Barone Antonio, Marconcini Simone, Giacomelli Luca, Rispoli Lorena, Calvo Josè Louis, Covani Ugo
Department of Oral Pathology and Medicine, University of Genova, Genoa, Italy.
J Oral Maxillofac Surg. 2010 Feb;68(2):330-6. doi: 10.1016/j.joms.2009.03.053. Epub 2010 Jan 15.
The purpose of this study was to investigate and compare, in a randomized and controlled clinical trial, the use of ultrasound bone surgery devices and the use of rotary instruments in lower third molar extractions.
We selected 26 patients (12 women and 14 men) for this study; the mean age was 31.2 years (range, 24-45 years). A randomized clinical trial was planned. Patients in the control group received treatment with the conventional rotary instruments; patients in the test group received treatment with the ultrasound bone surgery tools. Twenty-six third molars were allocated to the test and control groups according to a computer-generated randomization list. All the surgical procedures were performed by the same surgeon. Pain, trismus, cheek swelling, and number of analgesics taken were evaluated at baseline (before surgery) and at the first-, third-, fifth-, and seventh-day visits.
Pain levels (evaluated on a visual analog scale) were higher in the control group when compared with the ultrasonic group; however, no statistically significant differences were found. On the contrary, the number of analgesics taken in the test group was significantly lower when compared with the control group. The occurrence of trismus was significantly higher in the control group when compared with the test group. The clinical values of cheek swelling were higher in the rotary group when compared with the ultrasound group at the fifth-day visit.
This study showed that the use of ultrasound bone surgery for third molar extraction significantly reduced the occurrence of postsurgical trismus, the occurrence of swelling, and the number of analgesics taken after surgery.
本研究旨在通过一项随机对照临床试验，调查和比较超声骨手术器械与旋转器械在拔除下颌第三磨牙中的应用。
我们选取了26例患者（12名女性和14名男性）进行本研究；平均年龄为31.2岁（范围24 - 45岁）。计划进行一项随机临床试验。对照组患者接受传统旋转器械治疗；试验组患者接受超声骨手术工具治疗。根据计算机生成的随机列表，将26颗第三磨牙分配到试验组和对照组。所有手术操作均由同一位外科医生进行。在基线（手术前）以及术后第1天、第3天、第5天和第7天的随访中，评估疼痛、牙关紧闭、脸颊肿胀情况以及服用镇痛药的数量。
与超声组相比，对照组的疼痛程度（采用视觉模拟评分法评估）更高；然而，未发现统计学上的显著差异。相反，试验组服用的镇痛药数量与对照组相比显著更低。与试验组相比，对照组牙关紧闭的发生率显著更高。在术后第5天的随访中，旋转组的脸颊肿胀临床值高于超声组。
本研究表明，使用超声骨手术拔除第三磨牙可显著降低术后牙关紧闭的发生率、肿胀的发生率以及术后服用镇痛药的数量。
