Orhan Ayse Isil, Orhan Kaan, Aksoy Secil, Ozgül Ozkan, Horasan Sinan, Arslan Ahmet, Kocyigit Doruk
Division of Pediatric Dentistry, Ministry of Health 75th Year Ankara Oral and Dental Health Centre, Ankara, Turkey.
J Craniofac Surg. 2013 Jul;24(4):e365-9. doi: 10.1097/SCS.0b013e3182902f49.
The purpose of this study was to clarify the perimandibular neurovascularization with mandibular accessory mental foramina in a children population using cone-beam computed tomography (CBCT) to avoid complications during anesthetic and surgical procedures.
This retrospective study evaluated cone-beam CT images for bifid mandibular canals in the mandibles of 63 children (35 girls, 28 boys; age range, 7-16 years; mean age, 12.3 years). Both right and left sides were examined from CT images (n = 126), including axial, sagittal, cross-sectional, and panoramic views as well as reconstructed three-dimensional images, as necessary. The course, length, and superior and inferior angles between canals were classified and measured.
Bifid mandibular canals were observed in 34 (27%) of the 126 sides examined. The most frequently encountered type of bifid canal was the retromolar canal (11.1%), followed by the forward (7.14%), buccolingual (6.35%), and dental canal (2.4%). Mean lengths of bifid canals were 10.2 mm on the right side and 10.6 mm on the left side. Mean superior angles were 131 degrees on the right side and 147 degrees on the left side, whereas mean inferior angles were 47 degrees on the right side and 34 degrees on the left side. No statistically significant differences were found in the lengths or angles between the right and left sides or between boys and girls (P < 0.05). The most common position for the mental foramen was between the first and second premolars, and an accessory mental foramen was observed in 4 children (6.34%).
This study utilized CBCT images to identify bifid mandibular canals and accessory mental foramina in children. Cone-beam CT was found to be a useful technique for detecting secondary canals. However, despite the fact that CBCT uses less ionizing radiation than other types of three-dimensional imaging, unless the diagnostic information provided through CBCT improves treatment results, CBCT should not be recommended for use in children or adolescents.
本研究的目的是利用锥形束计算机断层扫描（CBCT）阐明儿童人群中下颌副颏孔周围的神经血管分布情况，以避免麻醉和外科手术过程中的并发症。
这项回顾性研究评估了63名儿童（35名女孩，28名男孩；年龄范围7 - 16岁；平均年龄12.3岁）下颌骨中双下颌管的锥形束CT图像。根据CT图像（n = 126）对左右两侧进行检查，必要时包括轴向、矢状、横断面和全景视图以及重建的三维图像。对管的走行、长度以及管之间的上下角度进行分类和测量。
在检查的126侧中，有34侧（27%）观察到双下颌管。最常见的双管类型是磨牙后管（11.1%），其次是向前型（7.14%）、颊舌型（6.35%）和牙根管型（2.4%）。右侧双管的平均长度为10.2 mm，左侧为10.6 mm。右侧的平均上角为131度，左侧为147度，而右侧的平均下角为47度，左侧为34度。左右两侧之间以及男孩和女孩之间在长度或角度上均未发现统计学上的显著差异（P < 0.05）。颏孔最常见的位置在第一和第二前磨牙之间，4名儿童（6.34%）观察到副颏孔。
本研究利用CBCT图像识别儿童中的双下颌管和副颏孔。发现锥形束CT是检测副根管的有用技术。然而，尽管CBCT比其他类型的三维成像使用的电离辐射少，但除非通过CBCT提供的诊断信息能改善治疗效果，否则不建议在儿童或青少年中使用CBCT。
