涡轮钻在拔牙术中的应用

涡轮钻一般是应用于口腔内科牙体治疗中开髓、备洞等 ,但近年来在牙槽外科拔牙手术中也越来越多地被采用[1 ,2 ] ,尤其应用于阻生智齿和困难牙的拔除手术[3] 中 ,使用涡轮钻去骨、分牙 ,使手术变得简单容易。我科自 80年代以来 ,常规使用涡轮钻拔除复杂阻生智齿约 15 0 0例 ,拔牙去骨、拔牙分根 6 4 1例 ,拔除多生、埋伏牙 139例。现将应用范围、操作步骤及术后并发症介绍如下。一、在阻生智齿拔除术中的应用1 在下颌低位水平阻生智齿拔除术中的应用　①切龈 :对完全骨内埋伏阻生者 ,在阻生齿牙冠、颈上方楔形切除一块牙龈组织。②去骨 :用…     

截冠去骨增隙法在阻生牙拔除术中的应用

下颌阻生第三磨牙拔除术是临床常见手术,而力求轻巧、快捷地拔除该牙,一直为口腔颌面外科医师所追求,亦为临床病人所期盼。本文对我科自１９９６年来,使用涡轮机截冠去骨增隙法拔除的３５６例下颌阻生第三磨牙病例作一回顾分析。１　材料与方法１１　对象　本组３５６例,其中男性１９２例,女性１６４例。年龄范围２３～６４岁,平均２８岁。３５６颗阻生牙阻生情况见表１。表１　３５６颗阻生牙阻生情况Ｔａｂ．１　Ｉｍｐａｃｔｅｄｃｏｎｄｉｔｉｏｎｏｆ３５６ｉｍｐａｃｔｅｄｔｅｅｔｈ阻生类别牙根数单根二根三根以上Ⅱ类近中…     

分步质控法在拔牙临床教学中的应用

拔牙治疗涉及问病史、病历书写、麻醉、相关器械的正确使用等多方面技巧，存在相当的风险，有必要建立全程质控体系。笔者将拔牙流程划分为10个步骤，便于在临床教学中针对每一步骤中的关键部分进行重点监控。     

倒冲法拔除后牙的牙挺挺尖设计及临床应用

目的 研究更有效率的拔牙方法,减轻患者的痛苦,方法 运用改良挺尖牙挺拔除法和传统牙挺拔除法分别拔除后牙各200颗,比较两种方法所耗费时间及术中术后并发症的发生率。结果 改良挺尖牙挺拔除法拔除后牙不仅手术时间短而且术中术后并发症明显少于传统牙挺拔除法。结论 改良挺尖牙挺拔除法更重视牙体牙根的解剖形态及其在牙槽骨中的方向,在牙槽外科手术中更具优越性,值得推广。     

高速涡轮手机联合气动拔牙挺在下颌阻生第三磨牙拔除术中的应用

目的：探究微创拔牙工具在下颌阻生第三磨牙拔除过程中的应用效果。方法：选取2020年10月至2022年3月来我院口腔诊疗中心行下颌阻生第三磨牙拔除术的患者78例,采用随机数字表法将患者分为对照组（39例）与研究组（39例）,对照组采取传统锤击牙挺联合微创高速涡轮手机的拔牙方法,研究组采取微创高速涡轮手机联合气动拔牙挺的拔牙方法。比较2组的手术指标（拔牙手术时间、拔牙窝的完整性）,术中并发症（牙根折断、牙龈撕裂、舌侧骨板折断、邻牙损伤）和术后评价指标（疼痛程度、术后72 h张口度、术后72 h面部肿胀度）的情况。结果：研究组的拔牙时间和拔牙窝完整性显著优于对照组（P<0.05）,研究组术中和术后的评价均显著优于对照组（P<0.05）。结论：下颌阻生第三磨牙拔除术中应用气动拔牙挺联合微创高速涡轮手机的治疗效果优于传统治疗方法,值得临床推广。     

Benex拔牙器在微创拔牙中的应用

目的:观察Benex拔牙器在微创拔牙中的临床应用效果。方法:应用Benex拔牙器对56例患者的81颗患牙进行根管预备,旋入螺纹钉,载入牵引器。Benex拔牙器利用牵引的原理将患牙拔除。结果:在56例81颗患牙中,成功拔除52例77颗,无一例断根,患者术后反应轻微;失败4例4颗,成功率为95%。结论:应用Benex拔牙器拔除患牙,实现了真正的微创拔牙,也使拔牙更容易,更快捷。     

无痛微创拔牙技术在齿槽外科的应用

目的：观察丙泊酚＋局麻涡轮钻拔牙法在困难牙拔除中的应用。方法：选择拔牙患者60例，随机分为治疗Ⅰ组（丙泊酚＋局麻涡轮钻拔牙法）、治疗Ⅱ组（局麻涡轮钻拔牙法），对照组（传统拔牙法），记录各组患者麻醉前、局麻时、拔牙中平均动脉压（MAP）、心率（HR）、氧饱和度（SpO2），拔牙时间，拔牙感受。结果：Ⅰ组患者MAP、HR波动小，感觉痛苦小，Ⅰ、Ⅱ组患者拔牙时间短，3组患者SpO2无差异。结论：丙泊酚＋局麻涡轮钻拔牙法，值得在困难牙拔除中应用。     

