CAJ | 학술논문

目的：探讨在完整拔出阻生第三磨牙时采用锥形束CT（CBCT）介导与常规X线介导下超声骨刀联合微创拔牙术的疗效差异，分析CBCT三维数字化模型在临床应用中的价值优势及增加患者对手术满意度的方法。方法选取深圳市龙华新区人民医院2014年3~11月收治的拟行拔除下颌阻生第三磨牙患者50例，按照随机数字表法分为研究组及对照组，每组各25例。研究组采用CBCT介导下超声骨刀联合微创拔牙术拔除下颌阻生第三磨牙，对照组采用常规X线介导下超声骨刀联合微创拔牙术拔除下颌阻生第三磨牙，记录拔除术中及术后出现并发症的情况并分析原因，进行患者满意度的评价。结果研究组发生术中并发症2例（8.0%），对照组发生术中并发症6例（24.0%），两组术中并发症发生率比较，差异有统计学意义（P<0.05）；出现术中并发症的8例患者中有5例出现了术后并发症，其中研究组1例（4.0%），对照组4例（16.0%），两组术后并发症发生率比较，差异有统计学意义（P<0.05）。研究组患者的满意率（76.0%）明显高于对照组（48.0%），差异有统计学意义（P<0.05）。结论使用CBCT三维数字化模型方法进行完整拔出阻生第三磨牙有明显的临床意义，适合复杂阻生牙的术前方案制订，有助于在减少患者发生术前及术中并发症的同时增加患者的满意程度，建议进行临床推广。
목적：탐토재완정발출조생제삼마아시채용추형속CT（CBCT）개도여상규X선개도하초성골도연합미창발아술적료효차이，분석CBCT삼유수자화모형재림상응용중적개치우세급증가환자대수술만의도적방법。방법선취심수시룡화신구인민의원2014년3~11월수치적의행발제하합조생제삼마아환자50례，안조수궤수자표법분위연구조급대조조，매조각25례。연구조채용CBCT개도하초성골도연합미창발아술발제하합조생제삼마아，대조조채용상규X선개도하초성골도연합미창발아술발제하합조생제삼마아，기록발제술중급술후출현병발증적정황병분석원인，진행환자만의도적평개。결과연구조발생술중병발증2례（8.0%），대조조발생술중병발증6례（24.0%），량조술중병발증발생솔비교，차이유통계학의의（P<0.05）；출현술중병발증적8례환자중유5례출현료술후병발증，기중연구조1례（4.0%），대조조4례（16.0%），량조술후병발증발생솔비교，차이유통계학의의（P<0.05）。연구조환자적만의솔（76.0%）명현고우대조조（48.0%），차이유통계학의의（P<0.05）。결론사용CBCT삼유수자화모형방법진행완정발출조생제삼마아유명현적림상의의，괄합복잡조생아적술전방안제정，유조우재감소환자발생술전급술중병발증적동시증가환자적만의정도，건의진행림상추엄。
Objective To explore the difference of third molar by CBCT mediated turbine drilling method and conven-tional X-ray mediated of turbine drill in complete pulling-out, in order to analyze the operation method to increase the satisfaction of patients. Methods From March to November 2014, in People's Hospital of Longhua New District in Shenzhen City, 50 patients with planning pulling-out mandibular impacted third molars surgery were selected, accord-ing to random number table, they were divided into research group and control group, with 25 cases in each group. The research group was given piezosurgery osteotomy combined with minimally invasive exodontias by CBCT in complete pulling-out mandibular impacted third molars, the control group was given piezosurgery osteotomy combined with mini-mally invasive exodontias by X-ray in complete pulling-out mandibular impacted third molars, complications occurred during operation and after operation were recorded, and the cause was analyzed, the satisfaction degree of patients were taken. Results 2 cases (8.0%) occurred intraoperative complications in the research group and 6 cases (24.0%) oc-curred intranperative complications in the control group, the incidence of intraoperative complications in two groups were compared, the difference was statistically significant (P<0.05). 5 patients occurred postoperative complications in 8 patients with intranperative complications, 1 case (4.0%) was in research group, 4 cases (16.0%) were in control group, the incidence of postoperative complications in two groups was compared, the difference was statistically signifi-cant (P< 0.05). The satisfaction degree of patients in research group (76.0%) was higher than that in control group (48.0%), the difference was statistically significant (P<0.05). Conclusion The use of CBCT three-dimensional digital model in complete pulling-out mandibular impacted third molars method has obvious clinical significance, it is suitable for making the scheme of complex impacted teeth before operation and helpful to increase patient satisfaction in the reduction of complications.