国际口腔医学杂志

国际口腔医学杂志 ›› 2017, Vol. 44 ›› Issue (2): 153-156.doi: 10.7518/gjkq.2017.02.007

• 论著 • 上一篇    下一篇

改良三角瓣对下颌第三磨牙拔除术后并发症的影响及其临床应用

张睿1, 张玲阁1, 李喜红1, 李锐2   

  1. 1.郑州市口腔医院口腔颌面外科 郑州 450000;
    2.郑州大学第一附属医院口腔颌面外科 郑州 450000
  • 收稿日期:2016-04-27 出版日期:2017-03-01 发布日期:2017-03-01
  • 通讯作者: 李锐,副主任医师,博士,Email：zzulirui@126.com
  • 作者简介:张睿,主治医师,硕士,Email：184354316@qq.com
  • 基金资助:
    国家自然科学基金（81300843）

Influence of improved triangular flap on postoperative complications after mandibular third molar removal and its clinical application

Zhang Rui, Zhang Lingge, Li Xihong, Li Rui   

  1. 1. Dept. of Oral and Maxillofacial Surgery, Zhengzhou Stomatological Hospital, Zhengzhou 450000, China;
    2. Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
  • Received:2016-04-27 Online:2017-03-01 Published:2017-03-01
  • Supported by:
    This study was supported by the National Natural Science Foundation of China(81300843).

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摘要： 目的通过对比改良三角瓣与传统三角瓣对下颌近中阻生第三磨牙拔除术后并发症的影响,探讨改良三角瓣的临床应用。方法选取110例门诊就诊需要拔除第三磨牙的患者,随机分为2组：改良三角瓣组和传统三角瓣组,记录患者术后2、7 d的疼痛程度、肿胀程度和张口受限程度,进行组间比较。结果术后2 d,改良三角瓣组的肿胀程度（Z=-3.432）和张口受限程度（t=19.188）均小于传统三角瓣组,其差异有统计学意义（P<0.05）,但术后7 d无此差别（P>0.05）。而在疼痛程度方面,两者在术后2 d和术后7 d均未看到明显差异（P>0.05）。结论与传统三角瓣相比,改良三角瓣早期并发症更轻,熟练掌握后操作更容易,值得推广。

关键词: 翻瓣设计, 改良三角瓣, 传统三角瓣, 下颌第三磨牙拔除术, 术后并发症

Abstract: Objective This study evaluated the effects of two different flap designs(improved triangular flap and traditional triangular flap) on mandibular third molar post-surgical complications, and to investigate the clinical application of the improved triangular flap. Methods A total of 110 patients were selected in our hospital between October 2015 and April 2016, and were randomly divided into two groups(improved triangular flap group and traditional triangular flap group). Data of postoperative swelling, pain and trismus were recorded 2 and 7 days after surgery, and compared between the two groups. Results There were less severe facial swelling(Z=-3.432, P<0.05) and trismus(t=19.188, P<0.05) in improved triangular flap group after two days compared with that in the traditional triangular flap group. However, no significant differences were found in the two groups(P>0.05) after 7 days. There were no significant differences in postoperative pain after 2 and 7 days between two flap designs(P>0.05). Conclusion The improved triangular flap is more beneficial to the early recovery of patients after surgery and easier to master for surgeons.

Key words: flap designs, improved triangular flap, traditional triangular flap, mandibular third molar extraction surgery, postoperative complications

中图分类号: 

