下颌阻生第三磨牙拔除术后邻牙远中骨缺损的CBCT评价

doi:10.19438/j.cjoms.2020.04.005

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (4): 314-318.doi: 10.19438/j.cjoms.2020.04.005

下颌阻生第三磨牙拔除术后邻牙远中骨缺损的CBCT评价

李晨琳, 谢千阳, 徐光宙^*, 蒋倩^*

上海交通大学医学院附属第九人民医院·口腔医学院口腔外科,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011

收稿日期:2020-03-03 出版日期:2020-07-20 发布日期:2020-09-10
通讯作者: 徐光宙,E-mail:xgzmy@163.com;蒋倩,E-mail:jiangqian0720@hotmail.com。^*共同通信作者
作者简介:李晨琳（1993-）,女,硕士研究生,E-mail:1342160590@qq.com
基金资助:
国家自然科学基金（31800816）; 浦东新区卫生和计划生育委员会卫生计生科研项目（PW2018D-08）; 上海申康医院发展中心临床科技创新项目（SHDC12019X01）; 上海交通大学医学院附属第九人民医院创客基金（CK2018002）

CBCT evaluation of second molar distal bone defects after extraction of impacted mandibular third molar

LI Chen-lin, XIE Qian-yang, XU Guang-zhou, JIANG Qian

Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. Shanghai 200011, China

Received:2020-03-03 Online:2020-07-20 Published:2020-09-10

摘要/Abstract

摘要： 目的: 分析成人下颌阻生第三磨牙（impacted mandibular third molar, impacted M3M）拔除术后6个月的第二磨牙（mandibular second molar, M2M）远中骨缺损变化及其影响因素。方法: 回顾性分析已拔除阻生M3M的25例患者（37颗M3M）的术前及术后6个月CBCT资料。采用SPSS 25软件包进行数据统计,采用重复测量方差分析比较手术前、后M2M远中骨缺损深度变化,采用独立样本t检验分析其影响因素。结果: M2M术后6个月远中骨缺损深度减少,骨高度相比术前改善;年龄、阻生类型是影响M2M术后6个月骨缺损的因素。结论: 年轻患者高风险M3M拔除后,M2M远端的骨高度有所恢复;年龄、阻生类型是其影响因素。当M3M需要拔除时,早期拔除可能对M2M的牙周健康产生有益影响;如M3M为低位阻生,应同期植入骨移植材料,以期获得更好的远中骨愈合。

关键词: 下颌第三磨牙, 拔除术, 下颌第二磨牙, 骨缺损, 牙周愈合

Abstract: PURPOSE: To explore bone defect of mandibular second molar (M2M) and its influencing factors 6 months after M3M extraction. METHODS: The preoperative and postoperative cone-beam CT (CBCT) data of 25 patients with 37 impacted M3Ms were analyzed retrospectively. IBM SPSS 25 software package was used for statistical analysis. Repeated measurement ANOVA was used to compare M2M distal osseous defect depth (ODD) before and after operation. Independent sample t test was used to analyze the influencing factors. RESULTS: M2M distal ODD decreased compared with that before extraction. Age and type of impaction before extraction were the factors influencing postoperative M2M distal bone defect. CONCLUSIONS: After removal of M3M in young patients with high risk, M2M distal bone height recovered. Age and type of impaction are the influencing factors. When M3M can be expected to be removed, early extraction may have a beneficial impact on periodontal health of M2M. When M3M is impacted deeply, bone transplantation materials should be implanted in order to achieve better bone healing.

Key words: Mandibular third molar, Extraction, Mandibular second molar, Osseous defect, Periodontal healing

中图分类号:

R782.1

李晨琳, 谢千阳, 徐光宙, 蒋倩. 下颌阻生第三磨牙拔除术后邻牙远中骨缺损的CBCT评价[J]. 中国口腔颌面外科杂志, 2020, 18(4): 314-318.

LI Chen-lin, XIE Qian-yang, XU Guang-zhou, JIANG Qian. CBCT evaluation of second molar distal bone defects after extraction of impacted mandibular third molar[J]. China J Oral Maxillofac Surg, 2020, 18(4): 314-318.

