Jeong Yeong Kon, Ku Jeong-Kui, Baik Sung Hyun, You Jae-Seek, Leem Dae Ho, Choi Sun-Kyu
Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Hospital, Armed Forces Medical Command, Saemaul-ro 117, Bundang-gu, Seongnam-si, 13634, Republic of Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Maxillofac Plast Reconstr Surg. 2021 Jan 19;43(1):4. doi: 10.1186/s40902-021-00291-w.
Several investigations have been performed for a postoperative edema after extraction, but the results have been controversial due to low objectivity or poorly reproducible assessments of the edema. The aim of this study was to suggest a classification and patterns of postoperative edema according to the anatomical division associated with extraction of mandibular third molar as a qualitative evaluation method.
This study was conducted forty-four mandibular third molars extracted and MRI was taken within 48 h after extraction. The postoperative edema space was classified by MRI (one anatomic component-buccinator muscle-and four fascial spaces-supra-periosteum space, buccal space, parapharyngeal space, and lingual space), and evaluated independently by two examiners. The inter-examiner reliability was calculated using Kappa statistics.
The evaluation of buccinator muscle edema showed good agreement and the fascial spaces showed constant high agreement. The incidence of postoperative edema was high in the following order: supra-periosteum space (75.00%), buccinator muscle (68.18%), parapharyngeal space (54.55%), buccal space (40.91%), and lingual space (25.00%).
Postoperative edema could be assessed clearly by each space, which showed a different tendency between the anatomic and fascial spaces.
针对拔牙术后水肿已开展了多项研究,但由于水肿评估的客观性低或重复性差,结果存在争议。本研究的目的是提出一种根据与下颌第三磨牙拔除相关的解剖分区对术后水肿进行分类和描述的方法,作为一种定性评估方法。
本研究纳入了44颗拔除的下颌第三磨牙,并在拔牙后48小时内进行了MRI检查。术后水肿区域通过MRI分为(一个解剖结构——颊肌——和四个筋膜间隙——骨膜上间隙、颊间隙、咽旁间隙和舌间隙),并由两名检查者独立评估。使用Kappa统计量计算检查者间的可靠性。
颊肌水肿的评估显示出良好的一致性,筋膜间隙显示出始终较高的一致性。术后水肿的发生率从高到低依次为:骨膜上间隙(75.00%)、颊肌(68.18%)、咽旁间隙(54.55%)、颊间隙(40.91%)和舌间隙(25.00%)。
术后水肿可通过各个间隙清晰评估,其在解剖间隙和筋膜间隙之间呈现出不同的趋势。