数字化辅助下牙根先脱位拔除上颌第二磨牙根分叉间埋伏第三磨牙1例

doi:10.7518/hxkq.2024.2023362

华西口腔医学杂志 ›› 2024, Vol. 42 ›› Issue (3): 403-408.doi: 10.7518/hxkq.2024.2023362

数字化辅助下牙根先脱位拔除上颌第二磨牙根分叉间埋伏第三磨牙1例

贺兰稀¹(), 居来提·吾麦尔null¹, 周子航², 于健³, 王昭领³, 陈虹瑜³()

^1.山东大学齐鲁医学院口腔医学院山东省口腔组织再生重点实验室口腔生物材料与组织再生山东省工程研究中心山东省口腔疾病临床医学研究中心，济南 250012
^2.口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心四川大学华西口腔医院正颌及关节外科，成都 610041
^3.山东大学齐鲁医学院口腔医学院·口腔医院综合科山东省口腔组织再生重点实验室口腔生物材料与组织再生山东省工程研究中心山东省口腔疾病临床医学研究中心，济南 250012

收稿日期:2023-10-27 修回日期:2024-02-19 出版日期:2024-06-01 发布日期:2024-05-24
通讯作者: 陈虹瑜 E-mail:1013486113@qq.com;hychen@sdu.edu.cn
作者简介:贺兰稀，学士，E-mail：1013486113@qq.com

Digital technology-assisted extraction of impacted maxillary third molar located between the furcation of maxillary second molar by root dislocation: a case report

He Lanxi¹(), Jurat·Omar ¹, Zhou Zihang², Yu Jian³, Wang Zhaoling³, Chen Hongyu³()

^1.School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
^2.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
^3.Dept. of General Dentistry, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China Correspondence: Chen Hongyu, E-mail: hychen@sdu. edu. cn

Received:2023-10-27 Revised:2024-02-19 Online:2024-06-01 Published:2024-05-24
Contact: Chen Hongyu E-mail:1013486113@qq.com;hychen@sdu.edu.cn

摘要/Abstract

摘要：

上颌阻生第三磨牙多位于上颌结节区，此区域手术操作空间小、视野差。本文报道1例牙冠位于邻牙两牙根之间、与上颌窦关系密切的上颌水平超高位阻生第三磨牙的拔除。利用数字化模拟技术三维重建患者部分上颌骨、相关牙齿等毗邻解剖结构，精准制定最佳手术方案，采用牙根先脱位、牙冠后脱位法拔除阻生牙。该法既保护了邻牙牙根，也降低了上颌窦黏膜损伤以及穿孔的风险，提高了手术效率，减小了手术创伤，符合微创牙槽外科理念，为临床上拔除此类埋伏阻生牙提供了新思路和经验。

关键词: 上颌阻生第三磨牙, 拔牙, 上颌结节, 微创, 数字化模拟技术

Abstract:

Most of the maxillary impacted third molars are located in the maxillary tuberosity, where the vision and operation space are limited. This paper reports a case of surgical extraction of the left maxillary horizontal superhigh impacted third molar, which is located between the roots of the adjacent teeth and is closely related to the maxillary sinus. The digital simulation technology was used to reconstruct a three-dimensional visual image of the patient’s maxilla, related teeth, and other adjacent anatomical structures to assist in finding the optimal surgical method accurately. Root dislocation before the crown not only protects the roots of the adjacent tooth, but also reduces the risk of maxillary sinus lining damage or perforation during operative procedures, improves the efficiency of the operation, and reduces surgical trauma, which conforms to the concept of minimally invasive surgery and provides a new idea and experience for the clinical extraction of such maxillary impacted third molars.

Key words: impacted maxillary third molar, extraction, maxillary tuberosity, minimally invasive, digital simu-lation technology

中图分类号:

R782.11

贺兰稀, 居来提·吾麦尔null, 周子航, 于健, 王昭领, 陈虹瑜. 数字化辅助下牙根先脱位拔除上颌第二磨牙根分叉间埋伏第三磨牙1例[J]. 华西口腔医学杂志, 2024, 42(3): 403-408.

He Lanxi, Jurat·Omar , Zhou Zihang, Yu Jian, Wang Zhaoling, Chen Hongyu. Digital technology-assisted extraction of impacted maxillary third molar located between the furcation of maxillary second molar by root dislocation: a case report[J]. West China Journal of Stomatology, 2024, 42(3): 403-408.

