Kim Hang-Gul, Lee Jae-Hoon
Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea.
J Korean Assoc Oral Maxillofac Surg. 2014 Dec;40(6):278-84. doi: 10.5125/jkaoms.2014.40.6.278. Epub 2014 Dec 26.
This study used cone-beam computed tomography (CBCT) images to categorize the relationships between the mandibular canal and the roots and investigated the prevalence of nerve damage.
Through CBCT images, contact and three-dimensional positional relationships between the roots of the mandibular third molar and the mandibular canal were investigated. With this data, prevalence of nerve damage according to the presence of contact and three-dimensional positional relationships was studied. Other factors that affected the prevalence of nerve damage were also investigated.
When the mandibular third molar and the mandibular canal were shown to have direct contact in CBCT images, the prevalence of nerve damage was higher than in other cases. Also, in cases where the mandibular canal was horizontally lingual to the mandibular third molar and the mandibular canal was vertically at the cervical level of the mandibular third molar, the prevalence of nerve damage was higher than in opposite cases. The percentage of mandibular canal contact with the roots of the mandibular third molar was higher when the mandibular canal was horizontally lingual to the mandibular third molar. Finally, the prevalence of nerve damage was higher when the diameter of the mandibular canal lumen suddenly decreased at the contact area between the mandibular canal and the roots, as shown in CBCT images.
The three-dimensional relationship of the mandibular third molar and the mandibular canal can help predict nerve damage and can guide patient expectations of the possibility and extent of nerve damage.
本研究使用锥形束计算机断层扫描(CBCT)图像对下颌管与牙根之间的关系进行分类,并调查神经损伤的发生率。
通过CBCT图像,研究下颌第三磨牙牙根与下颌管之间的接触及三维位置关系。利用这些数据,研究根据接触情况和三维位置关系的神经损伤发生率。还调查了影响神经损伤发生率的其他因素。
当CBCT图像显示下颌第三磨牙与下颌管直接接触时,神经损伤的发生率高于其他情况。此外,当下颌管位于下颌第三磨牙水平舌侧且下颌管位于下颌第三磨牙颈部水平时,神经损伤的发生率高于相反情况。当下颌管位于下颌第三磨牙水平舌侧时,下颌管与下颌第三磨牙牙根的接触百分比更高。最后,如CBCT图像所示,当下颌管管腔直径在与牙根接触区域突然变小时,神经损伤的发生率更高。
下颌第三磨牙与下颌管的三维关系有助于预测神经损伤,并可指导患者对神经损伤可能性和程度的预期。