不同方法治疗近中阻生大学生第二或三磨牙远中龋齿的疗效分析

目的:评价不同方法治疗近中阻生学生第二或三磨牙远中龋齿的临床效果。方法:采用多阶段抽样法从沧州市各高校名册随机抽取2500名在校学生,并采用问卷调查和口腔检查获取学生基本信息、口腔知识掌握情况和口腔资料。根据阻生智齿牙长轴方向和口腔诊断结果,将发生近中阻生智齿且第二、三磨牙远中龋齿,以及未达到诊疗标准的学生分别纳入拔牙组、移植组和对照组,分别行常规微创拔牙手术治疗、拔除第二磨牙移植第三磨牙干预和健康教育。干预后1个月、3个月、6个月、12个月进行随访,比较分析三组干预方案的预后差异。结果:抽取的2500名大学生中共有2060名大学完成问卷调查并接受口腔检查,问卷有效率为82.40%;下颌智齿检出率为67.84%。近中阻生组发生第二、三磨牙龋齿550例,其中男248例,女302例;完成全程随访的共26名,年龄平均(21±2)岁,其中男生12名,女生14名,男女比为6:7。男生第二、三磨牙龋齿率为12.90%,低于女生的29.47%(P<0.05);不同年龄、学历的学生龋齿率的差异无统计学意义(P>0.05);知晓口腔知识学生龋齿率低于不知晓的(P<0.05)。拔牙后症状较拔牙前缓解(χ2=6.138,P<0.05);移植后症状缓解较移植前明显缓解(χ^2=55.881,P<0.01);对照组护牙知识健康教育前后差异无统计学意义(χ^2=0.678,P>0.05)。不同性别学生接受牙移植术后牙位、牙稳固程度、牙周炎症、牙根吸收、叩痛感和牙功能的随访得分随着时间的增加而增加,其中女生的术后牙位、牙周炎症、牙根吸收和牙功能改善的幅度均较男生大(P<0.01)。结论:智齿知识和护牙常识知晓率偏低,拔牙法和移植法均能不同程度上解决近中阻生第二或三磨牙远中龋齿问题,其中第二磨牙龋齿应用移植法治疗的学生恢复情况较好,且经济实惠。

Evaluation of the Clinical Effect of Different Method for the Treatment of Distal or Middle Caries of Second or Third Molars

Objective To evaluate the clinical effect of different-method in the treatment of distal or middle molars in the middle or middle molars.Methods Two-stage sampling method was used to randomly select three schools from the colleges and universities in Cangzhou,and then from the school roster.A random sample of 2500 students.Questionnaires and oral examinations were used to obtain basic information,oral knowledge and oral conditions of the students,and the near-middle and vertical groups were based on the long axis of the impacted wisdom teeth.The near-middle group was subdivided into the extraction group,the transplantation group and the control group according to the oral diagnosis results,treatment plan and student's wishes.The routine minimally invasive extraction surgery,the second molar transplantation and the third molar intervention and health education were performed.Follow-up was performed at 1 month,3 months,6 months,and 12 months after the intervention,and the prognostic differences of the three groups were compared and analyzed.Results A total of 2,060 college students from 2500 colleges completed questionnaires and received oral examinations.The effective rate of the questionnaire was 82.40%;the detection rate of mandibular wisdom teeth was 67.84%,and the high(middle)vertical impact detection rate was 39.04%.The detection rate of high(middle)near-middle resistance was 22.01%;the detection rate of pericoronitis of wisdom teeth was 58.25%;the knowledge of wisdom tooth and common sense of tooth care were 40.12%and 51.04%,respectively.A total of 26 patients with secondary and third molars in the near-middle-impedance group completed the whole follow-up,with an average age of(21±2)years;the second and third molars of boys were 12.90%,which was lower than 29.47%of girls(P<0.05)There was no signifi cant difference in the rate of dental caries among students of different ages and academic qualifications(P>0.05).There were statistically significant differences in the knowledge of oral knowledge and unawareness(P<0.05).The symptoms were significantly relieved after extraction.The difference was statistically significant(χ2=6.138,P<0.05).The symptomatic relief after transplantation was significantly relieved compared with that before transplantation(χ2=55.881,P<0.01).There was no signifi cant difference in the group before and after health education(χ2=0.678,P>0.05).Follow-up scores of teeth,tooth stability,periodontal inflammation,root resorption,sputum pain and dental function of patients with different genders after tooth transplantation increased with time,including postoperative dental position and periodontal infl ammation in girls.The improvement of root absorption and tooth function was larger than that of males(P<0.01).Conclusion Both the extraction method and the transplantation method can solve the problem of the middle and third molars of the middle and the third molars in different degrees.Among them,the second molars and the transplanted patients are better and more economical.