CT三维重建在上颌埋伏牙微创拔除术的临床应用
Clinical application of CT three-dimensional reconstruction in the minimally invasive extraction of impacted maxillary teeth
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摘要: 目的：观察多层螺旋CT（MSCT）三维重建指导上颌埋伏牙微创拔除术的临床效果。方法：在MSCT三维重建引导下采用微创拔除术拔除上颌埋伏牙50例（观察组），选取同期采用锤击法拔除上颌埋伏牙的患者50例（对照组）。比较2组患者拔牙时间及术中、术后并发症发生情况。结果：2组患者均顺利完成手术。观察组患者的手术时间为（19.5±5.5）min，对照组为（35.5±8.5）min，2组差异有统计学意义（P<0.01）。观察组术中、术后疼痛，术后肿胀程度及邻牙损伤并发症发生率均低于对照组（P<0.05～P<0.01）。结论：MSCT三维重建可不同层面、不同角度地观察埋伏牙在颌骨内的三维空间位置，直观、准确地判断埋伏牙与周围组织结构的关系。在准确定位下微创拔除上颌埋伏牙可以精确手术进路，缩短拔牙时间，明显减小损伤及降低术中、术后并发症的发生率，值得在临床中进一步推广使用。Abstract: Objective: To observe the clinical effects of multi-slice helical CT(MSCT) three-dimensional reconstruction in the minimally invasive extraction of impacted maxillary teeth.Methods: The data of 50 patients with impacted maxillary teeth treated with minimally invasive extraction using the MSCT three dimensional reconstruction guiding(the observation group) were retrospectively analyzed,50 patients with impacted maxillary teeth treated with hammer method were set as the control group.The duration of extraction and the occurrence of intraoperative and postoperative complications between two groups were compared.Results: The operations of two groups were successful.The extraction duration of the observation group and control group were(19.5±5.5) min and(35.5±8.5) min,respectively,the difference of which was statistically significant(P<0.01).The degree of pain and swelling,and incidence of the adjacent teeth damage in observation group were less than those in control group(P<0.05 to P<0.01).Conclusions: The MSCT three dimensional reconstruction can clearly observe the three-dimensional position of impacted teeth in the jaw from different angles and levels,and intuitively and accurately judge the relationship of impacted teeth and surrounding tissue.It can provide the basis for operative accurate approach,reduce the duration,injury and intraoperative and postoperative complications,which is worth further popularizing in clinical use.
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