牵引增隙辅助拔除高危垂直阻生智齿8例报告

doi:10.3969/j.issn.1005-4979.2021.02.013

《口腔颌面外科杂志》 ›› 2021, Vol. 31 ›› Issue (2): 127-130. doi: 10.3969/j.issn.1005-4979.2021.02.013

• 病例报告 • 上一篇

牵引增隙辅助拔除高危垂直阻生智齿8例报告

马晓晴(), 项飞, 樊明月, 钱文昊()

上海市徐汇区牙病防治所口腔正畸科，上海 200032

收稿日期:2020-04-06 修回日期:2020-04-30 出版日期:2021-04-28 发布日期:2021-04-26
通讯作者: 钱文昊，教授. E-mail: pingyanlaoto@163.com.
作者简介:
马晓晴（1978—），男，山西人，副主任医师，硕士. E-mail: mxq780927@163.com
基金资助:
2017年徐汇区医学尖峰学科(SHXH201706); 上海市医学重点专科(ZK2019B12); 徐汇区医学科研项目(SHXH201915)

Extraction of high risk vertically impacted mandibular third molar aided by traction for gap increasing:8 cases report

MA Xiaoqing(), XIANG Fei, FAN Mingyue, QIAN Wenhao()

Department of Orthodontics, Shanghai Xuhui District Dental Center, Shanghai 200032, China

Received:2020-04-06 Revised:2020-04-30 Online:2021-04-28 Published:2021-04-26

摘要/Abstract

摘要：

探索牵引增隙辅助拔除紧邻下牙槽神经管和舌侧骨板低位阻生智齿的效果。锥形束CT（cone-beam CT,CBCT）显示紧邻下牙槽神经管和舌侧骨板的垂直阻生智齿8例，微种植钉增强支抗，NiTi悬臂梁颊向牵引智齿4~6周，当牵引点颊向移动距离>2 mm后转外科拔除。所有智齿拔除后均未出现严重并发症。牵引增隙可有效降低拔除紧邻下牙槽神经管和舌侧骨板垂直阻生智齿的风险。

关键词: 牵引, 增隙, 下颌阻生智齿, 悬臂梁

Abstract:

To study the effect of gap increasing resulted from orthodontic traction on the extraction of the mandibular third molar(M3) in close relationship with the inferior alveolar nerve and lingual bone. Eight vertically impacted M3s were included because they were proven to be adjacent to both the inferior alveolar nerve and the lingual bone by means of the cone-beam CT(CBCT). The miniscrews were used to enhance the anchorage and the NiTi cantilever beam were used to exert the buccal traction force for 4-6 weeks. When the traction points on the M3s moved buccally over 2 mm, they were extracted. After extraction, no patients showed any serious complications. Gap increasing resulted from orthodontic traction could reduce the risk of the extraction of the M3 adjacent to both the inferior alveolar nerve and the lingual bone

Key words: traction, gap increasing, impacted mandibular third molar, cantilever beam

中图分类号:

R782

马晓晴, 项飞, 樊明月, 钱文昊. 牵引增隙辅助拔除高危垂直阻生智齿8例报告[J]. 《口腔颌面外科杂志》, 2021, 31(2): 127-130.

MA Xiaoqing, XIANG Fei, FAN Mingyue, QIAN Wenhao. Extraction of high risk vertically impacted mandibular third molar aided by traction for gap increasing:8 cases report[J]. 《Journal of Oral and Maxillofacial Surgery》, 2021, 31(2): 127-130.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2021/V31/I2/127

图/表 7

图1 治疗前智齿与下牙槽神经及舌侧骨板的位置关系 A. 治疗前全景片;B. 治疗前CBCT矢状剖面观；C. 治疗前CBCT横截面观。

Figure 1 The relationship between the M3 and the inferior alveolar nerve and the lingual plate before treatment

图2 微种植钉植入，牵引钩粘接

Figure 2 Insertion of the miniscrew and the traction hook

图3 颊向牵引智齿

Figure 3 Buccal traction of the mandibular third molar

图4 牵引4周后

Figure 4 Four weeks after traction

图5 牵引后智齿与下牙槽神经及舌侧骨板位置关系 A. 牵引后全景片；B. 牵引后CBCT矢状剖面观，根尖牙周膜间隙明显增宽；C. 牵引后CBCT横截面观。

Figure 5 The relationship between the M3 and the inferior alveolar nerve and the lingual plate after traction

