下颌切牙管的三维空间分布规律研究及对颏部取骨的范围探讨

doi:10.13701/j.cnki.kqyxyj.2021.02.015

口腔医学研究 ›› 2021, Vol. 37 ›› Issue (2): 157-161.DOI: 10.13701/j.cnki.kqyxyj.2021.02.015

下颌切牙管的三维空间分布规律研究及对颏部取骨的范围探讨

喻缇, 周乔^*, 黄元丁, 季平, 黄弘

重庆医科大学附属口腔医院种植科,口腔疾病与生物医学重庆市重点实验室,重庆市高校市级口腔生物医学工程重点实验室重庆 401147

收稿日期:2020-08-25 发布日期:2021-02-11
通讯作者: 周乔,E-mail:467292102@qq.com
作者简介:喻缇(1993~ ),女,重庆人,硕士,研究方向:口腔种植学。
基金资助:
重庆市教委科学技术研究基金(编号:KJ110306)

Dimensional Variations and Spatial Distribution Regularities of Mandibular Incisive Canal and Its Impact on Safe Range of Bone Harvesting

YU Ti, ZHOU Qiao^*, HUANG Yuanding, JI Ping, HUANG Hong

Department of Dental Implant, The Affiliated Hospital of Stomatology, Chongqing Medical University; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China

Received:2020-08-25 Published:2021-02-11

摘要/Abstract

摘要： 目的:利用口腔锥形束CT(CBCT)探寻下颌切牙管(MIC)在下颌骨内的一般分布规律,为降低患者颏部截骨术后的神经并发症风险提供影像学依据。方法:收集80例患者下颌骨的CBCT影像资料,评估MIC在颏孔间区各牙位下方的检出率和清晰度,并对MIC的直径及其与下颌骨各平面之间的距离进行测量。结果:MIC的检出率为52.5%~77.4%,从下颌中切牙区到第一前磨牙区,其影像清晰度逐步增高。在颊舌方向上,MIC到下颌唇侧皮质骨板的平均水平距离和切线距离分别为(3.74±1.23) mm和(3.54±1.18) mm,差异有统计学意义(P＜0.005) ;在垂直方向上,MIC与双侧颏孔连线之间的垂直距离从第一前磨牙区(4.47±2.07) mm到中切牙区(7.36±2.61) mm逐渐增加(P＜0.0001),而MIC到根尖的垂直距离则逐渐降低(P＜0.0001)。结论:从颏孔区到下颌正中联合,MIC逐渐向根方走行,且清晰度和检出率逐渐下降;MIC到唇侧骨板的水平距离基本保持不变。为尽量避免MIC神经并发症的发生,颏部取骨的范围最好在正中联合区域,且厚度应控制在3.5 mm以内。

关键词: 下颌切牙管, 锥形束CT, 颏部取骨, 神经并发症

Abstract: Objective: To assess the dimensional variations and spatial distribution regularities of mandibular incisive canal (MIC) by means of CBCT, and to demonstrate its impact on safe range of bone harvesting. Methods: 160 semi-mandibles of 80 patients were recruited in this study. The CBCT data were reconstructed to evaluate the visibility, diameter, and location within the mandible of MIC. Results: The rate of the MIC identification had a range of 52.5%-77.4%, showing an upward tendency from the central incisor to the first premolar. The mean distance from MIC to the labial cortex were (3.74±1.23) mm in straight line and (3.54±1.18) mm in tangential direction respectively (P＜0.005). Conclusion: The MIC runs slightly downward from the foramen to the midline, with its diameter and visibility decreasing. It locates closer to the labial cortex as constantly as (3.54±1.18) mm in different tooth sites but remains below the link line of bilateral mental foramens with different level ranging from (3.79±1.78) mm to (8.41±2.91) mm. The harvesting of bone graft in the interforaminal region should be limited within the distance range.

