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评估使用密度和厚度参数的种植体钻头穿透下颌管的风险。

Assessment of the risk of perforation of the mandibular canal by implant drill using density and thickness parameters.

机构信息

Department of Oral Implantology, Yeditepe University, Faculty of Dentistry, Istanbul, Turkey.

出版信息

Gerodontology. 2011 Sep;28(3):213-20. doi: 10.1111/j.1741-2358.2009.00362.x. Epub 2010 Mar 4.

Abstract

OBJECTIVE

The objective of this study was to investigate whether the resistance of the bone surrounding the mandibular canal had sufficient density and thickness to avoid perforation by drills when preparing the bed of the implant.

BACKGROUND

Damage to the inferior alveolar nerve (IAN) is more common than expected. This injury may lead to serious complications ranging from mild paresthesia to total anaesthesia of the lower jaw.

MATERIALS AND METHODS

The CT images of 99 patients, whose ages ranged between 20 and 79years, and who applied for an implant application to the posterior aspect of the mandible were included in this study.

RESULTS

The overall average bone thickness in the premolar and molar regions was 0.8717±0.1818 and 0.8556±0.1756mm, respectively, whereas the bone density in the premolar and molar regions was 649.18±241.42 and 584.44±222.73 Hounsfield Units (HU), respectively (p<0.001).

CONCLUSION

It was determined that the average density and thickness of the bone that surrounds the mandibular canal was not sufficient to resist the implant drill. It can be concluded that the risk of injury to the IAN may be minimised by accurately determining the bone mass on the canal prior to the implant procedure, and avoiding excessive force when approaching the canal.

摘要

目的

本研究旨在探讨下颌管周围骨质的密度和厚度是否足以抵抗种植床预备时钻头的穿透。

背景

下牙槽神经(IAN)损伤比预期更为常见。这种损伤可能导致严重的并发症,从轻度感觉异常到下颌完全麻醉。

材料和方法

本研究纳入了 99 名年龄在 20 至 79 岁之间、申请在下颌后牙区植入的患者的 CT 图像。

结果

磨牙和前磨牙区的平均骨厚度分别为 0.8717±0.1818mm 和 0.8556±0.1756mm,而磨牙和前磨牙区的骨密度分别为 649.18±241.42HU 和 584.44±222.73HU(p<0.001)。

结论

确定了下颌管周围骨的平均密度和厚度不足以抵抗种植钻头。可以得出结论,通过在种植手术前准确确定管内的骨量,并在接近管时避免过度用力,可以最大程度地降低 IAN 损伤的风险。

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