第三磨牙牙根发育及第三磨牙手术后的恢复

Noori Haeman, Hill David L, Shugars Daniel A, Phillips Ceib, White Raymond P

Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.

J Oral Maxillofac Surg. 2007 Apr;65(4):680-5. doi: 10.1016/j.joms.2006.02.035.

PURPOSE

This study was conducted to determine if the completeness of the root formation of mandibular third molars prior to removal affected clinical and health-related quality of life (HRQOL) recovery.

PATIENTS AND METHODS

Data from HRQOL responses from patients and clinical outcome data were available after third molar surgery conducted by surgeons in community practice and academic centers. The root development of each mandibular third molar on presurgery panoramic radiographs for these patients was assessed by trained clinician observers. Patients were categorized as those with complete root formation (both mandibular third molars had 100% completely formed roots) or as those with incomplete root formation (at least 1 mandibular third molar not completely formed). The proportion of patients who experienced delayed clinical or HRQOL recovery that exceeded a clinically relevant criterion value were compared for these 2 groups of patients using chi2 statistics. Level of significance was set at 0.05.

RESULTS

Both mandibular third molars had 100% completely formed roots in 118 patients; at least 1 mandibular third molar was not completely formed in 218 patients. If patients had a mandibular third molar with roots less than 100% complete, they more likely: were female (65% vs 58%), were less than 25 years old (95% vs 54%), P < .01, and had not finished high school (59% vs 28%), P < .01. For those with incomplete root formation, bone removal for both mandibular third molars was more likely (84% vs 67%), P < .01, and the surgeons' overall estimate of degree of difficulty was greater (14/28 vs 12/28), P = .02. Median surgery time did not differ between groups. The proportion of patients who experienced delayed clinical or HRQOL recovery did not differ between the incomplete and complete root formation groups.

CONCLUSIONS

Incomplete lower third molar root formation presurgery may not be a predictor of better or worse clinical or HRQOL recovery after surgery. Other clinical, demographic, and health indicators should influence surgeons' recommendations and patients' decisions regarding third molar treatment including surgery.

目的

本研究旨在确定下颌第三磨牙拔除前牙根形成的完整性是否会影响临床及与健康相关的生活质量（HRQOL）恢复情况。

患者与方法

来自社区诊所和学术中心外科医生进行的第三磨牙手术后患者的HRQOL反应数据以及临床结果数据均可用。由训练有素的临床观察人员评估这些患者术前全景X线片上每个下颌第三磨牙的牙根发育情况。患者被分为牙根完全形成组（双侧下颌第三磨牙牙根均100%完全形成）或牙根未完全形成组（至少1颗下颌第三磨牙牙根未完全形成）。使用卡方检验比较这两组患者中经历延迟临床或HRQOL恢复且超过临床相关标准值的患者比例。显著性水平设定为0.05。

结果

118例患者双侧下颌第三磨牙牙根均100%完全形成；218例患者中至少有1颗下颌第三磨牙牙根未完全形成。如果患者有一颗下颌第三磨牙牙根未完全形成，他们更有可能：为女性（65%对58%）、年龄小于25岁（95%对54%），P < 0.01，且未完成高中学业（59%对28%），P < 0.01。对于牙根未完全形成的患者，双侧下颌第三磨牙均进行去骨操作的可能性更大（84%对67%），P < 0.01，并且外科医生对难度程度的总体估计更高（14/28对12/28），P = 0.02。两组之间的中位手术时间无差异。牙根未完全形成组和完全形成组中经历延迟临床或HRQOL恢复的患者比例无差异。