目的 探讨下颌水平低位阻生第三磨牙(智齿)拔除中应用超声骨刀对手术指标、术后疼痛及并发症的影响。方法 选取2022年8月—2023年10月收治的61例两侧为下颌水平低位阻生智齿患者(共计122颗下颌水平低位阻生智齿)进行研究。采用随机数字表法分为对照组(30例)和观察组(31例),分别采用传统凿骨劈冠法拔除和超声骨刀法拔除,比较两组患牙龈沟液炎症介质、氧化应激指标、手术时间、术中出血量、术后疼痛[采用模拟评分法(VAS)评估]、并发症情况。结果 术后,观察组白介素(IL)-1β、IL-6、丙二醛(MDA)低于对照组,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GPx)则高于对照组,差异均有统计学意义(均P<0.05);观察组手术时间、出血量,术后6 h、24 h的VAS评分,术后并发症发生率均低于对照组,差异均有统计学意义(均P<0.05)。结论 下颌水平低位阻生智齿拔除中应用超声骨刀,可缩短患者手术时间,减少术中出血量,改善炎症介质、氧化应激指标,缓解患者术后疼痛,降低并发症率,值得肯定。
Objective To explore the effects of ultrasound bone knife on surgical indicators, postoperative pain, and complications in the extraction of mandibular low impacted wisdom teeth. Methods A total of 61 patients with mandibular low impacted wisdom teeth on both sides (a total of 122 mandibular low impacted wisdom teeth) admitted from August 2022 to October 2023 were selected for the study. They were randomly divided into a control group of 30 cases and an observation group of 31 cases, using traditional bone chiseling and crown chopping methods for extraction and ultrasonic bone knife methods for extraction, respectively. The inflammatory mediators, oxidative stress mediators, surgical time, intraoperative bleeding volume, postoperative pain [visual analogue scale (VAS) score], and complications were compared between the two groups. Results After surgery, the interleukin (IL)-1β, IL-6 and malondialdehyde (MDA) levels were lower in the observation group than in the control group, while the superoxide dismutase (SOD) and glutathione peroxidase (GPx) were higher (P<0.05). The observation group had lower surgical time, bleeding volume, VAS scores at 6 and 24 h after surgery, and postoperative complication rate than the control group (P<0.05). Conclusion The application of ultrasound bone knife in the extraction of mandibular low impacted wisdom teeth can shorten the surgical time of patients, reduce intraoperative bleeding, improve inflammatory mediators and oxidative stress mediators, alleviate postoperative pain, and reduce the incidence of complications, which is worthy of recognition.
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