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。

Comparative study of complications among routine method,high speed turbine handpiece and piezosurgery device after extraction of impacted wisdom teeth

PURPOSE: To investigate complications in extraction of complicated impacted wisdom teeth whose root apex near to the inferior alveolar nerve(IAN) by using routine method(chisels),high speed turbine handpiece and piezosurgery device respectively.METHODS: Three hundred qualified patients with impacted wisdom teeth were divided into three groups randomly,one hundred patients in group A were extracted by routine method,one hundred patients in group B were extracted by high speed turbine handpiece,and one hundred patients in group C were extracted by piezosurgery device.The operation time,postoperative pain duration,dry socket and IAN injury were compared between each two groups.All statistical analysis was performed using SPSS 13.0 software package.Differences between groups were compared using a paired t test(quantitative data) or Chi-square test(qualitative data).RESULTS: The operation time in group A was(14.12±0.12)min,(7.22±0.15)min in group B,(25.23±0.32)min in group C;Significant difference was found between group A and group B(P<0.05),group B and group C(P<0.05),group A and group C(P<0.05).Postoperative pain duration was(62.15±1.51)h in group A,(48.23±1.23)h in group B,(14.34±O.80)h in group C;Significant difference was found between group A and group B(P<0.05),group B and group C(P<0.05),group A and group C(P<0.05).9 patients developed dry socket in group A,2 in group B,and 1 in group C;Significant difference was found between group A and group B(P<0.05),group A and group C(P<0.05).Six patients had IAN injury in group A,2 in group B,0 in group C.Significant difference was found between group A and group C.CONCLUSIONS: Compared with routine method,high speed turbine is better in extraction of impacted wisdom teeth,which can shorten operation time,lessen postopertive complications.Although there was longer operation time compared with group A and B,piezosurgery device is more effective in reducing postopertive complications.