Institute of Maxillofacial Surgery, Teknon Medical Center, Carrer de Vilana, 12 (Desp. 185), 08022, Barcelona, Spain.
Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
Oral Maxillofac Surg. 2024 Mar;28(1):345-353. doi: 10.1007/s10006-023-01148-4. Epub 2023 Mar 24.
To carry out a comparative evaluation of the intra- and postoperative complications, and bone healing, following bilateral sagittal split osteotomy (BSSO) with or without concomitant removal of third molars.
A retrospective analysis was performed of two cohorts subjected to BSSO with the intraoperative removal of third molars (test group) versus the removal of third molars at least 6 months prior to BSSO (control group), comprising at least 1 year of clinical and radiographic follow-up. Partially or completely erupted third molars were extracted immediately before completing the osteotomy, whereas impacted third molars were removed after the osteotomy had been performed. Hardware reinforcement was performed in bimaxillary cases where concomitant molar extraction impeded placement of the retromolar bicortical screw of the hybrid technique.
A total of 80 surgical sites were included (40 in each group). Concomitant extraction of the molar represented a mean increase in surgery time of 3.7 min (p < 0.001). No additional complications occurred in the test group (p = 0.476). The gain in bone density was preserved in both groups (p = 0.002), and the increase was of the same magnitude in both (p = 0.342), despite the fact that the immediate and final postoperative bone densities were significantly higher in the control group (p = 0.020).
The results obtained support concomitant molar extraction with BSSO as a feasible option.
对双侧矢状劈开截骨术（BSSO）伴或不伴第三磨牙同时去除的术中及术后并发症和骨愈合情况进行对比评估。
对两组接受 BSSO 手术的患者进行回顾性分析，其中一组术中同时去除第三磨牙（试验组），另一组至少在 BSSO 前 6 个月去除第三磨牙（对照组），均进行了至少 1 年的临床和影像学随访。在完成截骨术之前，立即拔除部分或完全萌出的第三磨牙，而对于阻生的第三磨牙，则在截骨术后拔除。在双颌病例中，如果同时拔除磨牙会妨碍混合技术中磨牙后皮质骨双皮质螺钉的放置，则进行硬件加固。
共纳入 80 个手术部位（每组 40 个）。第三磨牙同时拔除会使手术时间平均增加 3.7 分钟（p<0.001）。试验组未发生其他并发症（p=0.476）。两组的骨密度均有所增加（p=0.002），且增加幅度相同（p=0.342），尽管对照组的即刻和最终术后骨密度明显更高（p=0.020）。
研究结果支持 BSSO 伴第三磨牙同时去除是一种可行的选择。
