[紧邻下牙槽神经的下颌阻生第三磨牙去冠术的临床评估]
[Clinical evaluation for coronectomy of the impacted mandibular third molars in close proximity to inferior alveolar nerve].
作者信息
Wu Xing-Chen, Li Ying, Zhao Jun-Jun
机构信息
Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center of Stomatology; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology. Shanghai 200011, China. E-mail:
出版信息
Shanghai Kou Qiang Yi Xue. 2019 Feb;28(1):85-88.
PURPOSE
To evaluate the outcome of coronectomy for management of impacted mandibular third molars in close proximity to inferior alveolar nerve (IAN).
METHODS
Ten patients with impacted mandibular third molars which approached or was close to the inferior alveolar nerve diagnosed on panoramic film and cone-beam CT (CBCT) scan were included in the study. Coronectomy was conducted at the cemento-enamel junction, leaving the roots below the alveolar crest and primary closure was performed. After the root apex was pushed away from the inferior alveolar nerve, the impacted lower third molar was then removed.
RESULTS
Ten patients had little post-operative pain and swelling, none of them had IAN injury or infection. Only 1 patient was failed to move the roots away from IAN and the roots were left in the alveolar socket, but without any symptoms and side effects during 1 year of follow-up.
CONCLUSIONS
Coronectomy is effective in controlling inferior alveolar nerve injury following third molar surgery in radiographically evaluated high risk cases and it has very low incidence of complications.
目的
评估牙冠切除术治疗紧邻下牙槽神经（IAN）的下颌阻生第三磨牙的效果。
方法
本研究纳入10例经全景片和锥形束CT（CBCT）扫描诊断为接近或紧邻下牙槽神经的下颌阻生第三磨牙患者。在牙骨质-釉质界处进行牙冠切除术，将牙根留在牙槽嵴下方并进行一期缝合。在根尖从下牙槽神经推开后，再拔除阻生的下颌第三磨牙。
结果
10例患者术后疼痛和肿胀轻微，均未发生下牙槽神经损伤或感染。仅1例患者未能将牙根从下牙槽神经处推开，牙根留在牙槽窝内，但在1年的随访中无任何症状和副作用。
结论
在影像学评估为高风险病例中，牙冠切除术可有效控制第三磨牙手术后的下牙槽神经损伤，且并发症发生率极低。
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