Zheng X, Lin X, Wang Z
Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University (Guangdong Provincial Stomatological Hospital).
Br J Oral Maxillofac Surg. 2020 Sep;58(7):829-833. doi: 10.1016/j.bjoms.2020.03.029. Epub 2020 Jun 15.
The aim of this study was to investigate the clinical effect of the extraction of low horizontally impacted mandibular third molars by three-piece tooth sectioning. Sixty patients with low horizontally and buccally-impacted mandibular third molars on both sides were operated on under local anaesthesia. Three-piece tooth sectioning was used on one side (n=60) and the molars were extracted using a high-frequency electric knife, 45° reversed-angle high-speed turbine, and special long crank drill. Each molar was cut into three pieces, which were removed in the following order: middle, root, and crown. One month later, the molars on the other side of each patient's jaw were removed by conventional extraction (n=60) with the same equipment. The crown was cut and removed first, and then the remaining piece was extracted. The duration of the procedure, and incidence postoperative swelling, pain, and trismus were compared between the two groups. The procedure was shorter with the three-piece method (10.05 (0.51) min) than with the conventional method (20.15 (0.88) min, p<0.01). Postoperative swelling, pain, and trismus were all less severe with the three-piece method than with the conventional method (p<0.01). Three-piece tooth sectioning could be used to remove low horizontally and buccally-impacted mandibular third molars, as it can shorten the duration of the procedure, reduce trauma, and reduce the incidence of postoperative complications.
本研究的目的是探讨三段式牙切割法拔除低位水平阻生下颌第三磨牙的临床效果。60例双侧低位水平颊向阻生下颌第三磨牙患者在局部麻醉下接受手术。一侧采用三段式牙切割法（n = 60），使用高频电刀、45°反角高速涡轮机和特制长柄钻拔除磨牙。每颗磨牙切成三块，按以下顺序取出：中间部分、牙根和牙冠。1个月后，用相同设备对每位患者下颌另一侧的磨牙采用传统拔牙法拔除（n = 60）。先切割并拔除牙冠，然后拔除剩余部分。比较两组手术时间、术后肿胀、疼痛和张口受限的发生率。三段式方法的手术时间（10.05（0.51）分钟）比传统方法（20.15（0.88）分钟，p<0.01）短。三段式方法术后肿胀、疼痛和张口受限均比传统方法轻（p<0.01）。三段式牙切割法可用于拔除低位水平颊向阻生下颌第三磨牙，因为它可以缩短手术时间，减少创伤，并降低术后并发症的发生率。
