背景:部分阻生下颌第三磨牙手术的手术伤口处理对恢复以及食物影响保留有很大影响。本研究使用临床参数和与健康相关的生活质量(HRQL)来比较氰基丙烯酸酯应用与传统缝合第三磨牙嵌塞手术的结果。
方法:这是一项针对门诊第三磨牙手术受试者的回顾性观察研究。每位参与者都签署了知情同意协议。纳入标准如下:存在至少一个部分阻生的下颌第三磨牙,术前全景X光片证实。排除标准如下:吸烟,诊断为糖尿病。在2020年6月至2023年9月之间,共有78名患者,平均年龄31.14岁(范围21-40岁,标准偏差9.14),包括在这项研究中-38名患者是男性,40例患者为女性。一组患者接受传统丝线缝合(G1=41例),而第二组(G2=37例)接受纤维蛋白海绵止血,海绵完全浸泡后,在血凝块上应用氰基丙烯酸酯凝胶并缝合12/0针以恢复二次闭合。测量了以下参数:HRQL,平均疼痛(AP),最大疼痛(MP),并发症评分(CS),面部肿胀(FS),和红斑.
结果:对于HRQL参数,发现G1期的口腔残疾显着升高,而G2期的AP显着升高(p<0.05)。G2期AP较高(p=0.0098),以及MP(p=0.001)。关于CS没有发现差异(p=0.0759)。FS和红斑在G1期更高(面部肿胀,p<0.0001,红斑p=0.0001)。
结论:在本研究的基础上,下颌第三磨牙手术后使用氰基丙烯酸酯似乎对减少术后口腔残疾有用,面部肿胀,拔牙后出现红斑,平均和中度疼痛增加:临床医生可以考虑在某些情况下使用它。
BACKGROUND: The management of the surgical wound of partially impacted mandibular third molar surgery has a great impact on recovery as well as on food impact retention. The present study used clinical parameters and health-related quality of life (HRQL) to compare outcomes of cyanoacrylate application versus traditional suture of third molar impaction surgery.
METHODS: This was a retrospective observational study of subjects scheduled for outpatient third molar surgery. Each participant signed an informed consent agreement. Inclusion criteria were as follows: presence of at least one partially impacted mandibular third molar, confirmed with a preoperative panoramic radiograph. Exclusion criteria were the following: smoking, diagnosed diabetes mellitus. Between June 2020 and September 2023, a total of 78 patients of mean age 31.14 years old (range 21-40 years, standard deviation 9.14), were included in this study-38 patients were male, 40 patients were female. A group of patients received traditional silk suture (G1 = 41 patients), while the second group (G2 = 37 patients) received hemostasis performed with fibrin sponge and, after complete soaking of the sponge, the application of cyanoacrylate gel on the blood clot and suture with one 2/0 stitch in order for recovery for secondary closure. The following parameters were measured: HRQL, average pain (AP), maximum pain (MP), complication score (CS), facial swelling (FS), and erythema.
RESULTS: For HRQL parameters, oral disability was found to be significantly higher in G1 while AP was significantly higher in G2 (p < 0.05). AP was higher in G2 (p = 0.0098), as well as MP (p = 0.001). No differences were found with regards to CS (p = 0.0759). FS and erythema were higher in G1 (p < 0.0001 for facial swelling, and p = 0.0001 for erythema).
CONCLUSIONS: on the basis of this study, the use of cyanoacrylate after mandibular third molar surgery appears to be useful in order to reduce postoperative oral disability, facial swelling, and erythema after tooth extraction, with increased average and medium pain: clinicians may consider its use in selected cases.