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异位下颌第三磨牙至下颌骨下缘的口外手术入路

Extraoral surgical approach of ectopic mandibular third molar to the lower border of mandible.

作者信息

Laino Luigi, Menditti Dardo, Lo Muzio Lorenzo, Laino Gregorio, Lauritano Floriana, Cicciù Marco

机构信息

*Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy †Second University, Naples, Italy ‡Departments of Medical Disciplines and Odontostomatology §Human Pathology, School of Dentistry, University of Messina, Messina, Italy.

出版信息

J Craniofac Surg. 2015 May;26(3):e256-60. doi: 10.1097/SCS.0000000000001541.

Abstract

The surgical removal of impacted lower third molar is an ordinary intervention. The treatment of choice in this pathology is an intraoral or, seldom, extraoral surgical approach. Various surgical procedures have been described to remove ectopic mandibular teeth. The more common technique is an intraoral approach (so named "conservative"), even when the tooth is located in an ectopic area. However, the "intraoral approach" is often related with the difficulty of view, the bleeding of the surgical site, and with the possible lesions of inferior alveolar or lingual nerve. From the other side, a nonconservative surgical approach like "extraoral pathway" may be associated with no aesthetic cutaneous postoperative scar tissue. The aim of those 2 study cases is to highlight the management of infected ectopic third molars located close to the lower border of the mandibular body, underlining the anatomical land markers of the submandibular area. The authors have applied the extraoral pathway using an incision of small size. From our analysis, the treatment of those typical can be managed by using a "mini-skin-incision" (so termed as mini-submandibular approach) respecting the cosmetic expectations of the patients.

摘要

拔除阻生下颌第三磨牙是一种常见的手术干预。对于这种病症,首选的治疗方法是采用口内手术入路,很少情况下采用口外手术入路。已经描述了多种用于拔除异位下颌牙齿的手术方法。更常见的技术是口内入路(即所谓的“保守”入路),即使牙齿位于异位区域。然而,“口内入路”常常与视野受限、手术部位出血以及下牙槽神经或舌神经可能受损有关。另一方面,像“口外途径”这样的非保守手术入路可能不会留下影响美观的术后皮肤瘢痕组织。这两个研究病例的目的是强调对位于下颌体下缘附近的感染异位第三磨牙的处理,突出下颌下区域的解剖标志。作者采用了小切口的口外途径。通过我们的分析,对于这些典型病例,可以采用“小皮肤切口”(即所谓的小下颌下入路)进行治疗,同时满足患者对美观的期望。

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