Promma L, Sakulsak N, Putiwat P, Amarttayakong P, Iamsaard S, Trakulsuk H, Hirunyakorn K, Suarbua S, Wattanaraeungchai Y
Department of Oral Surgery, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand.
Department of Anatomy, Faculty of Medical Science, Naresuan University, Phitsanulok, Thailand.
Int J Oral Maxillofac Surg. 2017 May;46(5):572-577. doi: 10.1016/j.ijom.2016.12.008. Epub 2017 Jan 12.
Preoperative delineation of the mandibular canal and surrounding cortical bone thickness is mandatory prior to bilateral sagittal split osteotomy (BSSO). The cortical bone thickness of 101 cadaveric mandibles was measured to define the mandibular canal. The mandibles were cut at the anterior ramus, at the third, second, and first molar, and at the premolar. The cortical bone thickness was measured between the mandibular canal and inferior border, buccal cortex, and lingual cortex at each cutting point. No difference was found between the right and left sides of the mandible, or between males and females, with one exception: males were found to have thicker inferior cortical bone at the premolar site than females. The implications for BSSO are: (1) for sagittal bone cutting, the maximum cutting depth of the buccal cortex at the ramus is 4.5mm, at the second and third molars is 6.5mm, and at the first molar is 5mm; (2) for vertical bone cutting at the first molar, the maximum cutting depth from the inferior border is 7.5mm. The measurement of cortical bone thickness from cadaveric mandibles provides useful preoperative information and confirms the results of computed tomography.
在进行双侧矢状劈开截骨术（BSSO）之前，术前明确下颌管及周围皮质骨厚度是必不可少的。测量了101具尸体下颌骨的皮质骨厚度以确定下颌管。在下颌支前部、第三、第二和第一磨牙处以及前磨牙处切断下颌骨。在每个切断点测量下颌管与下颌下缘、颊侧皮质和舌侧皮质之间的皮质骨厚度。下颌骨左右两侧之间以及男性和女性之间均未发现差异，但有一个例外：发现男性在前磨牙部位的下颌下缘皮质骨比女性厚。对BSSO的意义在于：（1）对于矢状骨切开，下颌支颊侧皮质的最大切开深度在磨牙后区为4.5mm，在第二和第三磨牙处为6.5mm，在第一磨牙处为5mm；（2）对于第一磨牙处的垂直骨切开，距下颌下缘的最大切开深度为7.5mm。对尸体下颌骨皮质骨厚度的测量提供了有用的术前信息，并证实了计算机断层扫描的结果。
