Renton T, McGurk M
Department of Oral and Maxillofacial Surgery, Guy's Kings and St Thomas' Schools of Medicine Dentistry and Biomedical Sciences, King's College, London, UK.
Br J Oral Maxillofac Surg. 2001 Dec;39(6):423-8. doi: 10.1054/bjom.2001.0682.
The aim of this study was to investigate risk factors for temporary and permanent lingual nerve injury after extraction of mandibular third molars. It was based on a 4-year prospective study of 2134 consecutive mandibular third molar operations in 1384 consecutive day case patients. During the study period (1994-1998) data were collected prospectively on patient, dental and surgical factors and correlated with lingual nerve injury using Student's t test, xi(2) and multiple logistic regression analysis. The incidence of temporary and permanent lingual nerve injury was 1 and 0.3%, respectively, per tooth. Factors that predicted temporary and permanent lingual nerve injury by univariate analysis were age, depth of application, difficulty of operation, surgeon and surgical technique used. Independent risk factors identified by multivariate analysis for temporary lingual nerve injury were perforation of the lingual plate, exposure of the nerve and increased difficulty of operation. The predictors for permanent lingual nerve injury in order of importance were perforation of the lingual plate, surgeon, increased difficulty of operation, exposure of the nerve and increased age of the patient. Surgical factors are the main contributors to lingual nerve injury during third molar extraction, but patient and dental factors are also involved.
本研究的目的是调查下颌第三磨牙拔除术后舌神经暂时和永久性损伤的危险因素。该研究基于对1384例连续日间手术患者的2134例连续下颌第三磨牙手术进行的为期4年的前瞻性研究。在研究期间（1994 - 1998年），前瞻性收集了患者、牙齿和手术因素的数据，并使用学生t检验、卡方检验和多元逻辑回归分析将其与舌神经损伤相关联。每颗牙齿的舌神经暂时和永久性损伤发生率分别为1%和0.3%。单因素分析预测舌神经暂时和永久性损伤的因素有年龄、器械插入深度、手术难度、外科医生和所使用的手术技术。多因素分析确定的舌神经暂时损伤的独立危险因素是舌侧骨板穿孔、神经暴露和手术难度增加。永久性舌神经损伤的预测因素按重要性排序为舌侧骨板穿孔、外科医生、手术难度增加、神经暴露和患者年龄增加。手术因素是第三磨牙拔除术中舌神经损伤的主要原因，但患者和牙齿因素也有影响。
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