[摘要]目的：探究超声骨刀拔除下颌水平低位阻生智齿的疗效及与血清炎性介质的相关性。方法：选取2020年2月-2022年2月在笔者医院完成治疗的50例下颌水平低位阻生智齿患者，根据手术方法不同分为实验组和对照组，各50例。实验组为超声骨刀拔牙组，使用超声骨刀微创舌侧去骨法；对照组为传统拔牙组，选用锤、敲、劈冠去骨法。观察对比两组的临床疗效和血清炎性介质水平。结果：超声骨刀拔牙组术中出血量、拔牙时长均显著低于传统拔牙组，且能显著降低根折率、总体拔牙窝损伤变化率及总体邻近牙齿松动率等术中并发症的发生率，差异均有统计学意义（P＜0.05）；超声骨刀拔牙组患者术后中、重度心理畏惧患者占比远低于传统拔牙组，术后3 d开口受限程度及局部肿胀程度均低于传统拔牙组，术后干槽症、口唇部麻木、感染、面颊疼痛相关并发症发生率均显著低于传统拔牙组（P＜0.05）；超声骨刀拔牙组术后3 d血清CRP、IL-6、PTX3、PGE2水平均显著低于传统拔牙组（P＜0.05）。结论：超声骨刀拔牙在多维度上优于传统拔牙，能提高手术疗效的同时达到更好安全性，降低炎症反应，有临床推广价值。

[关键词]下颌水平低位阻生智齿；超声骨刀；微创舌侧去骨法；常规凿骨劈冠法；炎性介质

[中图分类号]R782.3+1" " [文献标志码]A" " [文章编号]1008-6455（2025）06-0152-03

Therapeutic Effect of Piezosurgery for Mandibular Impacted Lower Wisdom Tooth Extraction and Its Effect on Serum Inflammatory Cytokines

MA Yongquan， LU Zijie， PENG Weibin， HU Shunguang

（ Department of Stomatology， Shantou Second People's Hospital， Shantou 515000， Guangdong， China ）

Abstract： Objective" To explore the therapeutic effect of piezosurgery for mandibular impacted lower wisdom tooth extraction， and to discuss its correlation with serum inflammatory cytokines. Methods" Fifty patients underwent mandibular impacted lower wisdom tooth extraction in the hospital from February 2020 to February 2022 were enrolled， and assigned into two groups according to different surgical approaches， each with 50 cases. Experimental group received piezosurgery assisted lingual split bone technique， while control group was given conventional chisel osteotomy. Then the clinical efficacy and serum inflammatory cytokines were compared between two groups. Results" Compared with control group， experimental group had less intraoperative bleeding volume， shorter extraction time， and lower incidence rate of intraoperative complications， such as the root fracture rate， the socket injury following tooth extraction and the loosening of adjacent teeth， with statistical difference （all P＜0.05）. The proportion of the moderate and severely psychologically distressed patients after surgery was larger in control group than in experimental group， and the degree of restricted mouth opening and local swelling at 3 d after surgery were less severe in experimental group than in control group. The incidence of postoperative complications related to dry socket， numbness in the mouth and lips， infection， and cheek pain in experimental group was notably lower than those in control group （all P＜0.05）. Serum levels of C-reactive protein （CRP）， interleukin-6 （IL-6）， pentraxin 3 （PTX3） and prostaglandin E2 （PGE2） were remarkably lower in experimental group than in control group （P＜0.05）. Conclusion" Application of piezosurgery for mandibular impacted lower wisdom tooth extraction is superior to traditional extraction in many aspects， which exhibits an obvious therapeutic effect with good safety， and is of certain clinical promotion value.

Key words： mandibular impacted lower wisdom tooth; piezosurgery; minimally invasive lingual split bone technique; conventional chisel osteotomy; inflammatory cytokines

阻生智齿在口腔科是一种常见的疾病，由于颌骨的骨量小于牙量导致第三磨牙无法萌出，继而形成阻生智齿，甚至重者出现骨埋伏阻生，最终出现咬合异常、智齿冠周牙龈发炎、剧烈疼痛等一系列病症［1-3］。……