基于多维度微创技术的下颌阻生智齿拔除术优化研究

陈新; 鲁秀真; 黄传龙; 李扬

doi:10.16766/j.cnki.issn.1674-4152.004344

基于多维度微创技术的下颌阻生智齿拔除术优化研究

doi: 10.16766/j.cnki.issn.1674-4152.004344

安徽医科大学口腔医学院，安徽医科大学附属口腔医院，安徽省口腔疾病研究重点实验室，安徽合肥 230032

基金项目:

安徽医科大学口腔医学院学科建设“峰原”提升项目 2023xkfyts07

安徽省高校科研项目重点项目 2023AH050644

详细信息

通讯作者:
陈新，E-mail:chenxin2672@ahmu.edu.cn

中图分类号: R782.11
计量
- 文章访问数: 16
- HTML全文浏览量: 5
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2025-01-30
- 网络出版日期: 2026-04-01

Optimization study of mandibular impacted third molar extraction based on multidimensional minimally invasive techniques

College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China

摘要

摘要: 下颌阻生智齿拔除术是一项常见但复杂的口腔外科手术，由于手术区域受限、邻近重要解剖结构复杂，以及智齿阻生程度及牙根形态的多样性，使得这类手术的难度较大，术后并发症的风险也相对较高，目前面临术前镇静与疼痛控制不足、术后肿胀与出血管理困难以及神经损伤风险等挑战，在微创拔牙方面尚缺乏统一且系统的技术标准。本文基于临床实践经验，通过对围手术期镇静及疼痛控制策略、阻生智齿拔牙术围手术期抗生素使用规范、基于多维度阻力分析的规范化拔牙方式、下颌智齿拔除术中翻瓣方式的灵活选择、个性化下颌智齿拔除策略、拔牙创口封闭的考量等方面进行分析，提出了“多维度微创技术”这一新概念，(1)通过在围手术期采用镇静、有效的疼痛管理及规范化的抗生素预防性使用，减轻患者的焦虑与不适感，从而提高整体手术体验；(2)通过改进拔牙操作方法和灵活选择翻瓣技术，结合多维度阻力分析，优化手术策略，减少手术过程中的组织创伤；(3)通过灵活的创口封闭方式，并采取下牙槽神经保护措施，以最大限度地预防术后并发症；(4)标准化手术流程推动了个性化智齿拔除策略的实施，使得手术流程更加精细与高效。本研究旨在推动其在下颌阻生智齿拔除中的应用与发展，提升手术效果并减少并发症的发生。
- 下颌智齿 /
- 阻生齿 /
- 多维度微创技术 /
- 阻力分析 /
- 个性化拔牙策略 /
- 围手术期
Abstract: The extraction of impacted mandibular third molars is a common yet complex oral surgical procedure. Due to the restricted operative field, proximity to vital anatomical structures, and variations in impaction depth and root morphology, such surgeries are technically challenging and carry a relatively high risk of postoperative complications. Current challenges include insufficient preoperative sedation and pain control, difficulty in managing postoperative swelling and bleeding, and the risk of nerve injury. Moreover, a unified and systematic standard for minimally invasive extraction techniques is still lacking. Based on clinical practice, this study introduces the new concept of "multidimensional minimally invasive techniques" through an analysis of several key aspects, including perioperative sedation and pain control strategies, standardized antibiotic prophylaxis for impacted tooth extraction, resistance-based surgical planning, flexible flap design, individualized mandibular third molar extraction strategies, and wound closure considerations. (1) By implementing perioperative sedation, effective pain management, and standardized prophylactic antibiotic use, patients ' anxiety and discomfort are alleviated, thereby improving overall surgical experience. (2) Through optimization of extraction procedures and flexible flap techniques guided by multidimensional resistance analysis, intraoperative tissue trauma is minimized. (3) Appropriate wound closure techniques combined with inferior alveolar nerve protection measures help to prevent postoperative complications to the greatest extent possible. (4) Standardization of the surgical process promotes personalized extraction strategies, enhancing procedural precision and efficiency. This study aims to advance the application and development of multidimensional minimally invasive techniques in the extraction of impacted mandibular third molars, thereby improving surgical outcomes and reducing the incidence of complications.
- Mandibular third molar /
- Impacted teeth /
- Multidimensional minimally invasive techniques /
- Resistance analysis /
- Personalized extraction strategies /
- Perioperative period

HTML全文

图 1 下颌水平低位阻生智齿拔牙过程

注：A为全景片示38牙完全埋伏，牙体紧邻下牙槽神经管；B示颊侧行角形切口；C示翻瓣、去骨显露牙冠；D示涡轮机分牙截冠，“T”形分牙；E示去除近中牙冠阻力；F示牙根沿牙长轴脱离原位；G示牙龈对位缝合；H为取出的阻生齿及软组织；I为术后全景片示完整拔除阻生齿。

Figure 1. Extraction procedure of a horizontally impacted mandibular third molar

下载: 全尺寸图片幻灯片

图 2 个性化智齿拔除策略

Figure 2. Personalized extraction strategy for wisdom teeth

下载: 全尺寸图片幻灯片

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