埋伏歯の2つの抜歯方法と即時埋伏の組み合わせの臨床応用

[Clinical application of two extraction methods of impacted teeth combined with immediate implantation].

抄録

目的:

高速タービンを用いた低侵襲技術と従来の技術を組み合わせた即時埋入法が、複雑な埋伏歯の抜歯後の術後鎮痛、口の開き具合、歯槽骨吸収に及ぼす影響を観察する。

PURPOSE: To observe the effects of immediate implantation combined with high-speed turbine minimally invasive technology and traditional technology on postoperative analgesia, mouth opening and alveolar bone resorption after removal of complex impacted teeth.

方法は以下の通りです。:

2014年1月から2018年12月までに当院で治療を受けたインパクトティースの患者80名を、実験群と対照群の2群に無作為に分け、各群40例ずつとした。実験群の患者は、高速タービン低侵襲手術と即時埋入を組み合わせて治療し、対照群の患者は従来の手術と即時埋入を組み合わせて治療した。歯槽骨の吸収、痛み、腫れ、口の開きの制限、無傷の抜歯窩、合併症の違いを両群間で比較した。統計解析には，SPSS 19.0ソフトウェアパッケージが使用された．

METHODS: Eighty patients with impacted teeth treated in our hospital from January 2014 to December 2018 were randomly divided into 2 groups: experimental group and control group with 40 cases in each group. Patients in the experimental group were treated with high-speed turbine minimally invasive surgery combined with immediate implantation, while patients in the control group were treated with traditional surgery combined with immediate implantation. Differences in alveolar bone resorption, pain, swelling, limited mouth opening, intact extraction socket and complications were compared between the two groups. SPSS 19.0 software package was used to perform statistical analysis.

結果:

術後3ヵ月後、実験群の上顎前歯部、上顎臼歯部、下顎前歯部、下顎臼歯部のインプラント高さは、対照群に比べて有意に低かった。術後1日目のVASスコアは、実験群が対照群よりも有意に低かった（P<0.05）。術後3ヶ月後、VASスコアは両群間で有意な差はなかった（P>0.05）が、実験群の無傷の抜歯窩、腫れの程度、口の開きの制限は対照群よりも有意に低かった。実験群の歯根破折、隣接歯のゆるみ、歯肉裂傷、舌側骨板破折は対照群に比べて有意に低かった。

RESULTS: Three months after operation, the implant height of the maxillary anterior teeth, maxillary molar, mandibular anterior teeth and mandibular molar areas in the experimental group was significantly lower than that in the control group. One day after operation, the VAS score of the experimental group was significantly lower than that of the control group (P<0.05). Three months after operation,there was no significant difference in VAS score between the two groups (P>0.05); but intact extraction socket, swelling degree and mouth opening limitation of the experimental group were significantly lower than those of the control group. The root fracture, adjacent teeth loosening, gingival tear, lingual bone plate fracture of the experimental group were significantly lower than those of the control group.

おわりに:

複雑な埋伏歯の抜歯後、高速タービンによる低侵襲治療と即時埋伏を組み合わせることで、歯槽骨吸収を有意に増加させ、腫脹を緩和し、無傷の抜歯窩を維持し、術後の痛みや合併症を軽減することができる。この治療法は、クリニックでの普及をお勧めします。

CONCLUSIONS: High-speed turbine minimally invasive treatment combined with immediate implantation after extraction of complex impacted teeth can significantly increase alveolar bone resorption, relieve swelling and preserve intact extraction socket, reduce pain and complications after operation. It is recommended to be popularized in clinic.