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下颌阻生智齿的拔牙创口全缝合与半开放引流对术后反应的影响(1)
http://www.100md.com 2010年1月1日 《医学发展》 2010年第1期
下颌阻生智齿的拔牙创口全缝合与半开放引流对术后反应的影响
下颌阻生智齿的拔牙创口全缝合与半开放引流对术后反应的影响

     摘 要目的:观察下颌埋伏阻生智齿拔除后的创口作部分开放引流处理能否减轻术后肿胀反应。方法:380例下颌埋伏阻生智齿患者随机分为A、B两组,每组190人。A组拔牙后的创口粘膜瓣缝合后再作三角形切除6mm(毗邻第二磨牙的远中面)形成小窗口开放牙槽窝,B组作传统的疏松缝合,完全关闭牙槽窝。术后第三天复诊评估肿胀。结果:在A组中,有42例无肿胀出现(22.1%),B组全部出现肿胀。肿胀程度的比较,两组的轻度与中度相比均无显著性差异,但两组的重度相比,有显著性差异(P<0.005)。B组有3%患者术后一个月合并牙槽脓肿。结论:下颌埋伏阻生智齿拔牙后的牙槽窝宜小部分开放引流,可更有效减轻术后肿胀反应。

    关键词下颌智齿;埋伏阻生;创口;肿胀

    AbstractObjective:To evaluate the effect of partially open to the surgical wounds after removal of unerupted-impacted mandibular third molars on post-operative swelling. Methods: Three hundred and eighty patients with unerupted-impacted third molars were randomly divided into two groups of 190.Teeth were extracted, and in Group A a 6mm △ of mucosa adjacent to the second molar was excided in form of a small window for opening the socket. In Group B the socket was closed by tensionless suturing the flap. Swelling was evaluated on the third day after surgery. Results: There were 42 (22.1%) patients without swelling in Group B but in Group A. And there was significantly difference (P<0.005)between two groups at degree of severe swelling except degree of slight and medium.In Group B 3% of patients showed signs of suppurative alveolitis with re-infection of the socket at about a month after surgery. Conclusion: The socket of surgical wound should be open slightly after extraction of unerupted-impacted mandibular third molar for reducing in more effect of post-operative swelling. ......
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