口腔医学研究 ›› 2019, Vol. 35 ›› Issue (7): 686-689.DOI: 10.13701/j.cnki.kqyxyj.2019.07.016

• 口腔颌面外科学研究 • 上一篇    下一篇

鼻底入路拔除上颌中切牙区高位埋伏多生牙

崔庆赢, 陈思宇, 付帅, 张长彬, 马文, 黎明*   

  1. 昆明医科大学附属口腔医院口腔颌面外科 云南 昆明 650101
  • 收稿日期:2018-11-17 出版日期:2019-07-25 发布日期:2019-07-24
  • 通讯作者: 黎明,E-mai:1020513890@qq.com
  • 作者简介:崔庆赢(1990~ ),男,昆明人,硕士,主要从事颌面外科的临床及研究工作
  • 基金资助:
    云南省应用基础研究(昆医联合专项)[编号:2017FE467(-193)]

Extraction of Deeply Impacted Supernumerary Tooth in Anterior Maxilla through the Floor of Nasal Cavity

CUI Qingying, CHEN Siyu, FU Shuai, ZHANG Changbin, MA Wen, LI Ming*   

  1. Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University, Kunming 650101, China.
  • Received:2018-11-17 Online:2019-07-25 Published:2019-07-24

摘要: 目的:通过对比鼻底入路、唇侧入路、腭侧入路拔除上颌中切牙区高位埋伏多生牙手术效果,探讨更为方便、安全、有效的拔牙方法。方法:选取2015年1月~2018年9月我院口腔颌面外科上颌中切牙区高位埋伏多生牙患者40例(共44颗),术前均完善锥形束CT检查以定位埋伏多生牙。根据术前影像,按照纳入标准将实验对象分为4组,采用静吸复合全身麻醉方式。实验组采取鼻底入路涡轮反角手机去骨法拔牙,对照组采取唇侧入路、腭侧入路涡轮反角手机拔牙。术中记录患者术中出血量,手术时间,术后采用视觉模拟评分法量化患者术后疼痛情况,对患者手术时间、术中出血量、术后疼痛值进行对比分析。结果:对照组A和实验组A在拔牙时间、术中出血量、术后疼痛比较差异有统计学意义,实验组A均优于对照组A;对照组B和实验组B在拔牙时间、术中出血量比较差异有统计学意义,实验组B优于对照组B;在术后疼痛感实验组B和对照组B比较差异无统计学意义。结论:采用鼻底入路拔除上颌中切牙区高位埋伏多生牙不仅手术时间短、出血量少,且术后反应及并发症较少,是一种值得推广的拔牙方法

关键词: 多生牙, 微创拔牙, 鼻底入路, 锥型束CT

Abstract: Objective: To explore a more convenient, safe, and effective tooth extraction method. Methods: 40 patients (44 supernumerary teeth) with embedded supernumerary supraversion teeth in the maxillary central incisor area of our department from January 2015 to September 2018 were selected. The cone-beam CT examination was conducted before operation. According to the pre-operative images, the subjects were divided into 4 groups. In the experimental group, the extraction was performed by using the turbine antihorn handpiece through the nasal floor approach, while in the control group, the extraction was through the labial approach and palatal approach. The intraoperative blood loss and operation time were recorded. The postoperative pain was quantified by visual analogue scale. Results: The extraction time of experimental group A was shorter than that of the control group A (P<0.05). The intraoperative blood loss in experimental group A was less than that in control group A (P<0.05). The pain in experimental group A was lower than that in control group A (P<0.05). The extraction time of experimental group B was shorter than that of the control group B (P<0.05). The intraoperative blood loss in experimental group B was less than that in control group B (P<0.05). In terms of postoperative pain, there was no statistical difference between experimental group B and control group B. Conclusion: Extraction of embedded supernumerary supraversion teeth in maxillary central incisor area by nasal approach not only reduced operation time and bleeding amount, but also reduced the postoperative response and complications.

Key words: supernumerary teeth , minimally invasive extraction tooth, nasal floor approach, cone beam computed tomography