国际口腔医学杂志

国际口腔医学杂志 ›› 2023, Vol. 50 ›› Issue (6): 718-722.doi: 10.7518/gjkq.2023105

• 综述 • 上一篇    下一篇

评估下颌第三磨牙拔除难度分类方法的概述

柴安1(),雷荣昌2(),蒋智升2,曲彬彬2,郭锦材3,李鹤2,邵奇2   

  1. 1.湖南中医药大学附属口腔医院口腔颌面外科 长沙 410208
    2.长沙市口腔医院口腔颌面外科 长沙 410006
    3.长沙市口腔医院药剂科 长沙 410006
  • 收稿日期:2023-02-08 修回日期:2023-07-12 出版日期:2023-11-01 发布日期:2023-10-24
  • 通讯作者: 雷荣昌
  • 作者简介:柴安，医师，硕士，Email： chaian123@yeah.net

Review of classification methods for evaluating the difficulty of mandibular third molar extraction

Chai An1(),Lei Rongchang2(),Jiang Zhisheng2,Qu Binbin2,Guo Jincai3,Li He2,Shao Qi2   

  1. 1.Dept. of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Hunan University of Chinese Medicine, Changsha 410208, China
    2.Dept. of Oral and Maxillofacial Surgery, Changsha Stomatological Hospital, Changsha 410006, China
    3.Dept. of Pharmacy, Changsha Stomatological Hospital, Changsha 410006, China
  • Received:2023-02-08 Revised:2023-07-12 Online:2023-11-01 Published:2023-10-24
  • Contact: Rongchang Lei

RichHTML

35

PDF (PC)

483

摘要：

为了选择合适的拔除方法，一般通过口内检查辅以影像学检查来评估下颌第三磨牙位置关系及拔除难度。目前在临床上应用广泛的下颌第三磨牙分类主要有Winter分类和Pell-Gregory分类，但有研究表明评估结果和实际偏差较大，临床适用性不强。因此，学者们以此为基础，结合下颌第三磨牙的解剖学特点，进行更细化的分类，提出了如Pederson指数、综合阻生指数、Juodzbalys和Daugela分类法等。本文对评估下颌第三磨牙拔除难度的分类方法进行概述，为更安全高效地拔除下颌第三磨牙提供参考依据。

关键词: 下颌第三磨牙, 拔除难度, 分类方法, 预测模型

Abstract:

To select an appropriate extraction method, the position relationship and extraction difficulty of mandibular third molars are generally evaluated by intraoral examination and imaging examination. Now, the classification of mandi-bular third molars widely used in clinical practice mainly includes Winter classification and Pell-Gregory classification.Therefore some studies show that the evaluation results have a large deviation from the actual situation, and the clinical applicability is not strong. On this basis, the scholars combined with the anatomical characteristics of the mandibular third molar to make a more detailed classification, and proposed classification methods such as Pederson Index, Comprehensive Impacted Index, Juodzbalys and Daugela. This article summarizes the classification methods for evaluating the difficulty of mandibular third molar extraction, and provides a reference for safer and more efficient extraction of mandibular third molars.

Key words: mandibular third molars, difficulty of removal, classification method, forecast model

中图分类号: 

