- 期刊
Practical Classification System for Horizontal/Mesio-angular Impaction of Mandibular Third Molars
下顎水平阻生曁近心傾斜阻生第三大臼齒的實用臨床分類法
摘要
Purpose: Pell and Gregory's classification provides the benchmark of grading the difficulty of vertically impacted mandibular third molars based on the amount of tooth covered by the anterior border of the ascending ramus and the depth of the impaction relative to the adjacent second molars. However, Pell and Gregory's system cannot be used to evaluate horizontal/mesio-angular impactions, which are much more commonly encountered clinically. The purpose of this study was to provide a clear and efficient classification system for both horizontal and mesio-angular impaction of mandibular third molars. Materials and Methods: In 2015, 224 patients, 17 to 61 years of age, had an odontectomy of impacted mandibular third molars by two designated surgeons, one attending and one resident in our Department of Oral and Maxillofacial Surgery. We recorded the operation time and the visual analog scale (VAS) pain score on postoperative day 7 of these procedures (n = 224). Preoperative panoramic radiographs were routinely obtained for grading all impacted mandibular third molars according to the Taichung China Medical University (TCMU) classification system by another senior oral maxillofacial surgeon. Results: Linear regression analysis revealed significant (p ＜ 0.05) correlation of operation time and the TCMU classification system. There was also a significant relationship between VAS pain score and the grading system. Conclusion: Odontectomy of impacted third molars is one of the most common procedures conducted by oral maxillofacial surgeons. It is very important for surgeons to estimate or expect difficulties beforehand. The TCMU classification offers a simple and clear system for perioperative evaluation of horizontal and mesio-angular impaction of mandibular third molars.
並列摘要
目的：下顎阻生第三大臼齒拔除乃是口腔顎面外科醫師最常做的臨床手術之一，Pell和Gregory的分類提供了一個基準，係根據下顎升支的前緣所覆蓋牙齒的情況以及相對於鄰近的第二大臼齒的埋伏深度對垂直阻生的下顎阻生第三大臼齒的難度進行分級。由於以Pell和Gregory的系統針對水平／近心傾斜阻生的下顎第三大臼齒進行分類上常有限制。本研究之目的係針對水平／近心傾斜阻生下顎第三大臼齒提供一個簡明有效的分類並驗證其有效性。材料和方法：在2015年間，由口腔顎面外科醫師，針對需進行下顎阻生第三大臼齒齒切除術之患齒，參酌術前全景X光片，根據台中中國醫藥大學分類系統獲得進行分類；並由一名口腔顎面外科主治醫師和一名住院醫師對224例17至61歲的患者進行了下顎阻生第三大臼齒的齒切除術，在術後第7天（n =224）記錄了手術時間和視覺疼痛評分等，並將上述臨床數據進行分析。結果：線性回歸分析顯示手術時間與中國醫藥大學分類系統之間存在顯著（p ＜ 0.05）相關性。視覺疼痛評分與評分系統之間也存在顯著關係。結論：阻生下顎第三大臼齒切除術是口腔顎面外科醫生常見的手術。對於醫師而言，事先估計或預期其手術難易度非常重要。本研究顯示中國醫藥大學分類為水平／近心傾斜阻生下顎第三大臼齒手術期評估提供了一個簡明且有效的分類系統，對於評估手術難易度有所助益。