两种皮瓣用于拔除水平阻生下颌第三磨牙的比较分析：一项多中心随机对照试验

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology Pub Date : 2025-06-07 DOI:10.1016/j.ajoms.2025.06.005

Tomofumi Naruse , Satoshi Rokutanda , Satoshi Inokuchi , Keisuke Omori , Kohei Furukawa , Hiromasa Fukushima , Masahiro Umeda , Tomohiro Yamada

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引用次数: 0

摘要

目的探讨水平阻生下颌第三磨牙拔除术后的并发症。本研究旨在比较两种皮瓣设计对减少术后并发症的影响。方法对188例水平阻生下颌第三磨牙患者进行单盲、多中心、随机对照研究。患者按1:1的比例分为改良包膜瓣（mEF）组和三角瓣（TF）组。术后7（ ± ）天评估手术时间及术后并发症（疼痛、出血、神经感觉改变、干窝[牙槽骨炎]、感染）。结果mEF组患者术后疼痛明显减轻（P = 0.033）。在亚组分析中，低难度患者术后疼痛明显降低（Pell和Gregory分类IA， IIA， IIA， IB; P = 0.018）。其他因素与皮瓣设计无显著相关。结论对于水平阻生下颌第三磨牙拔除难度低的患者，mEF可减少术后疼痛。然而，目前的证据不足以推荐任何一种皮瓣设计。

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Comparative analysis of two flap designs for the extraction of horizontally impacted mandibular third molars: A multicenter randomized controlled trial

Objective

Most patients experience postoperative complications caused by the extraction of horizontally impacted mandibular third molars. The present study aimed to compare the effects of two flap designs on the reduction of postoperative complications.

Methods

A total of 188 patients with horizontally impacted mandibular third molars were included in this single-blind, multicenter, randomized control trial. The patients were assigned to either the modified envelope flap (mEF) or triangular flap (TF) group in a 1:1 ratio. The operation time and postoperative complications (pain, hemorrhage, neurosensory changes, dry socket [alveolar osteitis], and infection) were assessed for 7 ± 1 days postoperatively.

Results

In all cases, postoperative pain was significantly lower in the mEF group (P = 0.033). In the subgroup analysis, postoperative pain was significantly lower in cases of low difficulty (Pell and Gregory classification IA, IIA, IIA, IB; P = 0.018). Other factors were not significantly associated with the flap design.

Conclusions

Our study suggested that mEF resulted in less postoperative pain in cases of low difficulty of extracting horizontally impacted mandibular third molars. However, the current evidence is inadequate to recommend either flap design.

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