图/表 7

图 1

图 2

图 3

图 4

图 5

图 6

图 7

参考文献 15

1	Farish SE, Bouloux GF. General technique of third molar removal[J]. Oral Maxillofac Surg Clin North Am, 2007, 19(1): 23-43.
2	Lim AA, Wong CW, Allen JC. Maxillary third molar: patterns of impaction and their relation to oroantral perforation[J]. J Oral Maxillofac Surg, 2012, 70(5): 1035-1039.
3	Wang D, He X, Wang Y, et al. External root resorption of the second molar associated with mesially and horizontally impacted mandibular third molar: evidence from cone beam computed tomography[J]. Clin Oral Investig, 2017, 21(4): 1335-1342.
4	Oenning AC, Melo SL, Groppo FC, et al. Mesial inclination of impacted third molars and its propensity to stimulate external root resorption in second molars: a cone-beam computed tomographic evaluation[J]. J Oral Maxillofac Surg, 2015, 73(3): 379-386.
5	Smailienė D, Trakinienė G, Beinorienė A, et al. Relationship between the position of impacted third molars and external root resorption of adjacent second molars: a retrospective CBCT study[J]. Medicina (Kaunas), 2019, 55(6): E305.
6	赖颖, 潘韦霖, 刘畅, 等. 埋伏阻生牙导致牙根外吸收邻牙的预后的临床观察[J]. 华西口腔医学杂志, 2019, 37(3): 280-284.
	Lai Y, Pan WL, Liu C, et al. Prognosis of teeth with external root resorption caused by adjacent impacted teeth[J]. West China J Stomatol, 2019, 37(3): 280-284.
7	Carvalho RW, Araújo-Filho RC, Vasconcelos BC. Adver-se events during the removal of impacted maxillary third molars[J]. Int J Oral Maxillofac Surg, 2014, 43(9): 1142-1147.
8	Hasegawa T, Tachibana A, Takeda D, et al. Risk factors associated with oroantral perforation during surgical removal of maxillary third molar teeth[J]. Oral Maxillofac Surg, 2016, 20(4): 369-375.
9	张述寅, 莫静珍, 胡开进.两种手术拔除下颌水平阻生第三磨牙的效果比较[J]. 实用口腔医学杂志, 2023, 39(1): 64-68.
	Zhang SY, Mo JZ, Hu KJ. Comparison of two methods in the extraction of horizontally impacted mandibular third molars[J]. J Pract Stomatol, 2023, 39(1): 64-68.
10	孙宇琪, 赵吉宏. 牙根先脱位法拔除上颌超高位阻生第三磨牙1例[J]. 口腔医学研究, 2022, 38(12): 1205-1207.
	Sun YQ, Zhao JH. Application of “root removal first” strategy in the extraction of impacted maxillary third molar in position D: a case report[J]. J Oral Sci Res, 2022, 38(12): 1205-1207.
11	Hong B, Bulsara Y, Gorecki P, et al. Minimally invasive vertical versus conventional tooth extraction: an interrupted time series study[J]. J Am Dent Assoc, 2018, 149(8): 688-695.
12	吴詹强, 林汉武, 巫俊躯. 微创拔牙技术应用于下颌低位埋伏阻生智齿拔除中的临床效果[J]. 数理医药学杂志, 2020, 33(10): 1485-1486.
	Wu ZQ, Lin HW, Wu JQ. Clinical efficacy of application of minimally invasive tooth extraction technique in mandibular lower position impacted wisdom tooth extraction[J]. J Mathemat Med, 2020, 33(10): 1485-1486.
13	邓文正, 周诺, 覃求, 等. 螺旋CT结合Mimics软件实现颏管区测量和可视化[J]. 口腔颌面修复学杂志, 2014, 15(5): 297-300.
	Deng WZ, Zhou N, Qin Q, et al. Measurement and vi-sualization of mental canal by spiral CT combined with mimics software[J]. Chin J Prosthodont, 2014, 15(5): 297-300.
14	李爽, 施益军, 朱静峰, 等. Mimics软件系统行三维重建指导胸腔镜下解剖性肺段切除术的临床应用分析[J]. 中国胸心血管外科临床杂志, 2024, 31(1): 59-64.
	Li S, Shi YJ, Zhu JF, et al. Clinical application of Mi-mics software system to three-dimensional reconstruction to guide thoracoscopic anatomic pulmonary segmentectomy[J]. Chin J Clin Thorac Cardiovasc Surg, 2024, 31(1): 59-64.
15	Shan T, Tay FR, Gu L. Application of artificial intelligence in dentistry[J]. J Dent Res, 2021, 100(3): 232-244.

