口腔医学研究

口腔医学研究 ›› 2023, Vol. 39 ›› Issue (5): 440-444.DOI: 10.13701/j.cnki.kqyxyj.2023.05.012

• 口腔影像学研究 • 上一篇    下一篇

下颌正中舌侧管、下颌舌侧副管和下颌切牙神经管解剖关系的CBCT影像研究

于鸿滨1, 钱石兵1, 刘超峰2, 夏志刚1, 高雅格3, 张凌鹏1*   

  1. 1.昆明市延安医院·昆明医科大学附属延安医院口腔科 云南 昆明 650051;
    2.云南省口腔医院·昆明医科大学附属口腔医院第二门诊部 云南 昆明 650031;
    3.昆明市延安医院·昆明医科大学附属延安医院医学放射影像科 云南 昆明 650051
  • 收稿日期:2022-11-28 出版日期:2023-05-28 发布日期:2023-05-16
  • 通讯作者: *张凌鹏,E-mail:kmzlp500@sina.com
  • 作者简介:于鸿滨(1983~ ),男,河南郸城人,硕士,副主任医师,研究方向为口腔颌面外科和口腔全科临床医学、科研及教学。
  • 基金资助:
    云南省高层次卫生科技人才医学后备人才(编号:H-2018089);云南省科技厅-昆明医科大学应用基础研究联合专项资金[编号:2019FE001(-265)];昆明市卫生科技人才培养项目暨“十百千”工程培养计划[编号:2021-SW(省)-001,2020-SW(后备)-022]

Anatomical Relationship Between Mandibular Median Lingual Canal, Mandibular Accessory Canal, and Mandibular Incisor Neural Tube with CBCT Imaging

YU Hongbin1, QIAN Shibing1, LIU Chaofeng2, XIA Zhigang1, GAO Yage3, ZHANG Lingpeng1*   

  1. 1. Department of Stomatology, Kunming Yan' an Hospital, Yan' an Hospital Affiliated to Kunming Medical University, Kunming 650051, China;
    2. The Second Outpatient Department, Yunnan Provincial Stomatological Hospital, Stomatological Hospital Affiliated to Kunming Medical University, Kunming 650031, China;
    3. Department of Medical Radiology, Kunming Yan' an Hospital, Yan' an Hospital Affiliated to Kunming Medical University, Kunming 650051, China
  • Received:2022-11-28 Online:2023-05-28 Published:2023-05-16

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摘要： 目的: 明确下颌前牙区血管神经管网系统的走行,提高对下颌切牙神经及其小分支的临床认识。方法: 回顾性研究104例患者CBCT影像学资料,观测下颌正中舌侧管、下颌舌侧副管和下颌颊侧管三者同下颌切牙神经管的关系。纳入标准:读取矢状截面、冠状截面、水平截面、任意截面、曲面断层等多个不同的截面图像,能够明确观测到下颌切牙神经管、下颌正中舌侧管、下颌舌侧副管和下颌颊侧管的存在。结果: (1)观测到下颌正中舌侧管同下颌切牙神经管相通15例;双侧下颌切牙神经管相通22例;下颌舌侧副管或下颌颊侧管同下颌切牙神经管相通104例,共184支。结论: (1)下颌切牙神经会发出多个小分支于前磨牙、尖牙、切牙等相应牙位处的颊舌侧骨面,这些小分支的走行管道就是下颌舌侧副管和下颌颊侧管;(2)下颌正中舌侧管是从下颌骨舌侧到内部的一段趋向于消失的管道,并不与下颌切牙神经管相通,部分情况下会同下颌切牙神经吻合或者颊舌向贯穿下颌骨;(3)下颌正中舌侧管并非下颌切牙神经管发出的从下颌骨体内走行到骨面的小分支通行管道,而是来自口底区域的血管神经束发出的分支从软组织进入下颌骨体内的路径。

关键词: 锥形束CT, 下颌舌侧管, 种植手术, 颌骨精细解剖结构

Abstract: Objective: To clarify the course of vascular neural network system in the mandibular anterior teeth. Methods: The data of 104 cases of CBCT were retrospectively studied. The relationship between mandibular median lingual canal, mandibular accessory canal, mandibular buccal canal, and mandibular incisor neural tube was observed. Inclusion criteria were: when multiple cross-sectional images such as sagittal section, coronal section, horizontal section, arbitrary section, and curved section were read, the presence of mandibular incisor neural tube, mandibular median lingual canal, and mandibular accessory canal or mandibular buccal canal could be clearly observed. Results: (1) The median lingual canal of mandible communicated with the neural tube of mandibular incisors in 15 cases. Neural tube communication of bilateral mandibular incisors was observed in 22 cases. There were 104 cases of sublingual or buccal canal communicating with mandibular incisor neural tube, with a total of 184 branches. Conclusion: (1) The mandibular incisor nerve can send out several small branches on the buccalingual bone surface of the corresponding tooth position, such as premolars, canines, and incisors. The running channels of these small branches are the mandibular accessory canal and the mandibular buccalateral canal. (2) The median lingual canal of the mandible is a pipe from the lingual side of the mandible to the interior, which tends to disappear. It is not connected with the neural tube of the mandible incisor, and in some cases, it is anastomosed with the nerve of the mandible incisor or runs through the mandible. (3) The median lingual canal of the mandible is not a small branch from the mandible body to the bone surface issued by the neural tube of the mandible incisor, but a path from the soft tissue to the mandible body issued by the branch from the vascular and nerve bundle of the mouth floor.

Key words: CBCT, mandibular lingual lateral canal, implant surgery, fine anatomical structure of the jaw