摘要目的:探讨矢向分牙法在微创拔除下颌水平阻生第三磨牙中的临床效果。方法:本研究为回顾性队列研究，选取2023年1—12月北部战区总医院口腔颌面外科收治的200例行下颌水平阻生第三磨牙拔除术患者，男124例，女76例，年龄(29±11)岁，年龄范围为18～40岁。根据手术方式不同分为传统治疗组与矢向分牙法组，每组100例。两组患者均通过T字法或三段法分牙去除近中牙冠阻力，而后传统治疗组采用传统方式挺松后拔除，矢向分牙法组通过矢向分牙法进一步分牙后拔除。记录比较两组患者手术时间，术后疼痛、肿胀、张口受限程度及术中、术后并发症发生情况。结果:矢向分牙法组手术时间[(13.08±2.35)min]与传统治疗组[(12.16±4.35)min]比较，差异无统计学意义( P>0.05)。矢向分牙法组患者术后疼痛、肿胀、张口受限程度优于传统治疗组，差异有统计学意义( P<0.05)。矢向分牙法组舌侧骨板损伤发生率[0(0)]、术中意外断根发生率[3.0%(3/100)]、神经损伤发生率[0(0)]均低于传统治疗组[6.0%(6/100)、12.0%(12/100)、3.0%(3/100)]，差异有统计学意义( P<0.05)。 结论:矢向分牙法在微创拔除下颌水平阻生第三磨牙中并未延长手术时间，且可减轻术后肿胀、疼痛、开口受限程度，降低术中、术后并发症发生率。

abstractsObjective:To investigate the clinical effect of sagittal direction division method in extraction of horizontally impacted mandibular third molar.Methods:This study was a retrospective cohort study.A total of 200 patients undergoing mandibular horizontal impacted third molar extraction surgery admitted to the department of Oral and Maxillofacial Surgery in the General Hospital of Northern Theater Command from January 2023 to December 2023 were selected, including 124 males and 76 females, aged (29±11) years old, ranging from 18 to 40 years old.According to different surgical methods, the patients were divided into traditional treatment group and sagittal direction division method group, with 100 cases in each group.In both groups, the patients were treated with T-shaped or three-stage tooth separation to remove the resistance of the mesial crown.After that, the traditional treatment group was treated with traditional extraction, while sagittal direction division method group was treated with sagittal direction division method.The surgical time, postoperative pain, postoperative swelling, postoperative limitation of mouth opening, and intraoperative and postoperative complications of the two groups were compared.Results:The surgical time in the sagittal direction division method group[(13.08±2.35)min]compared with the traditional treatment group[(12.16±4.35)min], and there was no statistically significant difference ( P>0.05).The degrees of postoperative pain, postoperative swelling, postoperative limitation of mouth opening in the sagittal direction division method group was better than those in the traditional treatment group, and the differences were statistically significant( P<0.05).The incidences of lingual bone plate injury[0(0)], accidental root fracture[3.0%(3/100)] and nerve injury[0(0)]in the sagittal direction division method group were lower than those in the traditional treatment group[6.0%(6/100), 12.0%(12/100), 3.0%(3/100)], and the differences were statistically significant( P<0.05). Conclusions:The surgical time of sagittal direction division method is not prolonged in minimally invasive extraction of mandibular horizontally impacted third molar.The sagittal direction division method can alleviate postoperative reactions such as pain, swelling, and limitation of mouth opening, reduce the incidence of intraoperative and postoperative complications.