Sencimen Metin, Ortakoglu Kerim, Aydin Cumhur, Aydintug Yavuz S, Ozyigit Aykut, Ozen Tuncer, Gunaydin Yilmaz
Department of Oral and Maxillofacial Surgery, Gülhane Military Medical Academy, GATA Dişhekimliği Bilimleri Merkezi, Etlik, Ankara, Turkey.
J Oral Maxillofac Surg. 2010 Oct;68(10):2385-90. doi: 10.1016/j.joms.2010.02.024. Epub 2010 Jul 21.
Close proximity of the inferior alveolar nerve (IAN) to the third molar roots can result in nerve injuries during extraction of third molars. Consequently, it is necessary to determine the relationship of the nerve and roots to avoid damage to the IAN. Computed tomography scans are widely used to determine the correct relationship between the IAN and lower third molars.
The study consisted of 10 patients with 16 lower third molars in close relationship with the IAN who were divided into a study group and a control group. The patients in the study group were treated via coronectomies performed with endodontic treatments. The patients in the control group underwent coronectomies without endodontic treatment. The patients were followed up for at least 1 year.
We had to extract 7 of the roots because of the infection in 8 patients belonging to the study group, which were treated endodontically. Moreover, there were 3 cases of IAN damage because of the extraction in the study group. However, in the control group, no infection was determined and IAN damage was absent.
Coronectomy appears to be a reliable technique to protect the IAN from damage. This procedure has a low incidence of complications. Endodontic treatment does not affect the success of this method according to our results.
下牙槽神经(IAN)与第三磨牙牙根距离过近会导致在拔除第三磨牙时神经损伤。因此,有必要确定神经与牙根的关系以避免损伤IAN。计算机断层扫描被广泛用于确定IAN与下颌第三磨牙之间的正确关系。
该研究包括10例患者的16颗与IAN关系密切的下颌第三磨牙,这些患者被分为研究组和对照组。研究组患者通过牙髓治疗后行牙冠切除术进行治疗。对照组患者接受未进行牙髓治疗的牙冠切除术。对患者进行至少1年的随访。
研究组8例患者因感染不得不拔除7颗牙根,并进行了牙髓治疗。此外,研究组有3例因拔牙导致IAN损伤。然而,对照组未发现感染,也没有IAN损伤。
牙冠切除术似乎是一种保护IAN免受损伤的可靠技术。该手术并发症发生率低。根据我们的结果,牙髓治疗不影响该方法的成功率。