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早期拔除:避免下颌第三磨牙拔除时损伤神经的银弹?

Early extraction: a silver bullet to avoid nerve injury in lower third molar removal?

机构信息

Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guangzhou Medical College, 39 Huangsha Road, Liwan District, Guangzhou City, Guangdong Province, PR China.

出版信息

Int J Oral Maxillofac Surg. 2012 Oct;41(10):1280-3. doi: 10.1016/j.ijom.2012.03.030. Epub 2012 May 18.

Abstract

This retrospective study evaluated the effects of early extraction of immature lower third molar on preventing complications, particularly nerve injury following lower third molar removal. Patients were grouped according to age and radiographic results: group A (518 patients, ≤23 years, immature teeth with apical foramen not closed); group B (532 patients, >23 years, mature teeth with closed apical foramen). Group A included 230 males and 288 females (average age 17 years). In group A, 808 lower mandibular third molars were extracted bilaterally in 290 and unilaterally in 228 patients; the incidence of complications was 2.48% (20/808) (all were temporary), the incidence of nerve injury was 0%. Group B included 250 males and 282 females (average age 39 years). In group B, 810 lower third molars were extracted bilaterally in 278 and unilaterally in 254 patients; the incidence of complications was 10% (81/810), the incidence of nerve injury was 1.6% (13/810). All complications were temporary, except two removals of permanent inferior alveolar nerve numbness (>6 months). In this study, early removal of the lower third molar was effective in avoiding some postoperative complications, especially nerve injury. Early extraction of lower third molar in youngsters is recommended following a team consultation.

摘要

本回顾性研究评估了早期拔除未成熟第三磨牙对预防并发症的影响,特别是预防第三磨牙拔除后神经损伤。患者根据年龄和影像学结果分组:A 组(518 例,≤23 岁,未闭合的根尖孔未闭合的未成熟牙);B 组(532 例,>23 岁,根尖孔闭合的成熟牙)。A 组包括 230 名男性和 288 名女性(平均年龄 17 岁)。在 A 组中,290 例患者双侧拔除 808 颗下颌第三磨牙,228 例患者单侧拔除 808 颗下颌第三磨牙;并发症发生率为 2.48%(20/808)(均为暂时性),神经损伤发生率为 0%。B 组包括 250 名男性和 282 名女性(平均年龄 39 岁)。在 B 组中,278 例患者双侧拔除 810 颗下颌第三磨牙,254 例患者单侧拔除 810 颗下颌第三磨牙;并发症发生率为 10%(81/810),神经损伤发生率为 1.6%(13/810)。所有并发症均为暂时性,除 2 例永久性下牙槽神经麻木(>6 个月)外。在这项研究中,早期拔除下颌第三磨牙可有效避免一些术后并发症,特别是神经损伤。建议在团队咨询后,对年轻人进行早期的第三磨牙拔除。

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