Key words: mandibular incisive canal, cone beam CT, bone graft, neurological complication

喻缇, 周乔, 黄元丁, 季平, 黄弘. 下颌切牙管的三维空间分布规律研究及对颏部取骨的范围探讨[J]. 口腔医学研究, 2021, 37(2): 157-161.

YU Ti, ZHOU Qiao, HUANG Yuanding, JI Ping, HUANG Hong. Dimensional Variations and Spatial Distribution Regularities of Mandibular Incisive Canal and Its Impact on Safe Range of Bone Harvesting[J]. Journal of Oral Science Research, 2021, 37(2): 157-161.

参考文献

[1] Weibull L, Widmark G, Ivanoff CJ, et al. Morbidity after chin bone harvesting-a retrospective long-term follow-up study [J]. Clin Implant Dent Relat Res, 2009, 11(2): 149-157.
[2] Andersen K, Nørholt S, Knudsen J, et al. Donor site morbidity after reconstruction of alveolar bone defects with mandibular symphyseal bone grafts in cleft patients-111 consecutive patients [J]. Int J Oral Maxillofac Surg, 2014, 43(4): 428-432.
[3] Yovchev D, Deliverska E, Indjova J, et al. Mandibular incisive canal: a cone beam computed tomography study [J]. Biotechnol Biotechnol Equip, 2013, 27(3): 3848-3851.
[4] Apostolakis D, Brown JE. The dimensions of the mandibular incisive canal and its spatial relationship to various anatomical landmarks of the mandible: a study using cone beam computed tomography [J]. Int J Oral Maxillofac Implants, 2013, 28(1): 117-124.
[5] de Brito AC, Nejaim Y, de Freitas DQ, et al. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal [J]. Imaging Sci Dent, 2016, 46(3): 159-165.
[6] Ankush P, Pradhuman V, Princy M, et al. CBCT evaluation of the vital mandibular interforaminal anatomical structures [J]. Ann Maxillofac Surg, 2020, 10(1):149-157.
[7] Kong N, Hui M, Miao F, et al. Mandibular incisive canal in Han Chinese using cone beam computed tomography [J]. Int J Oral Maxillofac Surg, 2016, 45(9): 1142-1146.
[8] Al-Ani O, Nambiar P, Ha KO, et al. Safe zone for bone harvesting from the interforaminal region of the mandible [J]. Clin Oral Implants Res, 2013, 24 Suppl A100: 115-121.
[9] Pires CA, Bissada NF, Becker JJ, et al. Mandibular incisive canal: cone beam computed tomography [J]. Clin Implant Dent Relat Res, 2012, 14(1): 67-73.
[10] Parnia F, Moslehifard E, Hafezeqoran A, et al. Characteristics of anatomical landmarks in the mandibular interforaminal region: a cone-beam computed tomography study [J]. Med Oral Patol Oral Cir Bucal, 2012, 17(3): e420-425.
[11] Uchida Y, Noguchi N, Goto M, et al. Measurement of anterior loop length for the mandibular canal and diameter of the mandibular incisive canal to avoid nerve damage when installing endosseous implants in the interforaminal region: a second attempt introducing cone beam computed tomography [J]. J Oral Maxillofac Surg, 2009, 67(4): 744-750.
[12] Mardinger O, Chaushu G, Arensburg B, et al. Anatomic and radiologic course of the mandibular incisive canal [J]. Surg Radiol Anat, 2000, 22(3-4): 157-161.
[13] Hunt DR, Jovanovic SA. Autogenous bone harvesting: a chin graft technique for particulate and monocortical bone blocks [J]. Int J Periodontics Restorative Dent, 1999, 19(2): 165-173.
[14] Pommer B, Tepper G, Gahleitner A, et al. New safety margins for chin bone harvesting based on the course of the mandibular incisive canal in CT [J]. Clin Oral Implants Res, 2008, 19(12): 1312-1316.

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下颌切牙管的三维空间分布规律研究及对颏部取骨的范围探讨

Dimensional Variations and Spatial Distribution Regularities of Mandibular Incisive Canal and Its Impact on Safe Range of Bone Harvesting

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