MTF-S对冠部完全或部分骨埋伏下颌阻生智牙拔除的效果评价

doi:10.19439/j.sjos.2024.01.012

上海口腔医学 ›› 2024, Vol. 33 ›› Issue (1): 71-75.doi: 10.19439/j.sjos.2024.01.012

MTF-S对冠部完全或部分骨埋伏下颌阻生智牙拔除的效果评价

康铖, 朱挺, 罗善峰, 娄伊伊

绍兴市口腔医院口腔颌面外科,浙江绍兴 312000

收稿日期:2023-07-20 修回日期:2023-08-21 出版日期:2024-02-25 发布日期:2024-03-07
通讯作者: 康铖 ,E-mail: kchkc123@126.com
作者简介:康铖（1989-）,男,本科,主治医师
基金资助:
浙江省医药卫生科技计划项目（2020KY010）

Evaluation of the effect of MTF-S on the removal of impacted mandibular wisdom teeth with complete or partial crown impaction

KANG Cheng, ZHU Ting, LUO Shan-feng, LOU Yi-yi

Department of Oral and Maxillofacial Surgery, Shaoxing Stomatological Hospital. Shaoxing 312000, Zhejiang Province, China

Received:2023-07-20 Revised:2023-08-21 Online:2024-02-25 Published:2024-03-07

摘要/Abstract

摘要： 目的: 观察冠部完全或部分骨埋伏下颌阻生智牙拔除中经改良三角形皮瓣二期缝合（modified triangular flap-secondary healing,MTF-S）治疗的效果及对术后并发症的影响。方法: 选择2022年6月—2023年6月在绍兴市口腔医院拔除下颌阻生智牙的患者207例,其中,A组86例为冠部完全骨埋伏,B组121例为冠部分骨埋伏。患者均为双侧阻生,先选择拔除其中一侧智牙并采用三角皮瓣一期缝合（triangular flap-primary healing,TF-P）,2周后再拔除另一侧智牙,采用MTF-S缝合,将A、B 2组两侧阻生智牙依据缝合方法再各分为2个亚组,其中,A1、B1组采用TF-P,A2、B2组采用MTF-S。记录4组围术期指标,包括手术时间、断根率、拔牙窝完整性;比较4组术后并发症,包括疼痛、肿胀和开口受限等情况。采用SPSS 22.0软件包对数据进行统计学分析。结果: A1、A2、B1、B2组手术时间分别为（17.69±3.28）、（18.22±3.06）、（12.37±3.72）和（12.64±4.13） min,A1、A2组手术时间显著长于B1、B2组（P<0.05）;术后7天,A1、A2、B1、B2组VAS评分分别为（1.17±0.34）、（0.93±0.29）、（0.48±0.15）和（0.76±0.21）分,B1、B2组VAS评分显著低于A1、A2组,且A2组低于A1组,B2组显著高于B1组（P<0.05）;术后1、3、7天,B1组肿胀度显著小于A1组,A2、B2组肿胀度显著小于B1组（P<0.05）;A2、B2组开口受限度显著小于A1、B1组,且B2组开口受限度显著小于A2组（P<0.05）。结论: 与冠部分骨埋伏阻生智牙相比,冠部完全骨埋伏阻生智牙拔除术需要更长手术时间,对于冠部完全骨埋伏,MTF-S有利于减轻术后疼痛、肿胀度和开口受限度;而对于冠部分骨埋伏,MTF-S有利于减轻术后肿胀和开口受限,但在减轻患者疼痛方面效果不明显。

关键词: 下颌阻生智牙拔除术, 冠完全骨埋伏, 冠部分骨埋伏, 术后并发症, 切口设计, 缝合方法

Abstract: PURPOSE: To evaluation the effect of modified triangular flap-secondary healing (MTF-S) on the treatment of mandibular impacted wisdom teeth with full or partial bone impaction. METHODS: A total of 207 patients with mandibular impacted wisdom teeth were selected in Shaoxing Stomatological Hospital from June 2022 to June 2023. Among them, 86 patients had completely impacted wisdom teeth (group A), and 121 patients had partially impacted wisdom teeth (group B). All patients had bilateral impacted wisdom teeth. One of the wisdom teeth was removed first and was sutured with triangular flap-primary healing (TF-P). The other wisdom tooth was removed two weeks later and was sutured with MTF-S. Patients in groups A and B were divided into two subgroups based on suture methods, with TF-P used for group A1 and B1, and MTF-S used for groups A2 and B2. Perioperative indicators, including surgical time, root loss rate, and completeness of extraction sockets were recorded; Postoperative complications of four groups, including pain, swelling, and limited mouth opening were compared. SPSS 22.0 software package was used for statistical analysis. RESULTS: The surgical time of group A1, A2, B1 and B2 was (17.69±3.28), (18.22±3.06), (12.37±3.72) and (12.64±4.13) minutes, respectively. The surgical time of group A1 and A2 was significantly longer than that of group B1 and B2 (P<0.05). Seven days after surgery, the VAS scores of group A1, A2, B1 and B2 were (1.17±0.34), (0.93±0.29), (0.48±0.15) and (0.76±0.21), respectively. The VAS scores of group B1 and B2 were lower than those of group A1 and A2, and group A2 was lower than group A1 and B2 was higher than group B1 group(P<0.05). On the 1st day, 3rd day, and 7th day after surgery, the swelling degree in group A1 was greater than that in group B1, and the swelling degree in group B1 was greater than that in group A2 and B2(P<0.05); while the limitation of mouth opening mouth in group A2 and B2 was lower than that in group A1 and B1, and the limitation of opening mouth in group B2 was lower than that in group A2(P<0.05). CONCLUSIONS: Compared with partially impacted wisdom teeth, the extraction of completely impacted wisdom teeth has a longer surgical time. For completely impacted wisdom teeth, MTF-S is beneficial for reducing postoperative pain, swelling and mouth opening limitations. For partially impacted wisdom teeth, MTF-S is beneficial for reducing postoperative swelling and mouth opening limitations, but the effect is not significant in reducing patient pain.

Key words: Extraction of impacted mandibular wisdom teeth, Complete coronal bone embedding, Coronary bone embedding, Postoperative complications, Incision design, Suture methods

中图分类号:

R782.1

康铖, 朱挺, 罗善峰, 娄伊伊. MTF-S对冠部完全或部分骨埋伏下颌阻生智牙拔除的效果评价[J]. 上海口腔医学, 2024, 33(1): 71-75.

KANG Cheng, ZHU Ting, LUO Shan-feng, LOU Yi-yi. Evaluation of the effect of MTF-S on the removal of impacted mandibular wisdom teeth with complete or partial crown impaction[J]. Shanghai Journal of Stomatology, 2024, 33(1): 71-75.

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MTF-S对冠部完全或部分骨埋伏下颌阻生智牙拔除的效果评价

Evaluation of the effect of MTF-S on the removal of impacted mandibular wisdom teeth with complete or partial crown impaction

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