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切开翻瓣术与涡轮钻骨法在下颌阻生第三磨牙拔除术中应用的随机对照研究

The influence of flap design on sequelae and quality of life following surgical removal of impacted mandibular third molars: A split-mouth randomised clinical trial.

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey.

出版信息

J Oral Rehabil. 2019 Sep;46(9):828-835. doi: 10.1111/joor.12814. Epub 2019 May 14.

DOI:10.1111/joor.12814
PMID:31050816
Abstract

BACKGROUND

Surgical removal of impacted mandibular third molar is one of the most frequently performed interventions in oral and maxillofacial surgery.

OBJECTIVES

To compare two different flap designs in terms of sequelae and quality of life following surgical removal of impacted third molars.

METHODS

This prospective, randomised, split-mouth clinical study involved patients referred for surgical removal of bilateral symmetrical impacted mandibular third molars. Envelope flap and modified triangular flap techniques were used. The effects of flap design on trismus, swelling, wound dehiscence, alveolar osteitis, haematoma, infection and quality of life were evaluated on post-operative days 3 and 7. Pain levels were assessed on post-operative days 1, 3 and 7.

RESULTS

Significant differences were determined between the two groups in terms of trismus, pain and wound dehiscence scores on post-operative day 3. However, on post-operative day 7, this difference was observed only in trismus. Statistically significant differences were also determined between the two groups on post-operative day 3 for social isolation and eating subscale scores as well as total quality of life score.

CONCLUSION

Based on the study findings, the modified triangular flap may be superior to the envelope flap in terms of pain, trismus, and wound dehiscence in the first 3 days after impacted third molar surgery and may have a better impact on quality of life during this process.

摘要

背景

下颌阻生第三磨牙的外科切除是口腔颌面外科最常进行的干预之一。

目的

比较两种不同皮瓣设计在下颌阻生第三磨牙切除术后的并发症和生活质量方面的差异。

方法

本前瞻性、随机、分侧临床研究纳入了双侧对称下颌阻生第三磨牙需行外科切除的患者。使用信封瓣和改良三角瓣技术。评估皮瓣设计对术后第 3 天和第 7 天的张口受限、肿胀、伤口裂开、牙槽突炎、血肿、感染和生活质量的影响。术后第 1、3、7 天评估疼痛程度。

结果

术后第 3 天,两组在张口受限、疼痛和伤口裂开评分方面存在显著差异。然而,术后第 7 天,仅在张口受限方面存在差异。术后第 3 天,两组在社会隔离和饮食子量表评分以及总生活质量评分方面也存在显著差异。

结论

根据研究结果,改良三角瓣在术后第 3 天的疼痛、张口受限和伤口裂开方面可能优于信封瓣,并且在这个过程中对生活质量的影响可能更好。

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