图6 治疗前后重叠图及悬臂梁角度变化 A. 牵引前后重叠图；B. 悬臂梁角度变化，绿色代表治疗前，黄色代表治疗后。

Figure 6 The overlapping picture before and after treatment and the angulation change of the cantilever beam

表1 病例治疗基本情况

Table 1 Basic information of the cases

编号	年龄/岁	性别	阻生情况	牵引时间/周	拔除方法	拔牙时间/min	有无术后麻木等并发症
1	24	男	低位	4.6	挺+钳	4.1	无
2	25	女	低位	5.3	挺	2.3	无
3	28	女	中位	4.1	挺	2.8	无
4	25	男	低位	6.0	挺	2.2	无
5	27	男	低位	5.8	挺+钳	3.8	无
6	26	女	低位	5.0	挺+钳	4.8	无
7	24	女	中位	4.3	挺	2.3	无
8	28	女	低位	5.7	挺	3.1	无

参考文献 12

[1]	Wang DM, He XT, Wang YL, et al. Topographic relationship between root apex of mesially and horizontally impacted mandibular third molar and lingual plate: Cross-sectional analysis using CBCT[J]. Sci Rep, 2016, 6: 39268. doi: 10.1038/srep39268 pmid: 27991572
[2]	Chen YF, Liu JY, Pei J, et al. The risk factors that can increase possibility of mandibular canal wall damage in adult: A cone-beam computed tomography (CBCT) study in a Chinese population[J]. Med Sci Monit, 2018, 24: 26-36. doi: 10.12659/MSM.905475 URL
[3]	Martin A, Perinetti G, Costantinides F, et al. Coronectomy as a surgical approach to impacted mandibular third molars: A systematic review[J]. Head Face Med, 2015, 11: 9. doi: 10.1186/s13005-015-0068-7 pmid: 25890111
[4]	Matzen LH, Schropp L, Spin-Neto R, et al. Use of cone beam computed tomography to assess significant imaging findings related to mandibular third molar impaction[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017, 124(5): 506-516. doi: 10.1016/j.oooo.2017.07.007 URL
[5]	Alessandri Bonetti G, Bendandi M, Laino L, et al. Orthodontic extraction: Riskless extraction of impacted lower third molars close to the mandibular canal[J]. J Oral Maxillofac Surg, 2007, 65(12): 2580-2586. doi: 10.1016/j.joms.2007.06.686 URL
[6]	Park W, Park JS, Kim YM, et al. Orthodontic extrusion of the lower third molar with an orthodontic mini implant[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontology, 2010, 110(4): e1-e6.
[7]	Ma ZG, Xu GZ, Yang C, et al. Efficacy of the technique of piezoelectric corticotomy for orthodontic traction of impacted mandibular third molars[J]. Br J Oral Maxillofac Surg, 2015, 53(4): 326-331. doi: 10.1016/j.bjoms.2015.01.002 pmid: 25638568
[8]	沈宇清, 马志贵, 张瑛, 等. 微创牵引辅助拔除近中阻生下颌第三磨牙1例报告[J]. 中国口腔颌面外科杂志, 2014, 12(2): 189-192.
[9]	谢千阳, 马志贵, 钱文涛, 等. 正畸牵引法辅助拔除接触下牙槽神经管的埋伏阻生牙1例报告[J]. 中国口腔颌面外科杂志, 2012, 10(6): 525-528.
[10]	Wang Y, He DM, Yang C, et al. An easy way to apply orthodontic extraction for impacted lower third molar compressing to the inferior alveolar nerve[J]. J Craniomaxillofac Surg, 2012, 40(3): 234-237. doi: 10.1016/j.jcms.2011.05.001 pmid: 21641229
[11]	Ma ZG, Xie QY, Yang C, et al. An orthodontic technique for minimally invasive extraction of impacted lower third molar[J]. J Oral Maxillofac Surg, 2013, 71(8): 1309-1317. doi: 10.1016/j.joms.2013.03.025 URL
[12]	马晓晴, 项飞, 秦飞, 等. 双种植钉牵引拔除高危下颌水平阻生智牙8例报道[J]. 上海口腔医学, 2018, 27(4): 424-426.

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