287例汉族成人颏孔区锥形束CT测量分析

摘要/Abstract

摘要： 目的应用锥形束CT(cone-beam computed tomography, CBCT)对患者下颌骨颏孔、副颏孔、下颌神经前环等结构进行测量分析,为颏孔区手术提供参考。方法收集2015年1月—2015年8月在湘雅医院口腔医学中心就诊的287例汉族患者的CBCT图像,对颏孔区的解剖结构进行分析。采用SPSS17.0软件包对数据进行统计学分析。结果颏孔多位于下颌第二前磨牙根方及下颌前磨牙之间（分别为60.80%、30.14%）;副颏孔的发生率为4.88%,多位于下颌第二前磨牙根方,颏孔上方及远中;下颌神经前环的发生率为89.20%,长度为（1.99±1.39）mm;下颌第二前磨牙根尖到下颌神经前环或下颌管的距离为（5.21±2.50）mm。结论颏孔区域可有副颏孔;中国汉族人下颌神经前环的出现率较高,变异大,颏孔区手术时应予以高度重视。

关键词: 锥形束CT, 下颌神经, 颏孔, 副颏孔, 下颌神经前环

Abstract: PURPOSE: The mandibular anatomical structures including mental foramen, accessory mental foramina, anterior loop were measured and analyzed by cone-beam CT (cone-beam computed tomography, CBCT) , in order to provide some information during surgical procedures in interforaminal regions. METHODS: Two hundred and eighty-seven Chinese Han patients who visited Stomatological Department of Xiangya Hospital were included in this study. Patients were scanned by cone-beam computed tomography, and the information of interforaminal region was collected from the images. SPSS17.0 software package was used for statistical analysis. RESULTS: The mental foramen was usually apical to the second premolar or between the premolars（60.80% and 30.14%, respectively). The accessory mental foramina was observed in 4.88% of the mandibles, most of which were located under the second premolar, superiorly and distally to the mental foramen. The anterior loop was identified in 89.20% of cases with the mean length being (1.99±1.39) mm. The distance from the apex of the second mandibular premolar to the anterior loop or the inferior alveolar nerve was (5.21±2.50) mm. CONCLUSIONS: Accessory mental foramina is present in some mandibles. The anterior loop is highly prevalent in Chinese Han people, and its length is highly variable.

Key words: Cone-beam computed tomography, Inferior alveolar nerve, Mental foramen, Accessory mental foramina, Anterior loop

中图分类号:

R782.1

曾婷雯, 高清平, 高筱萌, 余慧敏, 伍艺伟. 287例汉族成人颏孔区锥形束CT测量分析[J]. 上海口腔医学, 2016, 25(6): 715-719.

ZENG Ting-wen, GAO Qing-ping, GAO Xiao-meng, YU Hui-min, WU Yi-wei. Interforaminal regions of 287 Han adults evaluated by cone-beam computed tomography[J]. Shanghai Journal of Stomatology, 2016, 25(6): 715-719.

参考文献

[1] Mozzo P, Procacci C, Tacconi A, et al. A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results [J]. Eur Radiol, 1998, 8(9): 1558-1564.
[2] Kau CH, Richmond S, Palomo JM, et al. Three-dimensional cone beam computerized tomography in orthodontics[J]. J Orthod, 2005, 32(4): 282-293.
[3] Apostolakis D, Brown JE. The anterior loop of the inferior alveolar nerve: prevalence, measurement of its length and a recommendation for interforaminal implant installation based on cone beam CT imaging [J]. Clin Oral Implants Res, 2012, 23(9): 1022-1030.
[4] Naitoh M, Nakahara K, Suenaga Y, et al. Comparison between cone-beam and multislice computed tomography depicting mandibular neurovascular canal structures [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 109(1): e25-31.
[5] Kamburoglu K, Kilic C, Ozen T, et al. Measurements of mandibular canal region obtained by cone-beam computed tomography: a cadaveric study [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(2): e34-42.
[6] Matherne RP, Angelopoulos C, Kulild JC, et al. Use of cone-beam computed tomography to identify root canal systems in vitro [J]. J Endod, 2008, 34(1): 87-89.
[7] Vujanovic-Eskenazi A, Valero-James JM, Sánchez-Garcés MA, et al. A retrospective radiographic evaluation of the anterior loop of the mental nerve: comparison between panoramic radiography and cone beam computerized tomography [J]. Med Oral Patol Oral Cir Bucal, 2015, 20(2): e239-245.
[8] Santana RR, Lozada J, Kleinman A, et al. Accuracy of cone beam computerized tomography and a three-dimensional stereolithographic model in identifying the anterior loop of the mental nerve: a study on cadavers [J]. J Oral Implantol, 2012, 38(6): 668-676.
[9] Voljevica A, Talovic E, Hasanovic A. Morphological and morphometric analysis of the shape, position, number and size of mental foramen on human mandibles [J]. Acta Med Acad, 2015, 44(1): 31-38.
[10] Katakami K, Mishima A, Shiozaki K, et al. Characteristics of accessory mental foramina observed on limited cone-beam computed tomography images [J]. J Endod, 2008, 34(12): 1441-1445.
[11] Muinelo-Lorenzo J, Suarez-Quintanilla JA, Fernandez-Alonso A, et al. Anatomical characteristics and visibility of mental foramen and accessory mental foramen: panoramic radiography vs. cone beam CT[J]. Med Oral Patol Oral Cir Bucal, 2015, 20(6): e707-714.
[12] Torres MG, Valverde L de F, Vidal MT, et al. Accessory mental foramen: a rare anatomical variation detected by cone-beam computed tomography [J]. Imaging Sci Dent, 2015, 45(1): 61-65.
[13] Cantekin K, Sekerci A. Evaluation of the accessory mental foramen in a pediatric population using cone-beam computed tomography [J]. J Clin Pediatr Dent, 2014, 39(1): 85-89.
[14] Boronat López A, Peñarrocha Diago M. Failure of locoregional anesthesia in dental practice. Review of the literature[J]. Med Oral Patol Oral Cir Bucal, 2006, 11(6): e510-513.
[15] Imada TS, Fernandes LM, Centurion BS, et al. Accessory mental foramina: prevalence, position and diameter assessed by cone-beam computed tomography and digital panoramic radiographs [J]. Clin Oral Implants Res, 2014, 25(2): e94-99.
[16] Kim TS, Caruso JM, Christensen H, et al. A comparison of cone-beam computed tomography and direct measurement in the examination of the mandibular canal and adjacent structures [J]. J Endod, 2010, 36(7): 1191-1194.
[17] 张军岐, 王青, 陈凤山. 下颌骨颏孔区CBCT分析 [J]. 口腔颌面外科杂志, 2014, 24(2): 123-126.
[18] 金柱坤, 李潇, 杨凯. 基于螺旋CT对68例中国人下颌神经管的位置研究 [J]. 实用口腔医学杂志, 2013, 29(4): 495-499.
[19] Lu CI, Won J, Al-Ardah A, et al. Assessment of the anterior loop of the mental nerve using cone beam computerized tomography scan [J]. J Oral Implantol, 2015, 41(6): 632-639.
[20] 王芳, 潘巨利, 李医丹, 等. 颏管的应用解剖学研究 [J]. 实用口腔医学杂志, 2004, 20(4): 463-465.
[21] Chen JC, Lin LM, Geist JR, et al. A retrospective comparison of the location and diameter of the inferior alveolar canal at the mental foramen and length of the anterior loop between American and Taiwanese cohorts using CBCT [J]. Surg Radiol Anat, 2013, 35(1): 11-18.