Cai Yu, Sun Rui, Zhao Ji-Hong
Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, P. R. China.
Medicine (Baltimore). 2018 Jul;97(27):e11398. doi: 10.1097/MD.0000000000011398.
This study aimed to investigate the application of piezosurgery-associated flapless surgery for increasing bone space during teeth extraction and evaluate its success rate, postoperative outcomes, and incidence of major complications.From January 2014 to December 2016, patients who experienced teeth extraction via piezosurgery-associated flapless surgery were enrolled in this study. The positions, diagnosis, dental medical history, and radiographic examination of teeth were recorded before the treatment. During the surgery, the fracture or displacement of root, injuries of soft tissue, and fractures of the alveolar process were noted.A total of 140 patients fulfilled the eligibility criteria in the present study. All these teeth were classified into 4 groups based on diagnosis: residual roots that underwent root canal therapy (28 cases), teeth with root fracture (37 cases), teeth extraction because of orthodontics needed (31 cases), and the vertically impacted lower third molar (44 cases). The radiographic presentation revealed about 50% ankylosed teeth. No root fracture and root displacement emerged, and all roots were removed intact. Moreover, fracture of the alveolar process did not occur. Two cases with buccal mucosal injury were noted, which were because of heat injuries caused by the basement of the tip while cool water was used out.This study introduced a novel mini-invasive strategy for increasing space during teeth extraction. The advantage of this piezosurgery-associated flapless surgery included maximal preservation of the alveolar bone, minimal injury to soft tissues, and prevention of root fracture during the surgery. Furthermore, the cool water used during the surgery must be carefully checked before the procedure.
本研究旨在探讨压电手术联合无瓣手术在拔牙过程中增加骨间隙的应用,并评估其成功率、术后效果及主要并发症的发生率。2014年1月至2016年12月,采用压电手术联合无瓣手术拔牙的患者纳入本研究。治疗前记录牙齿的位置、诊断、牙科病史及影像学检查情况。手术过程中,记录牙根的折断或移位、软组织损伤及牙槽突骨折情况。本研究共有140例患者符合纳入标准。所有这些牙齿根据诊断分为4组:接受根管治疗的残根(28例)、牙根折断的牙齿(37例)、因正畸需要拔除的牙齿(31例)及垂直阻生的下颌第三磨牙(44例)。影像学表现显示约50%的牙齿牙根粘连。未出现牙根折断和移位,所有牙根均完整拔除。此外,未发生牙槽突骨折。记录到2例颊黏膜损伤,是由于使用冷水时刀头底部造成的热损伤。本研究介绍了一种在拔牙过程中增加间隙的新型微创策略。这种压电手术联合无瓣手术的优点包括最大限度地保留牙槽骨、对软组织损伤最小以及在手术过程中防止牙根折断。此外,手术前必须仔细检查手术过程中使用的冷水。