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牙槽碘棉塞填塞可降低第三磨牙拔除术后的发病率。

Alveolar Iodine Tampon Packing Reduces Postoperative Morbidity After Third Molar Surgery.

作者信息

Tuk Jacco G, Lindeboom Jerome A, Sana Faro, van Wijk Arjen J, Milstein Dan M J

机构信息

Associate Professor, Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, and Private Practice, Amstelland Hospital, Amstelveen, The Netherlands.

Associate Professor, Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, and Private Practice, Amstelland Hospital, Amstelveen, The Netherlands.

出版信息

J Oral Maxillofac Surg. 2019 Dec;77(12):2401-2411. doi: 10.1016/j.joms.2019.06.175. Epub 2019 Jul 1.

Abstract

PURPOSE

The aim of this study was to assess the efficacy of an iodine tampon after mandibular third molar surgery on oral health-related quality of life (OHRQoL), use of painkillers, postoperative sequelae, and self-care behaviors in the first postoperative week.

MATERIALS AND METHODS

This prospective, crossover, randomized controlled study included patients undergoing surgical removal of bilateral symmetrically, horizontally impacted mandibular third molars. The surgical site was randomly allocated to receive an iodine tampon after surgery or wound closure and rinsing with a Monoject syringe (Tyco/Healthcare-Kendall, Mansfield, MA). The primary outcomes measured each day during the first postoperative week were the Oral Health Impact Profile 14 score and postoperative sequelae, including pain, swelling, limited mouth opening, postoperative infection, and alveolar osteitis. The secondary outcome measures were several self-care behaviors. Data were analyzed using repeated-measures analysis of variance and paired-samples t tests.

RESULTS

A total of 54 patients (25 men and 29 women; mean age, 25.1 years) were enrolled, with a total of 108 surgically removed impacted mandibular third molars. The use of an iodine tampon resulted in a significantly lower impact on OHRQoL (mean of 21.5 [standard deviation (SD), 9.6] vs 26.5 [SD, 10.6]) on the first postoperative day, which was observable until the seventh postoperative day. In addition, after removal of the impacted third molar, patients with the iodine tampon condition reported less pain (mean of 5.2 [SD, 1.9] vs 6.1 [SD, 2.1] on day 1, lasting throughout the week), less use of painkillers, less limited mouth opening, fewer problems chewing, less swelling, and earlier recovery.

CONCLUSIONS

The use of postoperative iodine packing after the removal of impacted mandibular third molars significantly reduces OHRQoL and postoperative sequelae.

摘要

目的

本研究旨在评估下颌第三磨牙手术后碘棉塞对术后第一周口腔健康相关生活质量(OHRQoL)、止痛药使用情况、术后后遗症及自我护理行为的影响。

材料与方法

这项前瞻性、交叉、随机对照研究纳入了接受双侧对称水平阻生下颌第三磨牙手术拔除的患者。手术部位随机分为术后接受碘棉塞处理或伤口缝合并用莫诺洁注射器(泰科/医疗保健 - 肯德尔公司,马萨诸塞州曼斯菲尔德)冲洗。术后第一周每天测量的主要结局指标为口腔健康影响量表14得分和术后后遗症,包括疼痛、肿胀、张口受限、术后感染及干槽症。次要结局指标为几种自我护理行为。数据采用重复测量方差分析和配对样本t检验进行分析。

结果

共纳入54例患者(25例男性和29例女性;平均年龄25.1岁),共拔除108颗阻生下颌第三磨牙。使用碘棉塞在术后第一天对OHRQoL的影响显著更低(均值21.5[标准差(SD),9.6]对比26.5[SD,10.6]),这种差异在术后第七天仍可观察到。此外,拔除阻生第三磨牙后,使用碘棉塞的患者报告疼痛较轻(第1天均值5.2[SD,1.9]对比6.1[SD,2.1],持续一整周)、止痛药使用较少、张口受限较少、咀嚼问题较少、肿胀较轻且恢复较早。

结论

拔除阻生下颌第三磨牙后使用术后碘棉塞可显著降低OHRQoL及术后后遗症。

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