目的 探讨对需要正畸牵引的埋伏上前牙进行开窗手术时,应用无痛口腔麻醉仪联合超声骨刀对比卡式注射器联合涡轮快机的临床效果。方法 选取因埋伏上前牙需要正畸牵引,实行开窗术的病例128例,随机分为无痛口腔麻醉仪联合超声骨刀组（麻醉仪联合超声骨刀组）和卡式注射器联合涡轮快机组（常规组）,每组64例;对比2组患者开窗术中的配合情况以及术后的肿胀和疼痛情况。结果 开窗术术中的配合程度比较,麻醉仪联合超声骨刀组0级和Ⅰ级占比分别为45.3%和31.3%,常规组0级和Ⅰ级分别为32.8%和20.3%,麻醉仪联合超声骨刀组术中配合优于常规组,差异有统计学意义（ Z=-2.676, P < 0.05）。术后24 h疼痛和术后48 h肿胀程度比较,麻醉仪联合超声骨刀组疼痛Ⅰ级为81.2%,常规组疼痛Ⅰ级为59.4%,麻醉仪联合超声骨刀组术后疼痛轻于常规组,差异有统计学意义（Z=-2.777, P < 0.05）;麻醉仪联合超声骨刀组术后肿胀Ⅰ级为81.2%,常规组肿胀Ⅰ级为71.9%,麻醉仪联合超声骨刀组术后肿胀轻于常规组,差异有统计学意义（ Z=-2.097, P < 0.05）。结论 在埋伏上前牙需要正畸牵引作开窗术时,使用无痛口腔麻醉仪联合超声骨刀,患者更加容易配合且术后反应较小。

Objective To investigate the clinical efficacy of painless oral anesthesia combined with piezosurgery compared with ordinary cassette syringe combined with high speed turbine handpiece in the Fenestration operation of orthodontic traction of impacted maxillary anterior teeth.Methods A total of 128 cases of impacted maxillary anterior teeth were treated with Fenestration operation and orthodontic traction, and the patients were randomly divided into two groups. Group A (64 patients) received painless oral anesthesia combined with piezosurgery. Group B (64 patients) received ordinary cassette syringe combined with high speed turbine handpiece. The cooperation of fenestration and the swelling and pain after operation were compared between the 2 groups.Results The proportion of 0 and Ⅰ in the anesthesia group was 45.3% and 31.3% respectively, and the conventional group 0 and I accounted for 32.8% and 20.3% respectively. The difference between the two groups was statistically significant ( Z=-2.676, P < 0.05). The pateints' cooperative degree in group A was better than that in group B ( P < 0.05). The ratio of pain and swelling in the anesthesia instrument combined with Piezosurgery group was 81.2%, the conventional group had a grade I ratio of 59.4%, and the anesthesia instrument combined with Piezosurgery group was lighter than the conventional group, The difference was statistically significant ( Z=-2.777, P < 0.05); anesthesia combined with Piezosurgery group after surgery accounted for 81.2% of the swelling, the conventional group of pain accounted for 71.9%, There was significant difference between the two groups ( Z=-2.097, P < 0.05). Symptoms and signs as swelling and pain degree in group A were relatively minor than those in group B ( P < 0.05).Conclusion It is worthy clinical promotion to use Painless oral anesthesia combined with piezosurgery in the fenestration and orthodontic traction of impacted maxillary anterior teeth, for its better cooperation and minor post-surgery reaction.