口腔医学研究

口腔医学研究 ›› 2025, Vol. 41 ›› Issue (8): 679-684.DOI: 10.13701/j.cnki.kqyxyj.2025.08.007

• 口腔颌面外科学研究 • 上一篇    下一篇

两种龈瓣缝合法对骨性埋伏下颌第三磨牙拔除后并发症影响的前瞻性临床研究

刘湘奇1,2, 吴家顺1,2#, 刘育豪1,2,3, 陈江海1,2, 罗雪婷1,2, 杨辛1,2, 匡世军1,2*   

  1. 1.中山大学光华口腔医学院·附属口腔医院口腔颌面外科 广东 广州 510055;
    2.广东省口腔疾病临床医学研究中心 广东 广州 510055;
    3.滨州医学院口腔医学院 山东 烟台 264003
  • 收稿日期:2025-02-28 出版日期:2025-08-28 发布日期:2025-08-15
  • 通讯作者: *匡世军,E-mail:kuangshj@mail.sysu.edu.cn
  • 作者简介:刘湘奇(1989~ ),男,湖南邵东人,博士,主治医师,研究方向:口腔颌面外科。吴家顺(1991~ ),男,广东河源人,博士,主治医师,研究方向:口腔颌面外科。#为共同第一作者
  • 基金资助:
    广州市科技项目(编号:2023A04J2167); 中国博士后科学基金(编号:2022TQ0381、2023M744045); 广东省自然科学基金(编号:2024A1515011990)

A Prospective Clinical Study on Effects of Two Kinds of Gingival Flap Suture on The Complications After Extraction of Bone Embedded Third Molar

LIU Xiangqi1,2, WU Jiashun1,2#, LIU Yuhao1,2,3, CHEN Jianghai1,2, LUO Xueting1,2, YANG Xin1,2, KUANG Shijun1,2*   

  1. 1. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-sen University, Guanghua School of Stomatology, Guangzhou 510055, China;
    2. Guangdong Provincial Clinical Research Center of Oral Diseases, Guangzhou 510055, China;
    3. School of Stomatology, Binzhou Medical University, Yantai 264003, China
  • Received:2025-02-28 Online:2025-08-28 Published:2025-08-15

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摘要： 目的: 评价两种龈瓣缝合法对骨性埋伏下颌第三磨牙(bone embedded mandibular third molar, BeM3M)拔除后并发症的影响。方法: 采用前瞻性、随机对照、单盲设计,将376颗BeM3M分为两组。对照组197颗BeM3M拔除后,对龈瓣进行封闭式缝合(一期缝合法);实验组179颗BeM3M拔除后,切除部分龈瓣组织,进行开放引流式缝合(二期缝合法)。记录术后出血和感染、术后反应、迟发性感染以及术后6个月第二磨牙(mandibular second molar, M2M)远中牙周探诊深度。结果: 拔牙后出血、感染、疼痛以及术后6个月M2M远中牙周探诊深度两组间差异无统计学意义(P>0.05)。实验组拔牙后肿胀和开口受限情况轻于对照组,两组间差异有统计学意义(P<0.05)。实验组迟发性感染发生率(2.8%)低于对照组(11.2%),两组间差异有统计学意义(P<0.05)。结论: 龈瓣二期缝合法能够减轻BeM3M术后的并发症,降低迟发性感染的发生率,且对M2M远中牙周探针深度无不利影响。

关键词: 缝合, 骨性埋伏下颌第三磨牙, 牙拔除术, 术后并发症, 感染

Abstract: Objective: To evaluate the effect of two kinds of gingival flap suture on the complications after extraction of bone embedded mandibular third molar (BeM3M). Methods: 376 BeM3M were divided into two groups in a prospective, randomized controlled, and single-blind design. In the control group, 197 BeM3M were extracted, and the gingival flap was closed suture (primary closure). In the experimental group, 179 BeM3M were removed, part of the gingival flap tissue was removed, and open drainage suture (secondary closure) was performed. Postoperative bleeding and infection, postoperative reaction, delayed infection, and distal periodontal probing depth of mandibular second molar (M2M) 6 months after surgery were recorded. Results: There was no statistically significant difference in the postoperative bleeding, infection, pain, and distal periodontal probing depth of M2M between two groups (P>0.05). The swelling and opening limitation in the experimental group were less than those in the control group (P<0.05). The incidence of delayed-onset infection in the experimental group (2.8%) was lower than that in the control group (11.2%), and the difference between the two groups was statistically significant (P<0.05). Conclusion: Gingival flap secondary closure could alleviate BeM3M postoperative complications, reduce the incidence of delayed-onset infection, and had no adverse effect on distal periodontal probing depth of M2M.

Key words: closure, bone embedded third molar, tooth extraction, postoperative complications, bacterial infections