Huang Chun-Yuan, Liao Yu-Fang
Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taipei, Taiwan; Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Formos Med Assoc. 2016 Nov;115(11):981-990. doi: 10.1016/j.jfma.2015.10.004. Epub 2015 Dec 23.
BACKGROUND/PURPOSE: The purpose of this study was to determine the position of the mandibular canal in relation to the buccal cortical bone in Chinese patients with three dentofacial relationships: normal dentition, retrognathism, and prognathism.
Cone-beam computed tomography and lateral cephalograms of patients with normal dentation, retrognathism, and prognathism (n = 32 each group) were reviewed. Measurements of the shortest distance from the outer/buccal edge of the mandibular canal to the inner surface of the buccal cortex, and the distance from the lingula of the ramus to the dorsal root of the first molar were recorded.
No significant difference was observed between the three groups in the distribution of contact or fusion of the mandibular canal, or in the course of the mandibular canal on the right or left side. When the shortest distance at the lingula on the left side was >2.1 mm, no instances of contact or fusion were observed. On the right side, 100% of the patients had no contact or fusion when the shortest distance was >2.7 mm at the lingula.
The shortest distance from the outer/buccal edge of the mandibular canal to the inner surface of the buccal cortex measured at the lingula can predict contact or fusion. During sagittal split ramus osteotomy, great care should be observed at the point halfway between the lingula and the anterior ramus border where the inferior alveolar nerve is the closest to the cortical bone.
背景/目的:本研究的目的是确定在中国具有三种牙颌面关系(正常牙列、下颌后缩和下颌前突)的患者中,下颌管相对于颊侧皮质骨的位置。
回顾性分析正常牙列、下颌后缩和下颌前突患者(每组n = 32)的锥形束计算机断层扫描和头颅侧位片。记录下颌管外/颊侧边缘至颊侧皮质骨内表面的最短距离,以及下颌支舌骨线至第一磨牙牙根背侧的距离。
三组在下颌管接触或融合的分布情况,以及左右侧下颌管走行方面均未观察到显著差异。当左侧舌骨线处的最短距离>2.1 mm时,未观察到接触或融合的情况。在右侧,当舌骨线处的最短距离>2.7 mm时,100%的患者无接触或融合。
在舌骨线处测量的下颌管外/颊侧边缘至颊侧皮质骨内表面的最短距离可预测接触或融合情况。在矢状劈开下颌支截骨术中,应特别注意舌骨线与下颌支前缘中点处,此处下牙槽神经最靠近皮质骨。