Qi Wei, Qian Jing, Zhou Wei, Li Jiannan, Mao Bochun, Wen Aonan, Zhao Yijiao, Pan Jie, Wang Yong
Department of General Dentistry, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
Clin Oral Investig. 2023 Apr;27(4):1499-1507. doi: 10.1007/s00784-022-04769-3. Epub 2022 Nov 14.
This prospective study introduced a digitally designed sectioning guide and evaluated its feasibility for the extraction of horizontally impacted lower third molars.
This study included 38 horizontally impacted lower third molars, randomly divided into experimental and control groups. The teeth were extracted using a 3D-printed titanium surgical guide in the experimental group; free-hand extractions were performed in the control group. The surgical duration, tooth sectioning duration, cortical bone perforation, and postoperative complications, including pain, swelling, trismus, dry socket, infection, and hemorrhage, were evaluated.
Although not statistically significant, guided surgery tended to reduce the number of tooth sectioning steps compared to free-hand extractions. There were no cases of cortical bone perforation in the experimental group. Although the surgical duration was greater in the experimental group (p < 0.05), there were no differences in postoperative pain, swelling, and trismus. There were no cases of postoperative infection and hemorrhage in either group.
3D-printed titanium surgical guides had superior accuracy and safety compared to free-hand surgery. Further studies with larger sample sizes are required to verify these findings.
The template improved the safety of tooth sectioning during impacted lower third molar surgery and resulted in a more predictable extraction. The narrow sectioning groove could fit comfortably with hypertrophic soft tissues in the posterior mandible.
本前瞻性研究引入了一种数字化设计的截骨导板，并评估其用于拔除水平阻生下颌第三磨牙的可行性。
本研究纳入38颗水平阻生下颌第三磨牙，随机分为实验组和对照组。实验组使用3D打印钛制手术导板拔牙；对照组采用徒手拔牙。评估手术时长、牙齿截骨时长、皮质骨穿孔情况以及术后并发症，包括疼痛、肿胀、张口受限、干槽症、感染和出血。
与徒手拔牙相比，尽管无统计学意义，但引导手术倾向于减少牙齿截骨步骤的数量。实验组无皮质骨穿孔病例。尽管实验组手术时长更长（p < 0.05），但术后疼痛、肿胀和张口受限方面无差异。两组均无术后感染和出血病例。
与徒手手术相比，3D打印钛制手术导板具有更高的准确性和安全性。需要更大样本量的进一步研究来验证这些发现。
该模板提高了阻生下颌第三磨牙手术中牙齿截骨的安全性，并使拔牙更具可预测性。狭窄的截骨槽能舒适地适配下颌后部肥厚的软组织。
