杜文斌　曹玮奇　姚国华　张 帅　李尔涛　任 辉

[关键词]十字形分牙法;下颌阻生牙;第三磨牙;拔牙

[中图分类号]R783.3    [文献标志码]A    [文章编号]1008-6455（2021）12-0105-03

The Clinical Effect Analysis of the Cross-shaped Teeth Method in the Extraction of Low Impacted Teeth Aat the Mandibular Level

DU Wen-bin， CAO Wei-qi， YAO Guo-hua， ZHANG Shuai， LI Er-tao， REN Hui

（Department of Stomatology， the Second Affiliated Hospital of Hebei North University，Zhangjiakou 075100，Hebei，China）

Abstract： Objective To explore the application value of the cruciform tooth division method in the treatment of low-level mandibular impacted third molar extraction. Methods  A selection of 200 patients who were admitted to the Department of Stomatology of our hospital who were to be treated for the extraction of low-level impacted third molars of the mandible were divided into a study group （using a cross-shaped tooth extraction method） and a conventional group （using a micro Invasive tooth extraction method） 100 cases each. Results  The extraction time of the study group was lower than that of the conventional group， and the difference was statistically significant （P<0.05）， at the time of extraction， the HR value of the study group was lower than that of the conventional group （P<0.05）. 30min after the extraction， the DAS score of the study group was low In the routine group， the difference was statistically significant （P<0.05）， after the tooth extraction， the mouth opening restriction and swelling degree of the operation side were observed. The study group had lighter mouth opening restriction and swelling degree than the routine group，and the difference was statistically significant （P<0.05）， postoperative observation， the complication rate of the study group was 6.00% lower than that of the routine group 16.00%， the difference was statistically significant （P<0.05）. Conclusion  The cruciform tooth division method has certain advantages over conventional minimally invasive tooth extraction in the treatment of impacted mandibular third molars，reducing surgical complications， reducing extraction time and bleeding， reducing patient tension， postoperative swelling， and restricted mouth opening degree.

Key words： cruciform tooth division method; impacted mandibular teeth; third molar; tooth extraction

下頜水平低位阻生第三磨牙口腔颌面外科常见的疾病，主要采取下颌第三磨牙拔除手术开展治疗，由于阻生齿位置及牙根变异大，导致手术时间较长，术后反应较重，尤其以拔除复杂下颌水平低位阻生齿时最为明显[1]。随着微创技术的飞速发展，临床常采用微创拔除方法治疗，该方法是在牙冠部横断牙体，使牙冠与牙根分离，先将牙冠拔出，再拔出牙根，效果显著，可以缩短手术时间，减轻患者痛苦，但是对于部分牙根数目≥2或牙根膨大的下颌水平低位阻生齿则效果并不显著，十字形分牙法通过牙颈部为中心做十字切割，可以解除牙根阻力，目前在临床鲜有应用[2]。本研究分析了十字形分牙法在下颌水平低位阻生第三磨牙拔除治疗中的作用，现将结果报道如下。

1  资料和方法

1.1 一般资料：选取笔者医院口腔科2019年1月-2020年10月收治的接受下颌水平低位阻生第三磨牙拔除治疗的200例患者为研究对象，采用随机数字表分为研究组（采用十字形分牙法实施牙拔除术）和常规组（采用微创拔牙方法），每组100例。纳入标准：①术前CBCT检查，选取下颌水平低位阻生且伴有牙根数目≥2或牙根膨大的定义为复杂下颌水平低位阻生齿;②年龄19～55岁;③患者具有正常的理解、交流能力，能够接受相关调查问卷;④术前凝血、心肺功能检测正常;⑤本研究方案与相关医学伦理学要求无相悖之处（医学伦理学文件编号：院伦（办）[2018]17号）。……