对比微创拔牙与传统拔牙在下颌阻生智齿治疗中的效果及并发症概率。方法：自2023年1月至2025年9月，选取110名下颌阻生智齿患者，采用随机数字列表法，将对象均衡地分为实验组（55人）与对照组（55人）。观察组行微创拔牙术（高速涡轮手机分牙+微创牙挺），对照组行传统拔牙术（骨凿劈冠+锤击增隙）。对比两组手术时间、术后疼痛程度、张口度及术中及术后并发症发生率。结果： 观察组施行手术的时间明显短于对照组[（25.38±5.47）min vs （31.65±6.83）min，P<0.001]；术后24h及7d的VAS评分均低于对照组[（3.52±1.21）分 vs （5.87±1.56）分，（0.89±0.65）分 vs （1.95±0.91）分，均P<0.001]，张口度大于对照组（均P<0.001）。观察组术中并发症总发生率（1.82%）显著低于对照组（14.55%）（P=0.009），术后并发症总发生率（3.64%）亦显著低于对照组（20.00%）（P=0.022）。结论：相较于常规拔牙方式，下颌阻生智齿的微创手术能显著减少治疗时间，减轻术后疼痛与张口受限，并显著降低术中及术后并发症风险，疗效与安全性俱佳，具备临床推广价值。

To compare the efficacy and complication rates of minimally invasive tooth extraction versus traditional extraction in treating impacted lower wisdom teeth. Methods: From January 2023 to September 2025,110 patients with impacted lower wisdom teeth were randomly assigned to an experimental group (55 cases) and a control group (55 cases) using a random number table. The experimental group underwent minimally invasive extraction (high-speed rotary mobile phone tooth splitting + minimally invasive tooth elevator), while the control group received traditional extraction (bone chisel splitting + hammer gap widening). The study compared operative time, postoperative pain (VAS score), mouth opening degree, and intraoperative/operative complications between the two groups. Results: The experimental group showed significantly shorter operative time [(25.38±5.47) min vs (31.65±6.83) min, P<0.001]. Postoperative VAS scores at 24h and 7d were significantly lower in the experimental group [(3.52±1.21) vs (5.87±1.56) points, (0.89±0.65) vs (1.95±0.91) points, both P<0.001], with greater mouth opening degree (P<0.001). The total intraoperative complication rate (1.82%) in the experimental group was significantly lower than the control group (14.55%) (P=0.009), and the postoperative complication rate (3.64%) was also significantly lower than the control group (20.00%) (P=0.022). Conclusion: Compared with traditional tooth extraction, minimally invasive tooth extraction can effectively shorten the operation time, reduce postoperative pain and limited mouth opening, and significantly reduce the risk of intraoperative and postoperative complications. The efficacy and safety are excellent, and it has the value of clinical promotion.

目的 探讨Nolla分期对青少年拔牙正畸患者下颌第三磨牙倾斜角的影响。方法 选择2018年10月—2022年10月收治的100例拔牙正畸青少年患者。100例患者均拔除了4颗前磨牙,共有100颗下颌第三磨牙,通过Nolla分期,可将100例患者分成四组,每组25例。Ⅰ组：牙冠正在形成,Ⅱ组：牙冠基本形成,Ⅲ组：牙根形成在1/2以下,Ⅳ组：牙根形成在1/2以上。在治疗前后,测量下颌第三磨牙倾斜角,对角度α的变化进行分析。结果 第三磨牙牙胚倾斜角、MP-SN、MP-FH在不同组间比较差异无统计学意义（F=0.256,P=0.857;F=0.033,P=0.992;F=0.028,P=0.994）;治疗前组间下颌第三磨牙角度比较差异无统计学意义（P>0.05）,治疗后不同组间下颌第三磨牙角比较差异有统计学意义（F=13.376,P<0.001）,治疗前后Ⅰ组、Ⅱ组、Ⅳ组第三磨牙的角度无差异（t=0.757,P=0.453;t=0.224,P=0.824;t=0.852,P=0.399）,Ⅲ组治疗后角度变化减少（t=3.697,P<0.001）。结论 青少年正畸拔牙后,下颌第三磨牙处于牙根形成阶段的一半以下可能会导致第三磨牙近中倾斜加重。当下颌第三磨牙处于牙冠形成阶段,牙冠形成超过一半时,第三磨牙角度变化较小。在治疗前应根据Nolla分期评估下颌第三磨牙的预后情况,并及时制定相应的干预策略。

Objective To explore the effect of Nolla staging on the inclination angle of mandibular third molars in adolescent orthodontic patients undergoing tooth extraction. Methods A total of 100 adolescent patients who underwent tooth extraction orthodontic treatment from October 2018 to October 2022 were included．All 100 patients had 4 premolars extracted,with a total of 100 mandibular third molars．According to Nolla staging,the 100 patients can be divided into 4 groups,with 25 cases in each group．Group I：The crown was forming,Group II：The crown was basically formed,Group III：The root formation was below 1/2,Group IV：The root formation was above 1/2．The inclination angle of the mandibular third molar was measured before and after treatment,and the angle α changes will be analyzed. Results There was no difference in the inclination angle,MP-SN,and MP-FH of the third molar tooth germ among different groups（F=0.256,P=0.857;F=0.033,P=0.992;F=0.028,P=0.994）．There was no difference in the angle of mandibular third molar teeth between groups before treatment（P>0.05）,the contrast of mandibular third molar angles between different groups after treatment was signifiant（F=13.376,P<0.001）,while the angles in Group I,Group and Group Ⅳ were not slgnificantly different（t=0.757,P=0.453;t=0.224,P=0.824;t=0.852,P=0.399）,and the angle change decreased after treatment in Group Ⅲ（t=3.697,P<0.001）. Conclusions After orthodontic extraction in adolescents,if the mandibular third molar is less than half of the root formation stage,it may lead to increased mesial inclination of the third molar．However,when the mandibular third molar is in the stage of crown formation and the crown is more than half formed,the angle change of the third molar is relatively small．Therefore,in clinical practice,Nolla staging should be evaluated in the prognosis of mandibular third molars before treatment and develop corresponding intervention strategies in a timely manner．