碘伏对牙科高速涡轮手机的腐蚀性观察

目的 评价碘伏对牙科高速涡轮手机的腐蚀性。方法 采用肉眼和扫描电镜（ＥＰＭＡ－８７０电子探针）,观察用碘伏及消毒灵分别浸泡手机轴承钢珠、轴砂内部非金属材料和手术刀片后不同时间的表面腐蚀情况。结果 碘伏对金属腐蚀性很小,非金属材料无影响。结论采用碘伏用擦拭法或联合消毒法消毒手机,对手机损伤小。     

超声骨刀联合高速涡轮钻拔除复杂下颌阻生智齿的临床护理

目的探讨超声骨刀拔除复杂下颌阻生智齿的效果及护理经验。方法选择90例下颌阻生智齿患者,随机平均分为三组：（1）A组,采用涡轮钻法拔除;（2）B组,采用超声骨刀法拔除：（3）C组,采用超声骨刀结合涡轮钻法除。观察三组患者手术时间、术后疼痛、肿胀程度等情况。采用SPSS13．0软件包进行统计学分析。结果C组拔牙时间低于A、B组。差异有统计学意义（tA=25．49,tB=9．44,P均〈0．05）,且并发症较低（3％）。结论超声骨刀结合涡轮钻法的应用,可明显提高工作效率,减少术后并发症．降低手术风险．优质的护理配合及熟练的“六手操作”是超声骨刀结合涡轮钻法微创、高效拔除复杂下颌阻生智齿的重要保障。     

Dental air turbine handpiece performance testing*

Air turbine handpieces are expected to continue to be widely used as the main means of carrying out dental cutting work and scope exists for further design improvements. An understanding of the theoretical principles governing the performance of these devices seems essential for the systematic development of better handpiece designs and methods of specification. Furthermore, for experimental work on cutting behaviour with air turbine equipment, this knowledge is required for appropriate characterization of the performance of the particular handpiece used with respect to actual rates of energy deposition. The literature relating to air turbine handpiece performance is critically reviewed to assess currently available methods of measuring important variables such as speed, torque, and power. In this, consideration is given to the current state of knowledge of the influence on these variables of air pressure, flow and turbine design features. It is apparent that, although various measurement methods have been described and data for individual handpieces published, no attempt has yet been made to explore the functional relationships that exist between the variables. It is concluded that there is a need to identify the factors influencing turbine performance, to develop measurement systems which would provide adequate accuracy and precision and then to investigate the functional relationships between these relevant variables.     

高速涡轮钻、超声骨刀和常规方法拔除下颌阻生智牙的比较

目的:通过比较常规拔牙法、高速涡轮钻、超声骨刀拔除邻近神经管下颌阻生智牙并发症的客观数据,寻求拔除此类牙的最佳方法。方法:将300例符合条件的患者随机均分为3组,A组采用骨凿、劈冠、增隙法拔牙,B组用高速涡轮钻,C组用超声骨刀拔牙。观察3组患者手术时间、术后疼痛持续时间、干槽症和下牙槽神经损伤发生情况。采用SPSS13.0软件包对计量资料进行配对t检验,对计数资料进行χ2检验。结果:手术时间A组为(14.12±0.12)min,B组为(7.22±0.15)min,C组为(25.23±0.32)min;3组间两两比较均有显著差异(P<0.05)。术后疼痛持续时间A组为(62.15±1.51)h,B组为(48.23±1.23)h,C组为(14.34±0.80)h;3组间两两比较均有显著差异(P<0.05)。干槽症发生例数A组为9例,B组为2例,C组为1例。下牙槽神经损伤A组6例,B组2例,C组0例。结论:与常规拔牙方法相比,高速涡轮钻拔除复杂阻生牙能缩短手术时间,减少术后并发症,超声骨刀和前2种方法相比虽然手术时间较长,但术后并发症更少。     

Comparison of cavity preparation quality using an electric motor handpiece and an air turbine dental handpiece

BACKGROUND: The high-speed high-torque (electric motor) handpiece is becoming more popular in dental offices and laboratories in the United States. It is reported to cut more precisely and to assist in the creation of finer margins that enhance cavity preparations. The authors conducted an in vitro study to compare the quality of cavity preparations fabricated with a high-speed high-torque (electric motor) handpiece and a high-speed low-torque (air turbine) handpiece. METHODS: Eighty-six dental students each cut two Class I preparations, one with an air turbine handpiece and the other with an electric motor high-speed handpiece. The authors asked the students to cut each preparation accurately to a circular outline and to establish a flat pulpal floor with 1.5 millimeters' depth, 90-degree exit angles, parallel vertical walls and sharp internal line angles, as well as to refine the preparation to achieve flat, smooth walls with a well-defined cavosurface margin. A single faculty member scored the preparations for criteria and refinement using a nine-point scale (range, 1-9). The authors analyzed the data statistically using paired t tests. RESULTS: In preparation criteria, the electric motor high-speed handpiece had a higher average grade than did the air turbine handpiece (5.07 and 4.90, respectively). For refinement, the average grade for the air turbine high-speed handpiece was greater than that for the electric motor high-speed handpiece (5.72 and 5.52, respectively). The differences were not statistically significant. CLINICAL IMPLICATIONS: The electric motor high-speed handpiece performed as well as, but not better than, the air turbine handpiece in the fabrication of high-quality cavity preparations.