Clinical application and three-dimensional finite element analysis of along-axis ex-traction method in mandibular mesial and horizontally impacted third molar surgery
10.19723/j.issn.1671-167X.2025.01.016
- VernacularTitle:顺牙长轴拔牙法在下颌近中与水平智齿拔除术中的应用及三维有限元分析
- Author:
Fei WANG
1
;
Xinyue ZHANG
;
Muqing LIU
;
Enbo WANG
;
Denghui DUAN
Author Information
1. 北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,北京 100081
- Publication Type:Journal Article
- Keywords:
Mandible;
Molar,third;
Tooth extraction;
Tooth,impacted;
Complications
- From:
Journal of Peking University(Health Sciences)
2025;57(1):106-112
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical application effect of the along-axis extraction method in the extraction of impacted mandibular third molars(IMTM)and to compare the biomechanical charac-teristics of different root extraction techniques through three-dimensional finite element analysis.Me-thods:A total of 68 patients requiring IMTM extraction were enrolled and randomly divided into two groups:the experimental group underwent the along-axis extraction method,while the control group un-derwent the traditional buccal bone removal and root extraction method.The duration of the procedure,intraoperative and postoperative complications were recorded.Three-dimensional finite element analysis further revealed the stress distribution in the tooth root,jawbone,periodontal ligament,and mandibular canal during different root extraction methods.Results:The duration of root extraction,pain score and swelling on the first postoperative day in the control group were(7.87±3.90)min,4.62±1.90 and(11.37±5.12)mm,respectively,which were significantly higher than those in the experimental group[(5.74±2.37)min,3.87±1.19 and(7.22±3.39)mm,respectively].The root fracture rate and lingual bone plate fracture rate in the control group were significantly higher than those in the experimen-tal group(P＜0.05).The results of finite element analysis showed that the control group's lingual al-veolar bone had the higher peak equivalent stress,and lingual bone plate fracture was prone to occur.The periodontal ligament of the experimental group had the higher equivalent stress value,making it more likely to rip and more likely to cause root displacement.When subjected to force,the experimental group's instantaneous root displacement was higher,but the control group's root displacement was more pronounced in the lingual direction.Conclusion:This study suggests that the along-axis extraction me-thod can not only effectively shorten the operative time but also reduce postoperative complications after extraction of impacted mandibular third molars,and enhance the safety of the operation and the patient's comfort.Three-dimensional finite element analysis shows the biomechanical characteristics of various root extraction techniques visually,serves as a valuable guide for choosing and refining clinical surgical tech-niques,and confirms that extracting a tooth's root along its long axis yields better clinical results.
