口腔医学研究

口腔医学研究 ›› 2016, Vol. 32 ›› Issue (10): 1070-1073.DOI: 10.13701/j.cnki.kqyxyj.2016.10.017

• 临床研究论著 • 上一篇    下一篇

部分牙冠切除术拔除近下牙槽神经管的下颌阻生第三磨牙的初步研究

戴银花, 戴群*, 冮建林   

  1. 南昌大学附属口腔医院综合科 江西 南昌 330000
  • 收稿日期:2016-03-18 出版日期:2016-10-26 发布日期:2016-10-26
  • 通讯作者: 戴群,电话:0791-86363621
  • 作者简介:戴银花(1982~ ),女,湖南人,硕士,住院医师,主要从事口腔牙槽外科的临床与科研工作。
  • 基金资助:
    江西省科技厅基金项目(编号:009BSB11300-2)

Preliminary Study on Partial Odontectomy in Extraction of Impacted Mandibular Third Molar Close to Inferior Alveolar Nerve.

DAI Yin-hua, DAI Qun*, GANG Jian-lin.   

  1. Department of General Dentistry, Affiliated Stomatological Hospital of Nanchang University, Nanchang 330000, China.
  • Received:2016-03-18 Online:2016-10-26 Published:2016-10-26

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摘要： 目的:初步探索部分牙冠切除术拔除近下牙槽神经管(inferior alveolar nerve canal, IANC)的下颌阻生第三磨牙(impacted mandibular third molars, IMTMs)术后常见并发症、剩余牙根移动距离及其相关影响因素。方法::收集符合纳入标准的IMTMs 44颗,行部分牙冠切除术,观察术后第24 h、第7天的疼痛反应、牙本质过敏情况;术后6个月测量牙根移动距离,待牙根完全离开IANC后拔除牙根,术后第7天检测IAN感觉功能。结果:术后第24 h疼痛发生率为31.8%,与牙齿萌出状态、阻生深度相关(P<0.05),术后第7天均未出现疼痛;术后第24 h牙本质过敏发生率为79.5%,与牙齿萌出状态、阻生深度、术中牙髓暴露相关(P<0.05),术后第7天发生率降至27.3%;44颗IMTMs的牙根均远离IANC移动,6个月内平均移动距离为(2.5±0.6) mm,与患者年龄成负相关(P﹤0.05);拔除剩余牙根后IAN均无损伤。结论:部分牙冠切除术拔除近IANC的IMTMs可减少甚至消除IAN损伤,术后并发症少,值得在临床推广使用。

关键词: 部分牙冠切除术, 下牙槽神经, 术后疼痛, 牙本质过敏

Abstract: Objective: To preliminarily investigate postoperative complications, movement of impacted mandibular third molars (IMTMs) and related factors after the surgery of partial odontectomy to extract IMTMs close to inferior alveolar nerve canal (LANC).Methods: 44 IMTMs, which met the inclusive criteria, were included. They were all extracted by partial odontectomy. Occurrence of postoperative pain, dentine hypersensitivity at the 24th hour and the 7th day after partial odontectomy were recorded. At the 6th month, migration of the roots was measured. When the roots departed from the LANC, they were removed. At the 7th day after the removal, the sensory function of IAN was checked.Results: The incidence of postoperative pain was 31.8% at the 24th hour, showing a significant correlation (P<0.05) with the status of eruption and the depth of the impacted tooth. No pain was observed for all patients on the 7th day after surgery. The incidence of dentine hypersensitivity was 79.5% at the 24th hour postoperative, showing a significant correlation (P<0.05) with the status of eruption, the depth of the impacted tooth and the exposure of dental pulp. However the incidence decreased to 27.3% on the 7th day postoperative. All the roots departed from IANC, and the average moving distance was 2.5±0.6mm in the 6th month, which had a negative correlation (P<0.05) with the age. No case of IAN injury was noted following root removal.Conclusion: Partial odontectomy is a worthwhile approach to extract the IMTMs close to the IAN, as it minimizes or even eliminates the IAN injury risk and postoperative complications.

Key words: Partial odontectomy, IAN, Postoperative pain, Dentine hypersensitivity

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