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阻生牙是指由于各种阻力导致不能正常萌出的牙齿的统称，通常阻生牙牙体大部甚至全部埋伏于骨内。阻生牙可导致各种并发症的发生，因此临床上一般主张预防性拔除阻生牙。阻生牙拔除手术因其难度高、风险大、术后反应重一直是口腔牙槽外科关注的重点。近年来随着手术器械、手术观念等方面的进步，阻生牙拔除术取得了一些临床进展。新型CT 扫描设备CBCT 可以为手术设计提供精确定位；借助各类微创器械，微创拔牙技术减小了手术创伤，降低了手术风险；新型麻醉方式和新型局麻药物可以极大减轻疼痛反应；心理干预也将成为阻生牙拔除患者围手术期管理的重要步骤。本文对近年来阻生牙拔除术在定位方式、微创技术、团队协作、疼痛控制和心理干预等方面的临床进展做一综述。

英文摘要:

A tooth is spoken as being impacted when its eruption is obstructed by bone or some other teeth. The impacted tooth is always partially or wholly displaced in the alveolar bone. Impacted teeth could cause many complications, so doctors suggest remove them preventively. Impacted tooth extraction is the focus of the alveolar surgery, for the surgical difficulty, risk and obvious postsurgical reaction. In recent years, with the development of operative instrument and concept, there were some clinical progresses in the surgical therapy of impacted tooth extraction. CBCT could provide precise positioning information; minimally invasive extraction could reduce surgical injury and lower the risk of surgery; the new anesthesia methods could greatly reduce the pain response. We think psychological intervention should be an important step for the impacted tooth extraction. This summary reviews some clinical progresses about the impacted tooth extraction in precise positioning, minimal invasive extraction, operative teamwork, pain management and psychological intervention.

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