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超声骨刀与传统器械在下颌第三磨牙阻生齿拔除术中术后并发症及牙槽骨再生的对比分析:一项随机对照临床研究。

A comparative analysis of postoperative morbidity and alveolar bone regeneration following surgical extraction of ımpacted lower third molar teeth using piezosurgery and conventional ınstruments: a split-mouth clinical ınvestigation.

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Lokman Hekim University, Söğütözü Mahallesi, 2179 Caddesi, No: 6, Çankaya, Ankara, Turkey.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Emniyet Mahallesi, Yenimahalle, Ankara, Turkey.

出版信息

Eur J Med Res. 2024 Sep 14;29(1):460. doi: 10.1186/s40001-024-02051-8.

DOI:10.1186/s40001-024-02051-8
PMID:39272144
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11401435/
Abstract

BACKGROUND-OBJECTIVE(S): This randomized, split-mouth study aimed to compare postoperative complications following the surgical extraction of impacted lower third molars using piezosurgery versus conventional rotary instruments.

MATERIALS AND METHODS

Twenty-one patients, aged 18-35 years, with bilaterally and symmetrically impacted lower third molars, were randomly assigned to undergo extraction using piezosurgery on one side and conventional rotary instruments on the other.

RESULTS

The piezosurgery method required a longer operation time. However, it resulted in quicker resolution of postoperative swelling by the 7th day compared to the conventional method, where swelling persisted longer. Mandibular angle-tragus measurements were significantly higher with the conventional method on the 1st, 3rd, and 7th postoperative days. Although mouth opening decreased significantly after piezosurgery, it returned to preoperative levels by the 7th day, outperforming the conventional method. Postoperative pain was notably higher with the conventional method during the first four days but showed no significant difference from the 5th day onward. Alveolar bone healing was significantly better with piezosurgery at the 3rd and 6th months. Temporary paresthesia occurred in one patient from the conventional group, resolving within four weeks. Neither method resulted in alveolar osteitis.

CONCLUSION(S): Within the study's limitations, piezosurgery demonstrated a reduction in postoperative discomfort, suggesting its advantage in enhancing patient recovery following lower third molar extractions.

CLINICAL SIGNIFICANCE

Piezosurgery, when used appropriately, can reduce postoperative complications compared to conventional methods. Clinicians should be aware of its indications, benefits, and potential challenges. Trial registration This study was registered as a clinical trial to the ClinicalTrials.gov, and the registration ID is NCT06262841 ( https://clinicaltrials.gov/study/NCT06262841 ).

摘要

背景目的

本随机、分口研究旨在比较使用超声骨刀和传统旋转器械行下颌第三磨牙阻生齿拔除术后的并发症。

材料与方法

21 名年龄在 18-35 岁之间、双侧且对称的下颌第三磨牙阻生患者,随机分为超声骨刀法组和传统旋转器械组。

结果

超声骨刀法组手术时间较长,但术后第 7 天肿胀消退速度快于传统组,后者肿胀持续时间较长。术后第 1、3、7 天,传统组的下颌角-耳垂测量值显著更高。尽管超声骨刀法组术后张口度显著下降,但第 7 天已恢复至术前水平,优于传统组。术后疼痛在传统组前 4 天显著更高,但第 5 天以后无显著差异。第 3、6 个月时,超声骨刀法组牙槽骨愈合明显更好。传统组 1 例患者出现短暂性感觉异常,4 周内缓解。两种方法均未发生牙槽骨炎。

结论

在本研究的限制范围内,超声骨刀法术后不适感降低,提示其在促进下颌第三磨牙拔除术后患者恢复方面具有优势。

临床意义

在适当使用的情况下,超声骨刀法与传统方法相比可减少术后并发症。临床医生应了解其适应证、优势和潜在挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1217/11401435/ec72447f9404/40001_2024_2051_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1217/11401435/4cf1aacb70f1/40001_2024_2051_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1217/11401435/ec72447f9404/40001_2024_2051_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1217/11401435/4cf1aacb70f1/40001_2024_2051_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1217/11401435/ec72447f9404/40001_2024_2051_Fig2_HTML.jpg

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