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[拔除智齿手术后感觉障碍的发生率、危险因素及随访。1106例病例研究]

[Incidence, risk factors and follow-up of sensation disorders after surgical wisdom tooth removal. Study of 1,106 cases].

作者信息

Gülicher D, Gerlach K L

机构信息

Klinik für Mund-, Kiefer- und Gesichtschirurgie, Otto-von-Guericke-Universität Magdeburg.

出版信息

Mund Kiefer Gesichtschir. 2000 Mar;4(2):99-104. doi: 10.1007/s100060050178.

Abstract

A study was carried out to determine the risk of dysesthesia of the inferior alveolar and of the lingual nerve after molar surgery. A total of 1103 impacted lower wisdom teeth and 3 impacted lower second molars were removed in 687 patients, all of whom with unaltered sensibility preoperatively. Clinical, radiological, and surgical factors of each case were recorded. Postoperative disturbances in the sensibility of the lip and tongue were evaluated by neurological examination. Follow-up was carried out for a maximum of 35 weeks. Dysesthesia of the inferior alveolar nerve occurred with an incidence of 3.57%. The lingual nerve was injured in 2.1% of patients. Most of the initially reported alterations in sensation resolved within the follow-up period. Dysesthesia of the inferior alveolar nerve persisted in 0.91%, and of the lingual nerve in 0.37%. However, the extent of the prolonged impairment was slight in general. The effect of the documented factors on the incidence of dysesthesia was analyzed. For the inferior alveolar nerve, analysis revealed significant effects in older patients, for completely developed roots, for deeply impacted teeth, in the radiological relationship of the roots and the inferior alveolar canal, for difficult surgery, and for intraoperative exposure of the nerve. The surgeon and the anesthesia had a significant influence on lingual dysesthesia.

摘要

开展了一项研究以确定磨牙手术后下牙槽神经和舌神经感觉异常的风险。在687例患者中总共拔除了1103颗低位阻生智齿和3颗低位阻生第二磨牙,所有患者术前感觉均未改变。记录了每个病例的临床、放射学和手术因素。通过神经学检查评估术后唇部和舌部的感觉障碍。随访最长进行了35周。下牙槽神经感觉异常的发生率为3.57%。2.1%的患者舌神经受损。大多数最初报告的感觉改变在随访期内得到缓解。下牙槽神经感觉异常持续存在的比例为0.91%,舌神经为0.37%。然而,总体而言,长期损害的程度较轻。分析了记录因素对感觉异常发生率的影响。对于下牙槽神经,分析显示在老年患者、牙根完全发育、牙齿深度阻生、牙根与下牙槽管的放射学关系、手术困难以及术中神经暴露等方面有显著影响。外科医生和麻醉对舌感觉异常有显著影响。

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