摘要：

目的：探讨下颌阻生第三磨牙拔除时，牙误入翼颌间隙的原因、处理及防范方法。方法：回顾总结了4例在外院拔除时误入翼颌间隙的下颌阻生牙病例，其转诊至我院后的进一步临床处理过程与相关临床资料。结合文献报道，对此类移位至翼颌间隙阻生牙的原因、处理 、防范进行了总结。结果：本文病例均在首次拔牙术中发生牙移位后2~4 h内，急诊转至我院。在详细X线片定位后，嘱患者避免过度吞咽等动作，以免周围肌肉运动导致移位牙再向深面移动。在完善检查和良好四手操作配合下，经口内辅助小切口探查，配合术者手感触摸，寻找移位牙，最终4例移位牙均在15 min内顺利取出。术中需注意避免损伤邻近神经等重要结构。结论：阻生牙误入翼颌间隙的发生，与拔牙术前治疗方案的制订、医生技术水平密切相关。及时正确处理误入翼颌间隙的下颌阻生第三磨牙，可避免后期肿胀、感染的发生。

关键词: 阻生牙, 翼颌间隙, 牙拔除术, 术中并发症

Abstract:

Objective: To discuss the prevention and treatment of impacted mandibular teeth strayed into pterygomandibular space during extraction. Methods: The clinic data of 4 patients transferred from other hospitals were retrospectively analyzed, who suffered with mandibular impacted teeth straying into the pterygomandibular space, during the tooth extraction. The causes, treatments and prevention of teeth straying into the pterygomandibular space, were reviewed. Results: Cooperated with four hands, small incision assisted by intraoral exploration were used. All the displaced teeth were removed successfully in 4 cases, with avoiding later swelling and infection. Conclusion: Accurate preoperative evaluation and correct treatment, may be help to prevent and treat the mandibular impacted teeth straying into the pterygomandibular space.

Key words: impacted teeth, pterygomandibular space, tooth extraction, intraoperation complication

中图分类号: 

• R782.1