下颌骨前突患者下颌管走行及临床价值探讨

doi:10.19439/j.sjos.2020.05.015

上海口腔医学 ›› 2020, Vol. 29 ›› Issue (5): 524-527.doi: 10.19439/j.sjos.2020.05.015

下颌骨前突患者下颌管走行及临床价值探讨

叶丽娟, 薄芳, 刘晶^*, 王跃平^*

上海交通大学医学院附属第九人民医院·口腔医学院口腔第二门诊部,上海 201999

收稿日期:2019-05-27 修回日期:2019-07-30 出版日期:2020-10-25 发布日期:2020-11-02
通讯作者: 刘晶,E-mail：lj3232475@163.com;王跃平,E-mail：wangyueping309@hotmail.com。^*共同通信作者
作者简介:叶丽娟（1982-）,女,硕士,E-mail：18801790090@163.com

Analysis of mandibular canal in patients with prognathism and its clinical significance

YE Li-juan, BO Fang, LIU Jing, WANG Yue-ping

Second Dental Center, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 201999, China

Received:2019-05-27 Revised:2019-07-30 Online:2020-10-25 Published:2020-11-02

摘要/Abstract

摘要： 目的：：运用锥形束CT(cone-beam CT,CBCT)分析正常人群和下颌骨前突患者下颌神经管轨迹,为临床手术方案的制订和操作时避开重要神经血管提供帮助。方法：选取28例骨性Ⅲ类下颌骨前突患者（男10例,女18例）、20例正常对照组患者（男12例,女8例）,使用CBCT拍摄下颌管影像,从下颌孔至第一磨牙区分为5个平面,在每个层面分别测量下颌管内外径、下颌骨厚度、下颌管至颊舌侧骨皮质及下颌骨下缘的距离。采用SPSS 17.0软件包对测量结果进行统计学分析。结果：下颌骨前突患者自下颌支到下颌角前部逐渐增厚,继续至下颌第一磨牙区逐渐变薄。下颌神经管的内外径自下颌支到下颌体部逐渐变细。颊侧骨皮质厚度自下颌支区域逐渐增厚,到下颌体部继续变薄。下颌骨前突患者与对照组患者下颌管的对比分析显示,骨髓腔宽度与下颌支厚度有显著差异,且具有显著相关性。结论：CBCT能够精确显示下颌神经管的走行及与周边结构的关系,下颌骨前突患者与对照组患者下颌支厚度的差异主要由颊侧骨髓腔宽度造成。

关键词: 下颌神经管, 锥形束CT, 下颌骨前突

Abstract: PURPOSE: The aim of this study was to investigate the position and course of mandibular canal in patients with prognathism using cone-beam CT(CBCT),and explore its clinical significance. METHODS: The mandibles of 28 patients with skeletal Class Ⅲ prognathism (10 males and 18 females) and 20 normal people(12 males and 8 females) were analyzed on CBCT. The position and course of mandibular canal from the lowest point of mandibular foramen to the first molar were measured at five specific sections from the mandibular foramen to the mandibular first molar area, including inner and outer diameter, mandibular bone thickness ,distance between mandibular canal and distance to the buccal and lingual bone cortex, and the inferior border of mandible bone. Statistical analysis was performed using SPSS 17.0 software package. RESULTS: The mandibular bones of patients with prognathism gradually thickened from the mandibular ramus to the forepart of the mandibular angle and thinned forward to the position where the mandibular first molar projected on the mandibular bone. Cortical bone of buccal side of the mandibular ramus thickened forward to the mandibular angle and thinned to the mandibular body. The width of buccal bone marrow cavity and diameter of mandibular bone were statistically different between genders. CONCLUSIONS: This study found that the difference between the thickness of the mandibular ramus in patients with mandibular protrusion from the controls was mainly due to the difference between the width of the buccal bone marrow cavity. CBCT can accurately locate the mandibular canal and display anatomic structures.

Key words: Mandibular canal, Cone-beam CT, Prognathism

中图分类号:

R782.1

叶丽娟, 薄芳, 刘晶, 王跃平. 下颌骨前突患者下颌管走行及临床价值探讨[J]. 上海口腔医学, 2020, 29(5): 524-527.