参考文献

[1] Sigron GR, Pourmand PP, Mache B, et al. The most common complications after wisdom-tooth removal: part 1: a retrospective study of 1,199 cases in the mandible [J]. Swiss Dent J, 2014, 124(10): 1042-1046, 1052-1056.
[2] Tabrizi R, Arabion H, Gholami M.How will mandibular third molar surgery affect mandibular second molar periodontal parameters?[J]. Dent Res(Isfahan), 2013, 10(4): 523-526.
[3] Huang GJ, Cunha-Cruz J, Rothen M, et al.A prospective study of clinical outcomes related to third molar removal or retention[J]. Am J Public Health, 2014, 104(4): 728-734.
[4] Peng KY, Tseng YC, Shen EC, et al.Mandibular second molar periodontal status after third molar extraction[J]. J Periodontol, 2001, 72(12): 1647-1651.
[5] Richardson DT, Dodson TB.Risk of periodontal defects after third molar surgery: an exercise in evidence-based clinical decision-making[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005, 100(2): 133-137.
[6] Chang HH, Lee JJ, Kok SH, et al.Periodontal healing after mandibular third molar surgery-A comparison of distolingual alveolectomy and tooth division techniques[J]. Int J Oral Maxillofac Surg, 2004, 33(1): 32-37.
[7] Inocêncio Faria A, Gallas-Torreira M, López-Ratón M, et al.Radiological infrabony defects after impacted mandibular third molar extractions in young adults[J]. J Oral Maxillofac Surg, 2013, 71(12): 2020-2028.
[8] Kugelberg CF, Ahlstrom U, Ericson S, et al.Periodontal healing after impacted lower third molar surgery in adolescents and adults. A prospective study[J]. Int J Oral Maxillofac Surg, 1991, 20(1): 18-24.
[9] Kugelberg CF.Periodontal healing two and four years after impacted lower third molar surgery: A comparative retrospective study[J]. Int J Oral Maxillofac Surg, 1990, 19(6): 341-345.
[10] Petsos H, Korte J, Eickholz P, et al.Surgical removal of third molars and periodontal tissues of adjacent second molars[J]. J Clin Periodontol, 2016, 43(5): 453-460.
[11] Faria AI, Gallas-Torreira M, López-Ratón M.Mandibular second molar periodontal healing after impacted third molar extraction in young adults[J]. J Oral Maxillofac Surg, 2012, 70(12): 2732-2741.
[12] Kugelberg CF, Ahlström U, Ericson S, et al.The influence of anatomical, pathophysiological, and other factors on periodontal healing after impacted lower third molar surgery: A multiple regression analysis[J]. J Clin Periodontal, 1991, 18(1): 37-43.
[13] Kugelberg CF.Impacted lower third molars and periodontal health. An epidemiological, methodological, retrospective and prospective clinical study[J]. Swed Dent J Suppl, 1990, 68: 1-52.
[14] Cetinkaya BO, Sumer M, Tutkun F, et al.Influence of different suturing techniques on periodontal health of the adjacent second molars after extraction of impacted mandibular third molars[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 108(2): 156-161.
[15] Kan KW, Liu JK, Lo EC, et al.Residual periodontal defects distal to the mandibular second molar 6-36 months after impacted third molar extraction[J]. J Clin Periodontol, 2002, 29(11): 1004-1011.
[16] Corinaldesi G, Lizio G, Badiali G, et al.Treatment of intrabony defects after impacted mandibular third molar removal with bioabsorbable and non-resorbable membranes[J]. J Periodontol, 2011, 82(10): 1404-1413.
[17] Sherrard JF, Rossouw PE, Benson BW, et al.Accuracy and reliability of tooth and root lengths measured on cone-beam computed tomographs[J]. Am J Orthod Dentofacial Orthop, 2010, 137(4 Suppl): S100-108.
[18] Blakey GH, Jacks MT, Offenbacher S, et al.Progression of periodontal disease in the second/third molar region in subjects with asymptomatic third molars[J]. J Oral Maxillofac Surg, 2006, 64(2):189-193.
[19] Thomas B.Management of mandibular third molar extraction sites to prevent periodontal defects[J]. J Oral Maxillofac Surg, 2004, 62(10):1213-1224.
[20] Inocêncio Faria A, Gallas Torreira M, López Ratón M.Repeatability and accuracy of a paralleling technique for radiographic evaluation of distal bone healing after impacted third molar surgery[J]. Dentomaxillofac Radiol, 2013, 42(1): 78022535.
[21] Kim TS, Caruso JM, Christensen H, et al.A comparison of cone-beam computed tomography and direct measurement in the examination of the mandibular canal and adjacent structures[J]. J Endod, 2010, 36(7): 1191-1194.
[22] Ge J, Yang C, Zheng J, et al.Autogenous bone grafting for treatment of osseous defect after impacted mandibular third molar extraction: A randomized controlled trial[J]. Clin Implant Dent Relat Res, 2017, 19(3): 572-580.
[23] Osborne WH, Snyder AJ, Tempel TR.Attachment levels and crevicular depths at the distal of mandibular second molars following removal of adjacent third molars[J]. J Periodontol, 1982, 53(2): 93-95.
[24] Barbato L, Kalemaj Z, Buti J, et al.Effect of surgical intervention for removal of mandibular third molar on periodontal healing of adjacent mandibular second molar: a systematic review and bayesian network meta-analysis[J]. J Periodontol, 2016, 87(3): 291-302.
[25] Arenaz -Búa J, Luaces -Rey R, Sironvalle -Soliva S, et al.A comparative study of platelet -rich plasma, hydroxyapatite, demineralized bone matrix and autologous bone to promote bone regeneration after mandibular impacted third molar extraction[J]. Med Oral Patol Oral Cir Bucal, 2010, 15(3): e483-e489.
[26] Tabrizi R, Khorshidi H, Shahidi S, et al.Use of lincomycin -impregnated demineralized freeze-dried bone allograft in the periodontal defect after third molar surgery[J]. J Oral Maxillofac Surg, 2014, 72(5): 850-857.
[27] Sammartino G, Tia M, Bucci T, et al.Prevention of mandibular third molar extraction-associated periodontal defects: a comparative study[J]. J Periodontol, 2009, 80(3): 389-396.
[28] Hassan KS, Marei HF, Alagl AS.Does grafting of third molar extraction sockets enhance periodontal measures in 30- to 35-year-old patients?[J]. J Oral Maxillofac Surg, 2012, 70(4): 757-764.
[29] Throndson RR, Sexton SB.Grafting mandibular third molar extraction sites: a comparison of bioactive glass to a nongrafted site[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2002, 94(4): 413-419.
[30] Hallman M, Lundgren S, Sennerby L.Histologic analysis of clinical biopsies taken 6 months and 3 years after maxillary sinus floor augmentation with 80% bovine hydroxyapatite and 20% autogenous bone mixed with fibrin glue[J]. Clin Implant Dent Relat Res, 2001, 3(2): 87-96.

下颌阻生第三磨牙拔除术后邻牙远中骨缺损的CBCT评价

CBCT evaluation of second molar distal bone defects after extraction of impacted mandibular third molar

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