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“瓣改良对第三磨牙拔除结果的影响”——一项随机双盲研究。

"Effects of flap modification on third molar extraction outcomes"-A randomised split mouth study.

作者信息

Sridharan Geetha, Nakkeeran Komagan Prabhu, Andavan Gnanam, Raja V B Krishna Kumar

机构信息

Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, 600089, Tamil Nadu, India.

出版信息

J Oral Biol Craniofac Res. 2020 Oct-Dec;10(4):619-624. doi: 10.1016/j.jobcr.2020.08.010. Epub 2020 Aug 31.

Abstract

AIM

The main purpose of this experimental study was to compare whether modifications in flap design influence the post-operative outcome of third molar surgeries.

MATERIALS AND METHODS

This study was designed as a randomized, single-blinded,split-mouth cross-over comparative study. The predictor variables were the flap type; Conventional Ward's was used to expose the tooth with a difference in the anterior release incision between the groups.Oblique anterior releasing incision and vertical anterior releasing incisions were used for the control and study group respectively.The primary outcome variables were pain measured using VAS (Visual analogue scale), swelling in mm; mouth opening measured in mm, periodontal probing depth in a mm, wound healing by modified Landry's score and surgical accessibility. Statistical significance was set at 5% (α = 0.05).

RESULT

Twenty five patients with bilateral, mirror-image impacted mandibular third molars participated in the study.The study group was associated with moderate swelling that was not statistically significant. .The outcome variables i.e. pain, wound healing, mouth opening, and periodontal pocket depth had no statistical difference on comparing the two groups. In terms of accessibility, the control group was found to be better with the statistical significance of p = 0.00184.

CONCLUSION

Modifying conventional Ward's design influences the degree of swelling and surgical accessibility. Vertical anterior releasing incision in conventional Ward's has no advantage over conventional Ward's with oblique anterior releasing incision.

摘要

目的

本实验研究的主要目的是比较皮瓣设计的改变是否会影响第三磨牙手术的术后结果。

材料与方法

本研究设计为随机、单盲、双侧交叉对照研究。预测变量为皮瓣类型;采用传统沃德氏皮瓣暴露牙齿,两组在前庭切口上存在差异。对照组和研究组分别采用斜向前庭切口和垂直前庭切口。主要观察指标包括采用视觉模拟评分法(VAS)测量的疼痛、以毫米为单位测量的肿胀程度、以毫米为单位测量的开口度、以毫米为单位测量的牙周探诊深度、采用改良兰德里评分法评估的伤口愈合情况以及手术可达性。统计学显著性设定为5%(α = 0.05)。

结果

25例双侧镜像阻生下颌第三磨牙患者参与了本研究。研究组出现中度肿胀,但无统计学意义。比较两组时,观察指标即疼痛、伤口愈合、开口度和牙周袋深度无统计学差异。在可达性方面,发现对照组更佳,p值为0.00184,具有统计学意义。

结论

改良传统沃德氏设计会影响肿胀程度和手术可达性。传统沃德氏皮瓣中的垂直前庭切口相较于带有斜向前庭切口的传统沃德氏皮瓣并无优势。

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