  • R 782
1 Vranckx M, Ockerman A, Coucke W, et al. Radiographic prediction of mandibular third molar eruption and mandibular canal involvement based on angulation[J]. Orthod Craniofac Res, 2019, 22(2): 118-123.
2 Alfadil L, Almajed E. Prevalence of impacted third molars and the reason for extraction in Saudi Arabia[J]. Saudi Dent J, 2020, 32(5): 262-268.
3 Synan W, Stein K. Management of impacted third molars[J]. Oral Maxillofac Surg Clin North Am, 2020, 32(4): 519-559.
4 Mello FW, Melo G, Kammer PV, et al. Prevalence of odontogenic cysts and tumors associated with impacted third molars: a systematic review and meta-analysis[J]. J Craniomaxillofac Surg, 2019, 47(6): 996-1002.
5 Chung KR, Noh MK, Oh SH, et al. Treatment of 2 impacted molars in a large dentigerous cyst (expan-sile cystic lesion) with combined orthodontic and surgical therapy[J]. Am J Orthod Dentofacial Orthop, 2020, 158(5): 752-758.
6 Hauer L, Seidlová P, Merglová V, et al. Complete removal of dentigerous cysts with preservation of associated teeth as an alternative to marsupialization in children and preadolescents[J]. J Craniomaxillofac Surg, 2020, 48(8): 808-814.
7 Primo FT, Primo BT, Scheffer MAR, et al. Evaluation of 1211 third molars positions according to the classification of Winter, Pell & Gregory[J]. Int J Odontostomat, 2017, 11(1): 61-65.
8 Khojastepour L, Khaghaninejad MS, Hasanshahi R, et al. Does the Winter or Pell and Gregory classification system indicate the apical position of impacted mandibular third molars[J]. J Oral Maxillofac Surg, 2019, 77(11): 2222.e1-2222.e9.
9 Santos KK, Lages FS, Maciel CAB, et al. Prevalence of mandibular third molars according to the Pell & Gregory and Winter classifications[J].J Maxillofac Oral Surg, 2022, 21(2): 627-633.
10 Gümrükçü Z, Balaban E, Karabağ M. Is there a relationship between third-molar impaction types and the dimensional/angular measurement values of posterior mandible according to Pell & Gregory/Winter Classification[J]. Oral Radiol, 2021, 37(1): 29-35.
11 Korkmaz YT, Kayıpmaz S, Senel FC, et al. Does additional cone beam computed tomography decrease the risk of inferior alveolar nerve injury in high-risk cases undergoing third molar surgery? Does CBCT decrease the risk of IAN injury[J]. Int J Oral Maxillofac Surg, 2017, 46(5): 628-635.
12 Bhansali SP, Bhansali S, Tiwari A. Review of difficulty indices for removal of impacted third molars and a new classification of difficulty indices[J]. J Maxillofac Oral Surg, 2021, 20(2): 167-179.
13 Akadiri OA, Obiechina AE. Assessment of difficulty in third molar surgery-a systematic review[J].J Oral Maxillofac Surg, 2009, 67(4): 771-774.
14 Mohanty R, Rout P, Singh V. Preoperative anatomic evaluation of the relationship between inferior alveo-lar nerve canal and impacted mandibular third molar in a population of Bhubaneswar, Odisha, using CBCT: a hospital-based study[J]. J Maxillofac Oral Surg, 2020, 19(2): 257-262.
15 Wihokrut S, Vorakulpipat C, Manosuthi P, et al. Proximity of mandibular third molar root(s) to surrounding cortical bone: cone beam computed tomo-graphy (CBCT) and panoramic findings[J]. Oral Maxillofac Surg, 2022, 26(2): 311-319.
16 Sammartino G, Gasparro R, Marenzi G, et al. Extraction of mandibular third molars: proposal of a new scale of difficulty[J]. Br J Oral Maxillofac Surg, 2017, 55(9): 952-957.
17 Koerner KR. The removal of impacted third molars.Principles and procedures[J]. Dent Clin North Am, 1994, 38(2): 255-278.
18 Akadiri OA, Obiechina AE. Assessment of difficulty in third molar surgery-a systematic review[J]. J Oral Maxillofac Surg, 2009, 67(4): 771-774.
19 Yuasa H, Kawai T, Sugiura M. Classification of surgical difficulty in extracting impacted third molars[J]. Br J Oral Maxillofac Surg, 2002, 40(1): 26-31.
