埋伏阻生齿拔除术后两种拔牙窝填塞剂对预后的影响

目的 观察骨埋伏阻生牙拔除术后两种不同的牙槽窝填塞剂对预后的影响。方法 选取315例骨埋伏的下颌第三磨牙拔除的患者,随机分成3组,组1拔除术后创面直接拉拢缝合+口服镇痛+口服抗炎;组2拔除术后创面明胶海绵+碘仿粉末填塞止血+拉拢缝合+口服镇痛+口服抗炎;组3拔除术后创面胶质银明胶海绵(止泰)填塞止血+拉拢缝合+口服镇痛+口服抗炎。比较3组术后出血,术后肿痛及术后干槽症的发生率。结果 组2和组3创面处理治疗后的术后出血,术后肿痛及术后干槽症的出现明显降低,预后优于组1(P<0.01),且组2和组3两组之间差异无统计学意义(P>0.05)。结论 胶原蛋白海绵+碘仿粉末或胶质银明胶海绵的两种术后创面处理方法皆疗效显著,值得临床进一步推广和应用。

Effects of two hemostatic packing materials into the extraction socket on the prognosis after impacted tooth extraction

Objective The aim of this study was to observe the effects of two hemostatic packing materials into the extraction socket on the prognosis after extraction of impacted mandibular third molar. Method 315 patients with bone embedded mandibular third molar were randomly assigned into 3 groups. In group 1, the intrasocket soft tissue was directly sutured and the patients after extraction were treated by oral administration of analgesia and anti-inflammmatory drugs. In group 2, the extraction socket was filled with gelatin sponge and iodoform powder for hemostasis and then sutured, and the patients after extraction were treated by oral administration of analgesia and anti-inflammmatory drugs. In group 2, the extraction socket was filled with colloidal silver gelatin sponge (Gelatamp) for hemostasis and then sutured, and the patients after extraction were treated by oral administration of analgesia and anti-inflammmatory drugs. The incidences of postoperative bleeding, swelling, pain and dry socket were compared between the three groups. Results The incidence of postoperative bleeding, swelling pain and dry socket in group 1 and group 2 was significantly lower than that in group 2 indicating the prgnosis of group 2 and group 3 was better than that of the group 1 (P<0.01). There was no significant difference in the incidence between group 2 and group 3 (P>0.05). Conclusion Both collagen sponge with iodine powder and colloidal silver gelatin sponge are effective and safe option for postoperative wound management after extraction of impacted mandibular third molar. It is worthy of further promotion and application in clinic.