  • R782.11
[1] Piecuch JF. What strategies are helpful in the ope-rative management of third molars[J]. J Oral Maxi-llofac Surg, 2012, 70(9 Suppl 1):S25-S32.
[2] 杨建, 白晓峰, 卢利. 2种拔除阻生下颌第三磨牙手术切口的比较[J]. 中国口腔颌面外科杂志, 2012, 10(3):249-252. Yang J, Bai XF, Lu L. Comparison of two incisions for removal of impacted mandibular third molar[J]. Chin J Oral Maxillofac Surg, 2012, 10(3):249-252.
[3] 乔峰, 朱东望. 封套瓣与三角瓣对下颌第三磨牙拔除术后并发症的影响[J]. 天津医药, 2015, 43(1): 78-81. Qiao F, Zhu DW. The influence of the envelope flap and triangular flap designs on postoperative com-plications after mandibular third molar removal[J]. Tianjin Med J, 2015, 43(1):78-81.
[4] 张玉波. 两种翻瓣术在拔除下颌阻生智齿中的不良反应观察[J]. 温州医科大学学报, 2015(6):452- 454. Zhang YB. Adverse effect report about the 2 diffe-rence flap designs after mandibular third molar removal[J]. J Wenzhou Med Univ, 2015(6):452- 454.
[5] Andersson L, Kahnberg KE, Pogrel MA. Oral and maxillofacial surgery[M]. Oxford:Wiley-Blackwell, 2010:179-338.
[6] Price DD, McGrath PA, Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain[J]. Pain, 1983, 17 (1):45-56.
[7] 胡开进, 李永锋, 吴迪. 微动力系统在牙拔除术中的应用[J]. 华西口腔医学杂志, 2015, 33(1):1-5. Hu KJ, Li YF, Wu D. Application of micro-power system in the surgery of tooth extraction[J]. West Chin J Stomatol, 2015, 33(1):1-5.
[8] Jerjes W, El-Maaytah M, Swinson B, et al. Experi-ence versus complication rate in third molar surgery [J]. Head Face Med, 2006, 2:14.
[9] 李永锋, 周宏志, 胡开进. 预防拔牙并发症的基本原则[J]. 中国实用口腔科杂志, 2014, 7(9):513-516. Li YF, Zhou HZ, Hu KJ. Basic principles on preven-ting tooth extraction complications[J]. Chin J Pract Stomatol, 2014, 7(9):513-516.
[10] 杨擎天, 胡开进, 薛洋, 等. 阻生下颌第三磨牙2种拔除方法的比较[J]. 实用口腔医学杂志, 2010, 26 (1):71-74. Yang QT, Hu KJ, Xue Y, et al. A comparison of two methods of extracting impacted mandibular third molars[J]. J Pract Stomatol, 2010, 26(1):71-74.
[11] 张国权, 张国志, 翁汝涟, 等. 龈缘封套瓣用于拔除下颌阻生第三磨牙[J/CD]. 中华口腔医学研究杂志(电子版), 2010, 4(6):604-607. Zhang GQ, Zhang GZ, Weng RL, et al. Envelope flap used for the extraction of impacted mandibular third-molar[J/CD]. Chin J Stomatol Res(Elect Vers), 2010, 4(6):604-607.
[12] Baqain ZH, Al-Shafii A, Hamdan AA, et al. Flap design and mandibular third molar surgery: a split mouth randomized clinical study[J]. Int J Oral Maxillofac Surg, 2012, 41(8):1020-1024.
[13] Goldsmith SM, De Silva RK, Tong DC, et al. Influ-ence of a pedicle flap design on acute posto-perative sequelae after lower third molar removal[J]. Int J Oral Maxillofac Surg, 2012, 41(3):371-375.
[14] Kirk DG, Liston PN, Tong DC, et al. Influence of two different flap designs on incidence of pain, swelling, trismus, and alveolar osteitis in the week following third molar surgery[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007, 104(1):e1-e6.
[15] 周宏志, 胡开进. 下颌第三磨牙拔除术后疼痛的临床分析及预防[J]. 华西口腔医学杂志, 2010, 28(2): 153-157. Zhou HZ, Hu KJ. Pain and prevention in extraction of the mandibular third molar[J]. West Chin J Stomatol, 2010, 28(2):153-157.
[16] Gbotolorun OM, Arotiba GT, Ladeinde AL. Assess-ment of factors associated with surgical difficulty in impacted mandibular third molar extraction[J]. J Oral Maxillofac Surg, 2007, 65(10):1977-1983.
[17] 邱蔚六, 张震康, 张志愿. 口腔颌面外科学[M]. 6版. 北京: 人民卫生出版社, 2008:81-95. Qiu WL, Zhang ZK, Zhang ZY. Oral and maxillo-facial surgery[M]. 6th ed. Beijing: People’s Medical Publishing House, 2008:81-95.
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