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第三磨牙手术中意外发生的下颌骨骨折:面对经验主义时手术技能的必要性

Accidental Intraoperative Mandibular Fracture in a Third Molar Surgery: When Surgical Skills Are Mandatory in the Face of Empiricism.

作者信息

Pinho John Nadson Andrade, da Mota Santana Lucas Alves, de Souza Leandro Napier, Kumar Paulo Nand, Júnior Paulo Almeida, de Almeida Souza Liane Maciel

机构信息

Department of Dentistry, Federal University of Sergipe (UFS), Aracaju, SE, Brazil.

Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

出版信息

Case Rep Dent. 2023 Jul 27;2023:2263554. doi: 10.1155/2023/2263554. eCollection 2023.

Abstract

Iatrogenic mandible fractures are rare complications from third molar removal surgeries. While most documented cases stress risk factors inherent to the patient and tooth presentation in fractures' etiology, appreciation of the risk factors underlying the practitioner's skills is scarce. Here, we describe an intraoperative fracture in a healthy 26-year-old female resulting from an incompatible surgical technique during the right mandibular third molar removal. The patient showed facial swelling, pain, malocclusion, and significant mobility of the fractured segment. The surgical management involved an intraoral open reduction with the installation of titanium plates for the fixation of the bone segments. Thus, we highlight that acknowledging the extent of the operator's surgical skills should be part of comprehensive treatment planning, serving as a valuable measure to prevent iatrogenic mandible fractures besides avoiding a traumatic experience for the patient.

摘要

医源性下颌骨骨折是第三磨牙拔除手术中罕见的并发症。虽然大多数已记录的病例强调了骨折病因中患者和牙齿表现所固有的风险因素,但对于从业者技能背后的风险因素的认识却很少。在此,我们描述了一名26岁健康女性在右侧下颌第三磨牙拔除过程中因手术技术不兼容而发生的术中骨折。患者出现面部肿胀、疼痛、咬合不正以及骨折段明显活动。手术治疗包括口内切开复位并安装钛板以固定骨段。因此,我们强调,认识到术者手术技能的程度应成为综合治疗计划的一部分,这是预防医源性下颌骨骨折的一项重要措施,同时也能避免患者经历创伤性体验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56d5/10400297/2ac3613628b0/CRID2023-2263554.001.jpg

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