Leung Y Y, Cheung K Y
Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
Int J Oral Maxillofac Surg. 2018 Jun;47(6):802-808. doi: 10.1016/j.ijom.2018.01.015. Epub 2018 Feb 9.
Coronectomy was introduced as a treatment for impacted lower third molars at high risk of inferior alveolar nerve damage. Root migration is considered one of the common surgical complications of this procedure. This study aimed to investigate the long-term behaviour of retained root(s) after coronectomy. This was a prospective study, with 3-5 years of follow-up, of patients who underwent lower third molar coronectomy. Panoramic radiographs were taken preoperatively and at 1 week, 6, 12, 24, 36, and 60 months postoperative. Root migration patterns were recorded. Factors including age, sex, type and pattern of impaction, and root form were analyzed with respect to the root migration rate. A total of 356 coronectomies were performed in 254 patients. Most root migration was found to occur within 6 months (91.1%) and 12 months (61.4%) postoperative. From 24 months onwards, less than 5% migrated further. Age was found to be a factor affecting root migration: migration decreased with increasing age (by 0.203mm less per year increase in age). Other factors investigated were found to be unrelated. Therefore, adequate preoperative warning should be given to young patients considering coronectomy as treatment for impacted lower third molars. However, it should also be noted that the incidence of root exposure leading to re-operation is low.
冠切除术被引入作为治疗存在下牙槽神经损伤高风险的阻生下颌第三磨牙的一种方法。牙根移位被认为是该手术常见的手术并发症之一。本研究旨在调查冠切除术后保留牙根的长期情况。这是一项对接受下颌第三磨牙冠切除术的患者进行的前瞻性研究,随访时间为3至5年。术前以及术后1周、6个月、12个月、24个月、36个月和60个月拍摄全景X线片。记录牙根移位模式。分析包括年龄、性别、阻生类型和模式以及牙根形态等因素与牙根移位率的关系。共对254例患者进行了356次冠切除术。发现大多数牙根移位发生在术后6个月内(91.1%)和12个月内(61.4%)。从24个月起,进一步移位的不足5%。发现年龄是影响牙根移位的一个因素:随着年龄增长,移位减少(年龄每增加一岁,移位减少0.203毫米)。研究的其他因素被发现与之无关。因此,对于考虑采用冠切除术治疗阻生下颌第三磨牙的年轻患者,应给予充分的术前警示。然而,还应注意的是,导致再次手术的牙根暴露发生率较低。