Absi E G, Shepherd J P
Department of Oral Surgery, Medicine and Pathology, University of Wales, College of Medicine, Dental School, Cardiff, UK.
Int J Oral Maxillofac Surg. 1993 Jun;22(3):149-53. doi: 10.1016/s0901-5027(05)80240-1.
Fifty-two consecutive healthy patients with bilateral, similarly impacted mandibular third molars were studied. For each patient, both third molars were removed at the same operation by the same experienced operator. On one side, the lingual split method by chisel was used; on the other, the buccal approach with surgical bur. Standard preoperative and postoperative drug regimens were used. Pain, facial swelling (visual analogue scales), and lingual and labial sensory disturbance were recorded for each side by the patients at home 6, 24, and 48 h and 7 days after surgery. Wound healing was assessed at 4 weeks. There were no statistically significant differences between methods in relation to pain, facial swelling, sensory loss, infection, or periodontal pocket depth distal to the second molar, although 2% of third molars removed by chisel had lingual sensory disturbance at 7 days, as compared with 8% where burs had been used. There were no statistically significant differences between duration of procedures; mean operating time with burs was 8.28 min (range 4-15 min) and with chisels 7.57 min (range 4-15 min). This study provided no evidence of difference in either efficiency or outcome between two standard methods of removing lower third molars.
对52例双侧下颌第三磨牙均有类似阻生情况的连续健康患者进行了研究。对于每位患者，同一经验丰富的手术医生在同一次手术中拔除双侧第三磨牙。一侧采用凿子进行舌侧劈开法；另一侧采用手术牙钻的颊侧入路法。采用标准的术前和术后药物治疗方案。患者在术后6小时、24小时、48小时和7天在家中记录每侧的疼痛、面部肿胀（视觉模拟评分）以及舌侧和唇侧感觉障碍情况。在4周时评估伤口愈合情况。两种方法在疼痛、面部肿胀、感觉丧失、感染或第二磨牙远中牙周袋深度方面无统计学显著差异，不过，采用凿子拔除的第三磨牙中有2%在术后7天出现舌侧感觉障碍，而使用牙钻的这一比例为8%。手术时间无统计学显著差异；使用牙钻的平均手术时间为8.28分钟（范围4 - 15分钟），使用凿子的为7.57分钟（范围4 - 15分钟）。本研究未提供证据表明两种拔除下颌第三磨牙的标准方法在效率或结果上存在差异。
