目的:拔除下颌阻生第三磨牙(IMTM)是口腔颌面外科最常见的手术。下牙槽神经(IAN)损伤是一种罕见但严重的并发症,在下牙槽管(IAC)附近的IMTM病例中,风险明显更高。提取这种IMTM的现有手术方法不够安全或耗时。需要更好的外科手术设计。
方法:2019年8月至2022年6月,南京口腔医院赵医生对23例患者进行了IMTM摘除术,医学院附属医院,南京大学,并被发现在IAC附近有IMTM。由于IAN受伤风险很高,
结果:冠状动脉切除术-微型手术插入和完全切除IMTM之间的时间为32.65±2.110天,明显短于传统正畸牵引。两点辨别测试显示没有IAN受伤,随访期间患者未报告损伤。其他并发症,如严重肿胀,严重出血,干燥插座,和有限的张嘴,没有被观察到。与传统的IMTM拔除组相比,冠状动脉切除术-微型牵引组的术后疼痛水平并没有显着升高。
结论:对于靠近IAC且必须提取的IMTM,冠状动脉切除术-微型机组人员牵引是一种新颖的方法,可以以更省时的方式将IAN损伤的风险降至最低,并发症的可能性较低。
OBJECTIVE: Extraction of impacted mandibular third molars (IMTMs) is the most common surgery performed in the Department of Oral and Maxillofacial Surgery. Inferior alveolar nerve (IAN) injury is a rare but severe complication, and the risk is significantly higher in cases of IMTM near the inferior alveolar canal (IAC). The existing surgical method to extract such IMTMs is either not safe enough or is time-consuming. A better surgical design is needed.
METHODS: From August 2019 to June 2022, 23 patients underwent IMTM extraction by Dr. Zhao at Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, and were found to have IMTMs in close proximity to the IAC. Due to high IAN injury risk, these patients underwent coronectomy-miniscrew traction to extract their IMTMs.
RESULTS: The time between coronectomy-miniscrew insertion and complete removal of the IMTM was 32.65 ± 2.110 days, which was significantly shorter than that of traditional orthodontic traction. Two-point discrimination testing revealed no IAN injury, and no injury was reported by patients during follow-up. Other complications, such as severe swelling, severe bleeding, dry socket, and limited mouth opening, were not observed. Postoperative pain levels were not significantly higher in the coronectomy-miniscrew traction group than in the traditional IMTM extraction group.
CONCLUSIONS: For IMTMs that are in close proximity to the IAC and must be extracted, coronectomy-miniscrew traction is a novel approach to minimize the risk of IAN injury in a less time-consuming way with a lower possibility of complications.