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

作　　者：喻缇 周乔 黄元丁[1] 季平[1] 黄弘[1] 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)

机构地区：[1]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

出　　处：《口腔医学研究》2021年第2期157-161,共5页Journal of Oral Science Research

基　　金：重庆市教委科学技术研究基金(编号:KJ110306)。

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。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.

关 键 词：下颌切牙管 锥形束CT 颏部取骨 神经并发症 

分 类 号：R78[医药卫生—口腔医学]