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下颌第三磨牙手术后的轻微并发症:类型、发生率及可能的预防措施。

Minor complications after mandibular third molar surgery: type, incidence, and possible prevention.

作者信息

Kim Jin-Cheol, Choi Seong-Seok, Wang Soon-Joo, Kim Seong-Gon

机构信息

Department of Oral and Maxillofacial Surgery, Sacred Heart Hospital, Hallym University, Kyungki-do, Republic of Korea.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Aug;102(2):e4-11. doi: 10.1016/j.tripleo.2005.10.050. Epub 2006 Jun 27.

Abstract

PURPOSE

The aim of this prospective study was to ascertain the incidence of minor complications after mandibular third molar surgery and to predict the risk of skin ecchymosis or mucosa petechiae related to the usage of an absorbable gelatin sponge.

PATIENTS AND METHODS

One hundred and four patients subjected to surgical extraction of horizontally impacted lower third molars were selected and investigated by means of questionnaires and clinical examinations. The independent sample t test was used for numeric variables. The chi-square test was used for logistic variables to determine the association between variables, and thereafter stepwise logistical regression was used.

RESULTS

The older group (> or = 30 years old), with deeply impacted teeth, and long operation times (> or = 10 minutes) were shown to have significantly higher swelling than the other groups (P < .05). The patients who had deeply impacted teeth or long operation times were shown to have significantly higher VAS scores compared to short operation times (P < .05). The use of an absorbable gelatin sponge in the extraction socket significantly decreased postoperative swelling, mucosal petechiae, and skin ecchymosis (P < .05).

CONCLUSION

The clinical variables related to postoperative bleeding disorder, pain, and trismus were identified. The insertion of an absorbable gelatin sponge into the extraction socket was found to be a very useful method to prevent postoperative bleeding problems.

摘要

目的

本前瞻性研究旨在确定下颌第三磨牙手术后轻微并发症的发生率,并预测与使用可吸收明胶海绵相关的皮肤瘀斑或黏膜瘀点的风险。

患者与方法

选取104例行水平阻生下颌第三磨牙手术拔除的患者,通过问卷调查和临床检查进行研究。数值变量采用独立样本t检验。逻辑变量采用卡方检验确定变量之间的关联,然后采用逐步逻辑回归分析。

结果

年龄较大组(≥30岁)、牙齿深度阻生以及手术时间较长(≥10分钟)的患者肿胀程度显著高于其他组(P<.05)。与手术时间短的患者相比,牙齿深度阻生或手术时间长的患者视觉模拟评分(VAS)显著更高(P<.05)。拔牙窝内使用可吸收明胶海绵可显著减轻术后肿胀、黏膜瘀点和皮肤瘀斑(P<.05)。

结论

确定了与术后出血障碍、疼痛和牙关紧闭相关的临床变量。发现将可吸收明胶海绵植入拔牙窝是预防术后出血问题的一种非常有用的方法。

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