[1]	朱桂全, 李春洁. 内镜下唾液腺切除术式的变迁与趋势——从内镜辅助到完全内镜[J]. 华西口腔医学杂志, 2023, 41(4): 377-384.
[2]	黄佳玥, 刘显, 王艳, 包崇云. 牙囊在埋伏上颌中切牙唇侧微创开放式牵引中的作用探讨[J]. 华西口腔医学杂志, 2023, 41(2): 197-202.
[3]	潘剑, 薛洋, 赵吉宏, 周青, 邹多宏, 陈松龄, 韩冰, 崔念晖, 刘显, 王了, 胡开进. 口服抗栓药物患者门诊拔牙围手术期管理的专家共识[J]. 华西口腔医学杂志, 2022, 40(3): 255-263.
[4]	高羽轩, 汪鎏, 傅裕杰, 杨帆, 张岚, 黄定明. 数字化导板引导技术辅助微创治疗前牙钙化根管[J]. 华西口腔医学杂志, 2022, 40(1): 111-122.
[5]	刘子嫣,赵凌,杨丽媛,高旭. 开髓方式与全冠修复对上颌中切牙应力分布影响的三维有限元分析[J]. 华西口腔医学杂志, 2019, 37(6): 642-647.
[6]	王鲲鹏,李博龙,袁逸杰,孟昭松,张婷婷. 对角分根法在下颌双根阻生第三磨牙拔除术中的应用[J]. 华西口腔医学杂志, 2019, 37(6): 684-686.
[7]	杨如倩,郭淑娟,肖诗梦,丁一. 激光在牙冠延长术中的临床应用[J]. 华西口腔医学杂志, 2019, 37(5): 551-555.
[8]	于海洋,赵雨薇,李俊颖,罗天,高静,刘洪臣,刘伟才,刘峰,赵克,Fei Liu,马楚凡,JuergenManfred Setz,梁珊珊,范琳,高姗姗,朱卓立,沈颉飞,王剑,朱智敏,周学东. 基于牙体牙髓、牙周及功能健康的显微微创牙体预备[J]. 华西口腔医学杂志, 2019, 37(3): 229-235.
[9]	向思捷,潘剑. 拔牙后牙槽嵴保持的研究现状[J]. 华西口腔医学杂志, 2019, 37(1): 97-101.
[10]	王小竞. 微创美容技术在儿童口腔治疗中的应用[J]. 华西口腔医学杂志, 2018, 36(4): 349-354.
[11]	崔庆赢, 陈思宇, 付帅, 张长彬, 黎明. 口腔颌面外科门诊拔牙患者牙科焦虑症调查分析[J]. 华西口腔医学杂志, 2018, 36(3): 314-318.
[12]	张英. 复杂冠根折的治疗策略[J]. 华西口腔医学杂志, 2017, 35(5): 456-460.
[13]	华成舸. 微创拔牙的刚体力学分析[J]. 华西口腔医学杂志, 2017, 35(2): 119-123.
[14]	谢乙加, 胡洲, 赵青, 林富伟, 曾阳, 徐晓梅, 曾琳, 杨璞. 正畸治疗中非常规拔牙的临床应用分析[J]. 华西口腔医学杂志, 2017, 35(2): 176-182.
[15]	刘涛程立杨惠王沪宁房宏志胡涛. 龋易感人群健康美学管理的策略与实践[J]. 华西口腔医学杂志, 2016, 34(5): 511-515.

数字化辅助下牙根先脱位拔除上颌第二磨牙根分叉间埋伏第三磨牙1例

Digital technology-assisted extraction of impacted maxillary third molar located between the furcation of maxillary second molar by root dislocation: a case report

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 7

参考文献 15

相关文章 15

编辑推荐

Metrics

本文评价