%、13.33%， 差异有统计学意义（P<0.05）。结论 与传统拔除病灶乳磨牙相比， 利用高速涡轮钻分牙、分根后再行拔除的微创拔牙技术能明显减轻术中及术后并发症的发生。

【关键词】 根尖周炎；乳磨牙；微创拔牙；并发症

DOI：10.14163/j.cnki.11-5547/r.2018.05.006

【Abstract】 Objective To compare the clinical effect of minimally invasive technique and traditional teeth extraction in removal of lesions primary molar of children. Methods A total of 60 children （64 involved teeth） with lesions primary molar were divided by visiting order into experimental group and control group， with 30 cases in each group. The experimental group received minimally invasive technique for teeth removal， and the control group received traditional technique for teeth removal. Comparison were made on intraoperative root fracture， complications of postoperative edema， pain and fever between the two groups. Results The experimental group had lower incidence of postoperative root fracture as 3.33% than 20.00% in the control group， and the difference was statistically significant （P<0.05）. The experimental group had edema rate as 6.67%， pain rate as 3.33% and fever rate as 0， which were all lower than 33.33%， 23.33% and 13.33% in the control group， and their difference was statistically significant （P<0.05）. Conclusion Compared with traditional removal of lesions primary molar， the minimally invasive extraction technique with high speed turbine drill and tooth extraction can significantly reduce intraoperative and postoperative complications.

【Key words】 Periapical periodontitis； Primary molar； Minimally invasive teeth extraction； Complications

乳磨牙根尖周病變会导致其牙根发生病理性内、外吸收， 也可导致根周大面积牙槽骨组织的吸收， 进而影响继承恒牙胚的正常发育及萌出。因此， 临床需对这些无法保留的患牙进行拔除。由于乳磨牙具有根分叉角度大的解剖特点， 因此， 拔除时冠方的阻力较大， 直接用钳夹拔除时不仅对牙周组织创伤较大， 而且还增加断根的风险。近年来， 微创治疗理念及微创治疗技术在各个医疗部门越来越受到关注。关于微创拔牙的研究报道多见于阻生智齿的拔除， 而关于乳牙微创拔除的相关报道甚少。本研究通过结合高速涡轮牙钻将病灶乳磨牙进行分牙、分根处理后再拔除的方法与传统的直接拔除法进行对比， 为临床应用提供参考。具体报告如下。

1 资料与方法

1. 1 一般资料 选取2015年1月～2016年4月在大连市口腔医院儿童口腔科就诊且需要拔除病灶乳磨牙的患儿60例（患牙64颗）。纳入标准：①年龄5～8岁；②乳磨牙至少有1个牙根吸收1/3以上而其余牙根吸收不足1/3；……