University Medical and Dental School, Valencia, Spain.
Med Oral Patol Oral Cir Bucal. 2010 Jul 1;15(4):e628-32.
Accessing the tooth roots in periapical surgery (PS) requires the elimination of periapical bone.
To compare the postoperative morbidity and prognosis following PS on mandibular molars by ostectomy, or by osteotomy with repositioning of the vestibular cortical.
A retrospective clinical study of mandibular molars subjected to PS with ultrasound. Two groups were considered according to the surgical procedure used to access the roots: Group 1 (G1) with ostectomy and Group 2 (G2) with osteotomy and repositioning of the vestibular cortical. Only patients who had properly followed the post-operative instructions, adequately completed the post-operative questionnaires, and with a minimum of 12 months follow-up were included in the study. Post-operative morbidity was evaluated, and a clinical and radiographic follow-up was carried out using the criteria established by von Arx and Kurt in 1999. The SPSS program version 15 for Windows was used, considering values of p < or =0.05 as statistically significant.
Seventy-five patients, including 18 men and 57 women, with 87 mandibular molars and 107 periapical lesions were subjected to PS. The mean age of the patients was 38.5 years old (range 15-74 years old). The patients were monitored for an average of 27.2 months (range 12-120 months). Sixty-six patients (78 teeth) were treated in G1, and 9 patients (9 teeth) in G2. There was no relationship between the size of the ostectomy and pain, swelling or prognosis (p>0.05). Patients who underwent ostectomy presented more swelling than those subjected to osteotomy (p<0.05). There was no relationship between prognosis and the variables studied (p>0.05).
There was no statistically significant relationship between the surgical procedure used and post-operative pain or prognosis. Patients who underwent an ostectomy presented more swelling than those who were treated with an osteotomy and repositioning of the vestibular cortical.
在根尖手术（PS）中，为了接近根尖，需要去除根尖周围的骨组织。
比较磨牙 PS 中通过骨切除或骨切开并重新定位颊侧皮质骨来获得术区视野的术后发病率和预后。
这是一项回顾性临床研究，纳入了接受超声辅助下 PS 的下颌磨牙。根据手术入路将患者分为两组：组 1（G1）行骨切除，组 2（G2）行骨切开并重新定位颊侧皮质骨。仅纳入那些能够正确遵循术后医嘱、充分完成术后问卷调查且随访时间至少 12 个月的患者。评估术后发病率，并使用 von Arx 和 Kurt 于 1999 年制定的标准进行临床和影像学随访。采用 Windows 版 SPSS 程序 15 版进行数据分析，以 p 值≤0.05 为统计学显著差异。
共纳入 75 例患者（18 名男性，57 名女性），87 颗下颌磨牙和 107 个根尖病变接受了 PS。患者平均年龄 38.5 岁（15-74 岁）。平均随访时间为 27.2 个月（12-120 个月）。66 例患者（78 颗牙）行 G1 治疗，9 例患者（9 颗牙）行 G2 治疗。骨切除的大小与疼痛、肿胀或预后之间无相关性（p>0.05）。行骨切除的患者肿胀程度大于行骨切开的患者（p<0.05）。预后与研究的变量之间无相关性（p>0.05）。
手术方式与术后疼痛或预后之间无统计学显著相关性。行骨切除的患者肿胀程度大于行骨切开并重新定位颊侧皮质骨的患者。
