摘要： 目的：探讨超声骨刀微创技术拔除儿童上颌前牙区多生牙的临床应用效果。方法：选取2021年7月至2023年7月于我院就诊的128例上颌前牙区多生牙患儿，根据手术方式的不同将患儿分为2组：传统组（n=64）采用传统拔牙法，超声骨刀组（n=64）采用超声骨刀微创技术。比较2组围术期指标（手术成功率采用χ ²检验，手术时间采用独立样本t检验）、术后疼痛程度（采用Mann-WhitneyU检验）及龈沟液炎性介质[髓过氧化物酶（myeloperoxidase，MPO）、前列腺素E₂（prostaglandin E₂，PGE₂）、穿透素-3（pentraxin-3，PTX3）]与应激介质[过氧化物酶体增殖物激活受体γ（peroxisome proliferator-activated receptor γ，PPARγ）、谷胱甘肽过氧化物酶（glutathione peroxidase，GPX）]水平（采用独立样本t检验）变化。结果：2组手术成功率差异无统计学意义（P>0.05），超声骨刀组手术时间显著短于传统组（P<0.001）；术后第1、3天，2组疼痛程度比较，超声骨刀组低于传统组（P<0.05）；术后3 d，2组患者MPO、PGE₂、PTX3及PPARγ水平均较术前升高，但超声骨刀组较传统组低，2组GPX水平均降低，但超声骨刀组较传统组高（均P<0.01）。结论：应用超声骨刀微创技术拔除儿童上颌前牙区多生牙，效果良好，能显著缩短手术时间、减轻手术创伤、降低术后疼痛程度，并有效缓解局部炎症与应激反应。

关键词: 超声骨刀技术, 儿童, 上颌, 前牙区, 多生牙

Abstract: Objective:To investigate the clinical efficacy of minimally invasive ultrasonic bone surgery for extracting maxillary anterior supernumerary teeth in children.Methods:A total of 128 children with maxillary anterior supernumerary teeth treated in our hospital between July 2021 and July 2023 were included. Based on the surgical methods, the patients were divided into 2 groups: The conventional group (n=64) underwent the conventional extraction, and the ultrasonic bone surgery group (n=64) underwent the minimally invasive ultrasonic bone surgery. Perioperative parameters were compared, including success rate (χ ² test), operation time (independent-samplet-test), postoperative pain (Mann‑WhitneyUtest), and changes in gingival crevicular fluid levels of inflammatory mediators [myeloperoxidase (MPO), prostaglandin E₂ (PGE₂), pentraxin‑3 (PTX3)] and stress mediators [peroxisome proliferator‑activated receptor γ (PPARγ), glutathione peroxidase (GPX)] (independent-samplet-test).Results:The success rate did not differ significantly between the two groups (P>0.05). However, the ultrasonic bone surgery group had a significantly shorter operation time than the conventional group (P<0.001). Postoperative pain scores were significantly lower in the ultrasonic bone surgery group on day 1 and day 3 than in the conventional group (P<0.05). On postoperative day 3, levels of MPO, PGE₂, PTX3, and PPARγ increased in both groups compared with preoperative levels, but were significantly lower in the ultrasonic bone surgery group than in the conventional group. GPX levels decreased in both groups, but were significantly higher in the ultrasonic bone surgery group than in the conventional group (allP<0.01).Conclusion:Minimally invasive ultrasonic bone surgery for extraction of maxillary anterior supernumerary teeth in children demonstrated favorable outcomes, significantly shortening operation time, reducing surgical trauma, alleviating postoperative pain, and effectively mitigating local inflammation and stress responses.

Key words: ultrasonic bone surgery, children, maxilla, anterior region, supernumerary teeth