Pippi Roberto, Alvaro Roberto
Department of Oral and Maxillo-Facial Sciences, Faculty of Medicine and Dentistry, "Sapienza" University of Rome, Rome, Italy.
J Craniofac Surg. 2013 Mar;24(2):531-3. doi: 10.1097/SCS.0b013e31826463f7.
The lingual split technique is a surgical procedure for extraction of impacted mandibular third molar throughout a lingual approach. The main disadvantage of this technique is the high rate of temporary lingual nerve injury mainly because of the trauma induced by the lingual flap retraction. The purpose of this paper is to suggest the use of piezosurgery in performing the lingual cortical plate osteotomy of the third molar alveolar process.
Surgical procedure was performed under general anesthesia, and it lasted approximately 60 minutes. After the buccal and lingual full-thickness flaps were incised and elevated, a piezosurgical device was used for osteotomy. A well-defined bony window was then removed, and it allowed the entire tooth was extracted in a lingual direction. The patient did not show any neurological postoperative complication. Lingual and inferior alveolar nerve functionality was normal before as well as after surgery.
The use of piezoelectric surgery seems to be a good option in removing lower third molars when a lingual access is clearly indicated. The only disadvantage of this technique can be represented by an operating time lengthening possibly because of a lower power cut of the piezoelectric device, to the high mineralization of the mandibular cortical bone and to the use of inserts with a low degree of sharpening.
舌侧劈开技术是一种通过舌侧入路拔除下颌阻生第三磨牙的外科手术。该技术的主要缺点是暂时性舌神经损伤发生率高，主要原因是舌侧瓣牵拉引起的创伤。本文的目的是建议在进行第三磨牙牙槽突舌侧皮质骨切开术时使用压电外科手术。
手术在全身麻醉下进行，持续约60分钟。切开并掀起颊侧和舌侧全厚瓣后，使用压电外科设备进行骨切开术。然后去除一个界限清晰的骨窗，使整个牙齿能够向舌侧拔除。患者术后未出现任何神经并发症。术前及术后舌神经和下牙槽神经功能均正常。
当明确需要舌侧入路时，使用压电外科手术似乎是拔除下颌第三磨牙的一个好选择。该技术的唯一缺点可能是手术时间延长，这可能是由于压电设备功率较低、下颌皮质骨矿化程度高以及使用的刀片锐度较低所致。
