J Am Dent Assoc. 2018 Aug;149(8):688-695. doi: 10.1016/j.adaj.2018.03.022. Epub 2018 May 24.
Minimally invasive vertical tooth extraction techniques have evolved in light of the limitations of conventional tooth extraction techniques and flap surgery in preserving the alveolar bone. The authors conducted a study to obtain data on the performance of a vertical extraction system. This included comparing the need for flap surgery using the vertical extraction system versus conventional tooth extraction techniques for the extraction of anterior teeth and premolars not suitable for forceps extraction.
The authors conducted a prospective observational clinical study of the vertical extraction system versus conventional tooth extraction techniques using an interrupted time series in line with the Idea, Development, Exploration, Assessment, Long-term Follow-up collaboration framework for surgical innovation.
Overall, 276 of 323 teeth (85.4%) in 240 patients were successfully extracted using the vertical extraction system. Of the 47 failures in the vertical tooth extraction cohort, 18 required flap surgery, resulting in an overall incidence of flap surgery of 5.6% (95% confidence interval [CI], 3.2% to 8.7%). During the routine care period, of the 94 anterior teeth and premolars in 78 patients, 21 teeth could not be extracted using conventional techniques and required flap surgery, leading to an incidence of flap surgery of 22% (95% CI, 14% to 32%).
The results suggest that the vertical extraction system may be used with a high success rate for extraction of severely destroyed teeth, and its use may lead to a marked reduction in the need for flap surgery. Randomized clinical trials are needed to confirm the findings.
The use of a vertical extraction system may lower the incidence of flap surgery.
微创垂直拔牙技术的发展是基于传统拔牙技术和翻瓣手术在保护牙槽骨方面的局限性。作者进行了一项研究,以获取垂直拔牙系统性能的数据。这包括比较使用垂直拔牙系统与传统拔牙技术对不适合使用钳子拔牙的前牙和前磨牙进行拔牙时,对翻瓣手术的需求。
作者按照 Idea、Development、Exploration、Assessment、Long-term Follow-up(IDEA)协作框架进行了一项前瞻性观察性临床研究,比较了垂直拔牙系统与传统拔牙技术。
总体而言,240 名患者的 323 颗牙齿中有 276 颗(85.4%)成功使用垂直拔牙系统拔出。在垂直拔牙队列中,47 例失败,其中 18 例需要进行翻瓣手术,总翻瓣手术发生率为 5.6%(95%置信区间,3.2%至 8.7%)。在常规护理期间,78 名患者的 94 颗前牙和前磨牙中,有 21 颗无法使用传统技术拔出,需要进行翻瓣手术,翻瓣手术发生率为 22%(95%置信区间,14%至 32%)。
结果表明,垂直拔牙系统可用于成功率较高的严重破坏牙齿的拔除,且其使用可能显著减少翻瓣手术的需求。需要进行随机临床试验来证实这些发现。
使用垂直拔牙系统可能会降低翻瓣手术的发生率。