口腔颌面外科杂志2025，Vol.35Issue(6)：471-477,7.DOI:10.12439/kqhm.1005-4979.2025.06.007
前庭沟入路拔除下颌第三磨牙牙胚对邻牙牙周组织变化的影响
Effect of mandibular third molar tooth germ extraction via vestibular sulcus approach on periodontal tissue changes of adjacent teeth
摘要
Abstract
Objective:To investigate the impact of extracting mandibular third molar(M3M)tooth germs via the vestibular sulcus approach on the periodontal tissue of adjacent teeth and on patient postoperative recovery,providing a reference for the clinical application of this technique.Methods:This self-controlled study included 27 patients who required bilateral M3M germ extraction and presented to the Department of Oral and Maxillofacial Surgery,Qujing Central Hospital of Yunnan Province between May 2023 and July 2024.For each patient,one side was randomly assigned(by drawing lots)to the vestibular sulcus approach(vestibular approach group),while the contralateral side was assigned to the classic angular incision approach(angular incision group).Operative time was compared between the two groups.On postoperative days 1,3,and 7,facial swelling,degree of mouth opening limitation,and pain visual analog scale(VAS)scores were assessed.The occurrence of complications(hemorrhage,nerve injury,dry socket,adjacent tooth injury,and wound dehiscence)was recorded.Probing depth(PD)and gingival index of the adjacent teeth were compared between the two groups preoperatively,and at 1 and 3 months postoperatively.At 6 months postoperatively,cone beam CT(CBCT)was used to compare the distobuccal osseous defect depth(ODD)of the adjacent teeth between the two groups.Results:A total of 24 patients(48 tooth germs)completed all follow-ups.On postoperative day 7,there were no statistically significant differences(P>0.05)between the two groups in facial swelling,pain VAS scores,or degree of mouth opening limitation.No postoperative complications occurred in any patient.There were no statistically significant differences(P>0.05)in operative time or the adjacent teeth gingival index at 1 and 3 months postoperatively between the two groups.At 1 month postoperatively,the distobuccal PD of adjacent teeth in the vestibular approach group was essentially unchanged from the preoperative level and was significantly smaller than that in the angular incision group(P<0.01);by 3 months postoperatively,the difference in this indicator between the two groups was not statistically significant(P>0.05).At 6 months postoperatively,CBCT results showed that the distobuccal ODD of adjacent teeth in the vestibular approach group was significantly smaller than that in the angular incision group(P<0.001).Conclusion:The vestibular sulcus approach for extracting M3M tooth germs is more beneficial for preserving the periodontal tissues on the distal aspect of the adjacent teeth,while showing no significant difference in postoperative recovery compared to the angular incision approach.关键词
前庭沟入路/角形切口入路/下颌第三磨牙牙胚/牙拔除术Key words
vestibular sulcus approach/angular incision approach/mandibular third molar tooth germ/tooth extraction分类
医药卫生引用本文复制引用
张斌,胡欢,濮宏积,陈菊仙,李海,陈波..前庭沟入路拔除下颌第三磨牙牙胚对邻牙牙周组织变化的影响[J].口腔颌面外科杂志,2025,35(6):471-477,7.基金项目
云南省教育厅科学研究基金项目(2024J1623、2025J1674) （2024J1623、2025J1674）
