Kuzmanovic Dusan V, Payne Alan G T, Kieser Jules A, Dias George J
Department of Oral Rehabilitation, School of Dentistry, University of Otago, New Zealand.
Clin Oral Implants Res. 2003 Aug;14(4):464-71. doi: 10.1034/j.1600-0501.2003.00869.x.
Treatment planning for dental implant patients is often complicated by the unknown extent of the anterior loop of the mental neurovascular bundle. The aim of this study was to determine the correlation between the visual interpretation of the panoramic radiographs and the anatomical dissection findings in a cadaveric sample. Panoramic radiographs of the 22 randomly selected coronally sectioned human head specimens were taken using the Scanora (Soridex, Orinon Corporation Ltd, Helsinki, Finland) radiographic unit jaw panorama (Programme 001, magnification 1.3) and dental panorama (Programme 003, magnification 1.7) and interpreted by two calibrated observers. Bilateral anatomical dissection was then performed on all specimens. The anterior loop of the mental canal was only identified in six panoramic radiographs (27%) (range 0.5-3 mm). There was a significant positive correlation between both observers of the radiographs and between the two radiographic programmes used. Anatomical measurements of the anterior loop of the mental neurovascular bundle revealed its presence in eight dissected specimens (range 0.11-3.31 mm; mean 1.20, +/-0.90). Fifty percent of the radiographically observed anterior loops of the mental canal were misinterpreted by observers with both radiographic programmes and 62% of the anatomically identified loops were not observed radiographically. Clinicians should not rely on panoramic radiographs for identifying the anterior loop of the mental nerve during implant treatment planning. However, a safe guideline of 4 mm, from the most anterior point of the mental foramen, is recommended for implant treatment planning, on the basis of our anatomical findings.
牙种植患者的治疗计划常常因颏神经血管束前袢范围不明而变得复杂。本研究的目的是确定在尸体样本中全景X线片的视觉解读与解剖学解剖结果之间的相关性。使用Scanora（芬兰赫尔辛基的奥里农公司Soridex）X线摄影设备的颌全景（程序001，放大倍数1.3）和牙全景（程序003，放大倍数1.7）对22个随机选取的经冠状切片的人类头部标本进行全景X线片拍摄，并由两名经过校准的观察者进行解读。然后对所有标本进行双侧解剖。仅在6张全景X线片（27%）中识别出颏管前袢（范围为0.5 - 3毫米）。两位X线片观察者之间以及所使用的两种X线摄影程序之间均存在显著的正相关。对颏神经血管束前袢的解剖学测量显示，在8个解剖标本中发现了该结构（范围为0.11 - 3.31毫米；平均值1.20，±0.90）。在两种X线摄影程序下，观察者对X线片上观察到的颏管前袢有50%解读错误，而解剖学上识别出的袢有62%未在X线片上观察到。在种植治疗计划过程中，临床医生不应依赖全景X线片来识别颏神经前袢。然而，根据我们的解剖学发现，建议在种植治疗计划中从颏孔最前端起4毫米的安全指导距离。
