Ma Zhigui, Xu Guangzhou, Yang Chi, Xie Qianyang, Shen Yuqing, Zhang Shanyong
Department of Oral Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, PR China.
Department of Oral Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, PR China.
Br J Oral Maxillofac Surg. 2015 Apr;53(4):326-31. doi: 10.1016/j.bjoms.2015.01.002. Epub 2015 Jan 28.
Our aim was to assess the efficacy of piezoelectric corticotomy for orthodontic traction of mandibular third molars close to the inferior alveolar nerve. Thirty patients with impacted third molars close to the nerve were included in the study, 15 of whom were treated with conventional orthodontic traction and 15 with piezoelectric corticotomy. We recorded duration of treatment including exposure and orthodontic traction, and time to the final extraction. Postoperative complications including trismus, swelling, and pain were also noted. Alveolar bone levels mesial and distal to the second molars were evaluated on cone-beam computed tomographic (CT) images. Student's t test was used to assess the significance of differences between the groups. After orthodontic treatments all impacted third molars were successfully removed from the inferior alveolar nerve without neurological damage. The mean (SD) duration of surgical exposure in the piezoelectric corticotomy group was significantly longer than that in the conventional group (p=0.01). The mean (SD) duration of traction was 4 (2.3) months after piezoelectric corticotomy, much shorter than the 7.5 (1.3) months in the conventional group (p=0.03). There were no significant differences in postoperative complications between the groups. There was a significant increase in the distal alveolar height of second molars after treatment in both groups (p<0.01). We conclude that the use of piezoelectric corticotomy allows more efficient and faster traction of third molars with a close relation between the root and the inferior alveolar nerve, although it took longer than the traditional technique.
我们的目的是评估压电截骨术用于牵引靠近下牙槽神经的下颌第三磨牙的疗效。本研究纳入了30例第三磨牙近神经阻生的患者,其中15例采用传统正畸牵引治疗,15例采用压电截骨术治疗。我们记录了包括暴露和正畸牵引在内的治疗持续时间以及最终拔除的时间。还记录了术后并发症,包括牙关紧闭、肿胀和疼痛。在锥形束计算机断层扫描(CT)图像上评估第二磨牙近中及远中的牙槽骨水平。采用学生t检验评估两组间差异的显著性。正畸治疗后,所有阻生第三磨牙均成功从下牙槽神经处拔除,未出现神经损伤。压电截骨术组的平均(标准差)手术暴露时间显著长于传统组(p = 0.01)。压电截骨术后的平均(标准差)牵引时间为4(2.3)个月,远短于传统组的7.5(1.3)个月(p = 0.03)。两组术后并发症无显著差异。两组治疗后第二磨牙远中牙槽高度均显著增加(p < 0.01)。我们得出结论,尽管压电截骨术所需时间比传统技术长,但它能更有效、更快地牵引牙根与下牙槽神经关系密切的第三磨牙。