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全景片上所研究的放射学变量对预测第三磨牙拔除术后下牙槽神经感觉异常的意义。

Significance of radiological variables studied on orthopantamogram to pridict post-operative inferior alveoler nerve paresthesia after third molar extraction.

作者信息

Pathak Sachin, Mishra Nitin, Rastogi Madhur Kant, Sharma Shalini

机构信息

Assistant Professor, Department of Dental Science, Sri Ram Murti Smarak Institute of Medical Science , Bareilly, India .

Associate Professor, Department of Dermatology, Sri Ram Murti Smarak Institute of Medical Science , Bareilly, India .

出版信息

J Clin Diagn Res. 2014 May;8(5):ZC62-4. doi: 10.7860/JCDR/2014/8392.4399. Epub 2014 May 15.

Abstract

CONTEXT

Removal of impacted third molar is a procedure that is often associated with post-operative complications. The rate of complications is somewhat high because of its proximity to the vital structures. Inferior alveolar nerve paresthesia is one of the common complications of impacted their molar surgery. This is due to intimate relationship between roots of mandibular third molar and inferior alveolar canal. To access the proximity of inferior alveolar canal to third molar many diagnostic methods are suggested but in conventional radiography orthopantamogram is considered as the best. There are many findings onorthopantamogram that are suggestive of close proximity of nerve to the canal. In this study authors reviewed seven radiographic findings related to proximity of roots to the inferior alveolar nerve as seen on orthopantamogram and try to find a relationship between these radiographic variables and presence of post-operative paresthesia.

STUDY DESIGN

The study containd 100 impacted third molars need to be removed. Presence of radiographic findings on orthopantamogram were noted and analyzed, to find a relationship with occurrence of post-operative inferior alveolar nerve paresthesia.

MATERIALS AND METHODS

This study comprises of 100 impacted third molar teeth indicated for extraction. Cases were randomly selected from the patients, needs to undergo extraction of impacted mandibular third molar. After extraction cases were evaluated for occurrence of inferior alveolar nerve paresthesia. Stastical Analyisis: Data was transferred to SPss 21 software for frequency calculation, and two tailed p-values were obtained betweens these variables and post-operative paresthesia, by applying Fischer's exact test (GRAPH PAD SOFTWARE).

RESULTS

Out of seven, four radiological findings that are grooving of roots, hooked roots, bifid roots and obliteration of white line are significantly related to post-operative paresthesia while bending of canal, narrow canal and darkening of tooth roots over the canal are not significantly associated with post-operative morbidity of facial nerve.

摘要

背景

拔除阻生第三磨牙是一种常伴有术后并发症的手术。由于其靠近重要结构,并发症发生率较高。下牙槽神经感觉异常是阻生第三磨牙手术常见的并发症之一。这是由于下颌第三磨牙的牙根与下牙槽神经管关系密切。为了解下牙槽神经管与第三磨牙的接近程度,人们提出了许多诊断方法,但在传统放射学中,全景曲面断层片被认为是最佳的。全景曲面断层片上有许多表现提示神经与神经管接近。在本研究中,作者回顾了全景曲面断层片上与牙根接近下牙槽神经相关的七种影像学表现,并试图找出这些影像学变量与术后感觉异常之间的关系。

研究设计

该研究包含100颗需要拔除的阻生第三磨牙。记录并分析全景曲面断层片上的影像学表现,以找出与术后下牙槽神经感觉异常发生的关系。

材料与方法

本研究包括100颗拟拔除的阻生第三磨牙。病例从需要拔除下颌阻生第三磨牙的患者中随机选取。拔牙后评估下牙槽神经感觉异常的发生情况。统计分析:数据传输至SPss 21软件进行频率计算,并通过应用费舍尔精确检验(GRAPH PAD软件)获得这些变量与术后感觉异常之间的双侧p值。

结果

在七种影像学表现中,牙根沟、钩状根、双根和白线消失这四种影像学表现与术后感觉异常显著相关,而神经管弯曲、神经管狭窄和神经管上方牙根变黑与面神经术后发病率无显著相关性。

相似文献

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Radiographic proximity of the mandibular third molar to the inferior alveolar canal.下颌第三磨牙与下牙槽神经管的影像学毗邻关系。
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Nov;100(5):545-9. doi: 10.1016/j.tripleo.2005.03.009.

本文引用的文献

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Complications of third molar surgery.第三磨牙手术的并发症。
Oral Maxillofac Surg Clin North Am. 2007 Feb;19(1):117-28, vii. doi: 10.1016/j.coms.2006.11.013.

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