YE Li-juan, BO Fang, LIU Jing, WANG Yue-ping. Analysis of mandibular canal in patients with prognathism and its clinical significance[J]. Shanghai Journal of Stomatology, 2020, 29(5): 524-527.

参考文献

[1] 张震康. 正颌外科学[M]. 北京: 人民卫生出版社, 1994: 180-246.
[2] 周会喜, 艾伟健, 刘曙光, 等. 下颌支矢状劈开术同期行下颌角修整矫正下颌前突伴偏斜畸形[J]. 广东医学, 2013, 34(11): 1712-1713.
[3] 任晓旭, 牛勇梅, 秦晓中, 等. 正颌-正畸联合治疗下颌前突伴偏颌畸形患者的临床应用[J]. 临床口腔医学杂志, 2016, 32(1): 57-59.
[4] Hasegawa T, Tateishi C, Asano M, et al.Changes in the sensitivity of cutaneous points and the oral mucosa after intraoral vertical ramus osteotomy[J]. Int J Oral Maxillofac Surg, 2013, 42(11): 1454-1461.
[5] Levine JP, Patel A, Saadeh PB, et al.Computer-aided design and manufacturing in craniomaxillofacial surgery: the new state of the art[J]. J Craniofac Surg, 2012, 23(1): 288-293.
[6] Whitlock EL, Kasukurthi R, Yan Y, et al.Fibrin glue mitigates the learning curve of microneurosurgical repair[J]. Microsurgery, 2010, 30(3): 218-222.
[7] Peltola SM, Melchels FP, Grijpma DW, et al.A review of rapid prototyping techniques for tissue engineering purposes[J]. Ann Med, 2008, 40(4): 268-280.
[8] 马嘉, 阎秀林.双侧下颌支矢状劈开截骨术后咽腔气道的变化[J]. 中国口腔颌面外科杂志, 2015, 13(5): 425-428.
[9] Levine MH, Goddard AL, Dodson TB.Inferior alveolar nerve canal position: a clinical and radiographic study[J]. J Oral Maxillofac Surg, 2007, 65(3): 470-474.
[10] Kagawa T, Fukunari F, Shiraishi T.Development of a simple image viewer designed for small X-ray field CT equipment 3DX[J]. Oral Radiol, 2006, 22(2): 47-51.
[11] Lofthag-Hansen S, Huumonen S, Gröndahl K, et a1. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007, 103(1): 114-119.
[12] 沈聪聪, 张艳, 李青峰, 等. 3-D打印技术制备人工骨修复下颌角截骨整形术后骨缺损[J]. 中国修复重建外科杂志,2014, 28(3): 300-303.
[13] Al-Bishri A, Barghash Z, Rosenquist J, et al.Neurosemory disturbance after sagittal split and intraoral vertical ramus osteotomy: as reported in questionnaires and patients' records[J] . Int J Oral Maxillofac Surg, 2005, 34(3): 247-251.
[14] Hueman EM, Noujeim ME, Langlais RP, et al.Accuracy of cone beam computed tomography in determining the location of the genial tubercle[J]. Otolaryngol Head Neck Surg, 2007,137(1): 115-118.
[15] Tsuji Y, Muto T, Kawalami J, et al.Computed tomographic analysis of the position and course of the mandibular canal: relevance to the sagittal split ramus osteotomy[J]. Int J Oral Maxillofac Surg, 2005, 34(3): 243-246.
[16] Ribeiro DP, Gandelmann IH, Medeiros PJ.Comparison of mandibular rami width in patients with prognathism and retrognathia[J]. J Oral Maxillofac Surg, 2006, 64(10): 1506-1509.
[17] Muto T, Shigeo K, Yamamoto K, et al.Computed tomography morphology of the mandibular ramus in prognathism: effect on the medial osteotomy of the sagittal split ramus osteotomy[J]. J Oral Maxillofac Surg, 2003, 61(1): 89-93.

下颌骨前突患者下颌管走行及临床价值探讨

Analysis of mandibular canal in patients with prognathism and its clinical significance

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