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下颌阻生第三磨牙拔除后下牙槽神经的神经感觉缺损:一期完整拔除与二期分阶段牙冠切除术手术技术的比较

Neurosensory Deficits of Inferior Alveolar Nerve Following Impacted Mandibular Third Molar Extraction: Comparison of One-Stage Complete Extraction with Two-Stage Partial Coronectomy Surgical Technique.

作者信息

James Olutayo, Oyeneyin Aliyu Ope, Adeyemi Michael Olayinka, Erinoso Olufemi Akinwunmi, Adekunle Adeola Adegbayi, Adeyemo Wasiu Lanre

机构信息

Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria.

Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria.

出版信息

J Maxillofac Oral Surg. 2023 Mar;22(1):178-186. doi: 10.1007/s12663-021-01601-5. Epub 2021 Jun 13.

Abstract

OBJECTIVES

Inferior alveolar nerve neurosensory deficit is a worrisome complication of surgical extraction of impacted mandibular third molars. A novel approach using two-stage partial coronectomy has been proposed as an alternative surgical procedure to reduce this complication. This study compared neurosensory deficits of inferior alveolar nerve following impacted mandibular third molar extraction using one-stage complete extraction with the two-stage partial coronectomy technique.

MATERIAL AND METHODS

Subjects with mesioangular or horizontal impacted mandibular third molar with an intimate relationship with inferior dental canal who met the inclusion criteria were recruited for the study. Subjects were divided into one-stage and two-stage partial coronectomy techniques. The subjects were evaluated for the presence of inferior alveolar neurosensory deficit, and the relationships of neurosensory nerve deficit with sex, age and type of impaction.

RESULTS

Neurosensory deficit was observed in 5 subjects (7.8%), with all cases seen in the one-stage group. This difference was statistically significant ( = 0.03). The relationship between the incidence of neurosensory deficit and age, sex, type of impaction, surgical difficulty, operating time and root morphology was not statistically significant ( > 0.05).

CONCLUSION

Findings from this study suggest partial coronectomy compared to one-stage complete extraction reduces the incidence of Inferior alveolar nerve neurosensory deficit.

摘要

目的

下牙槽神经感觉功能障碍是下颌阻生第三磨牙拔除术后令人担忧的并发症。一种采用两阶段部分冠切除术的新方法已被提出作为一种替代手术程序以减少该并发症。本研究比较了采用一期完整拔除术与两阶段部分冠切除术拔除下颌阻生第三磨牙后下牙槽神经的感觉功能障碍情况。

材料与方法

招募符合纳入标准的近中阻生或水平阻生下颌第三磨牙且与下牙槽神经管关系密切的受试者进行研究。受试者分为一期手术组和两阶段部分冠切除术组。评估受试者下牙槽神经感觉功能障碍的情况,以及感觉神经功能障碍与性别、年龄和阻生类型的关系。

结果

5名受试者(7.8%)出现感觉功能障碍,所有病例均见于一期手术组。这种差异具有统计学意义(P = 0.03)。感觉功能障碍的发生率与年龄、性别、阻生类型、手术难度、手术时间和牙根形态之间的关系无统计学意义(P > 0.05)。

结论

本研究结果表明,与一期完整拔除术相比,部分冠切除术可降低下牙槽神经感觉功能障碍的发生率。

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