20 Diniz-Freitas M, Lago-Méndez L, Gude-Sampedro F, et al. Pederson scale fails to predict how difficult it will be to extract lower third molars[J]. Br J Oral Maxillofac Surg, 2007, 45(1): 23-26.
21 Carvalho RW, do Egito Vasconcelos BC. Assessment of factors associated with surgical difficulty during removal of impacted lower third molars[J]. J Oral Maxillofac Surg, 2011, 69(11): 2714-2721.
22 Juodzbalys G, Daugela P. Mandibular third molar impaction: review of literature and a proposal of a classification[J]. J Oral Maxillofac Res, 2013, 4(2): e1.
23 徐光宙, 杨驰, 范新东, 等. 以下颌神经管为参照的下颌阻生第三磨牙的分类及临床意义[J]. 中国口腔颌面外科杂志, 2014, 12(2): 131-135.
Xu GZ, Yang C, Fan XD, et al. Classification and clinical significance of mandibular impacted third molars with reference to mandibular nerve canal[J]. Chin J Oral Maxillofac Surg, 2014, 12(2): 131-135.
24 楚德国. 下颌第三磨牙阻生类型与手术时间关系及临床分类研究[J]. 口腔医学, 2014, 34(1): 59-61.
Chu DG. Study of the relationship between the impaction types and the extraction time of mandibular third molars and clinical classification[J]. Stomatology, 2014, 34(1): 59-61.
25 Zhang XY, Wang LX, Gao ZH, et al. Development of a new index to assess the difficulty level of surgical removal of impacted mandibular third molars in an Asian population[J]. J Oral Maxillofac Surg, 2019, 77(7): 1358.e1-1358.e8.
26 Yoo JH, Yeom HG, Shin W, et al. Deep learning based prediction of extraction difficulty for mandi-bular third molars[J]. Sci Rep, 2021, 11(1): 1954.
27 Susarla SM, Dodson TB. Risk factors for third molar extraction difficulty[J]. J Oral Maxillofac Surg, 2004, 62(11): 1363-1371.
28 Peñarrocha-Diago M, Camps-Font O, Sánchez-Torres A, et al. Indications of the extraction of symptomatic impacted third molars. A systematic review[J]. J Clin Exp Dent, 2021, 13(3): e278-e286.
29 Almendros-Marqués N, Berini-Aytés L, Gay-Escoda C. Evaluation of intraexaminer and interexami-ner agreement on classifying lower third molars according to the systems of Pell and Gregory and of Winter[J]. J Oral Maxillofac Surg, 2008, 66(5): 893-899.
30 Chuang SK, Perrott DH, Susarla SM, et al. Risk factors for inflammatory complications following third molar surgery in adults[J]. J Oral Maxillofac Surg, 2008, 66(11): 2213-2218.
31 雷飞, 倪菁, 王丹杨. 微创拔牙技术在下颌埋伏阻生智齿拔除过程中的应用研究[J]. 临床口腔医学杂志, 2020, 36(6): 338-341.
Lei F, Ni J, Wang DY. Application of minimally invasive tooth extraction technology in extraction of mandibular unerupted-impacted wisdom teeth[J].J Clin Stomatol, 2020, 36(6): 338-341.
[1] 谢瑜,周懿. 截冠术：下颌第三磨牙保守拔除术[J]. 国际口腔医学杂志, 2020, 47(1): 17-21.
[2] 张睿, 张玲阁, 李喜红, 李锐. 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[J]. 国际口腔医学杂志, 2017, 44(2): 153-156.
[3] 胡艺蝶 周力 王艳民. 拔牙矫治与下颌第三磨牙萌出状况的关系[J]. 国际口腔医学杂志, 2015, 42(3): 367-370.
[4] 姜世同1 刘军2 陈玉长2 王作君3 马德庆1 焦广军1 姜良坤1. 近中水平阻生下颌第三磨牙的矫治探索[J]. 国际口腔医学杂志, 2012, 39(6): 730-732.
[5] 周宏志综述 胡开进审校. 下颌阻生第三磨牙拔除创伤控制的相关研究[J]. 国际口腔医学杂志, 2010, 37(4): 470-473.
[6] 钟时春综述 张志光审校. 半导体激光在下颌第三磨牙拔除术后并发症预防的应用进展[J]. 国际口腔医学杂志, 2010, 37(3): 355-355～358.
[7] 何苇1，谢文扬1，刘夏诚2. 冠周炎的发生于下颌第三磨牙位置的相关研究[J]. 国际口腔医学杂志, 2009, 36(1): 1-1～3.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 张京剧. 青年期至中年期颅面复合体变化的头影测量研究[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 刘玲. 镍铬合金中铍对可铸造性和陶瓷金属结合力的影响[J]. 国际口腔医学杂志, 1999, 26(06): .
[3] 王昆润. 在种植体上制作固定义齿以后下颌骨密度的动态变化[J]. 国际口腔医学杂志, 1999, 26(06): .
[4] 王昆润. 修补颌骨缺损的新型生物学相容材料[J]. 国际口腔医学杂志, 1999, 26(06): .
[5] 陆加梅. 不可复性关节盘移位患者术前张口度与关节镜术后疗效的相关性[J]. 国际口腔医学杂志, 1999, 26(06): .
[6] 王昆润. 重型颌面部炎症死亡和康复病例的实验室检查指标比较[J]. 国际口腔医学杂志, 1999, 26(06): .
[7] 王昆润. 二甲亚砜和双氯芬酸并用治疗根尖周炎[J]. 国际口腔医学杂志, 1999, 26(06): .
[8] 汤庆奋,王学侠. 17β-雌二醇对人类阴道和口腔颊粘膜的渗透性[J]. 国际口腔医学杂志, 1999, 26(06): .
[9] 王昆润. 咀嚼口香糖对牙周组织微循环的影响[J]. 国际口腔医学杂志, 1999, 26(06): .
[10] 宋红. 青少年牙周炎外周血分叶核粒细胞的趋化功能[J]. 国际口腔医学杂志, 1999, 26(06): .