Velasco-Torres M, Padial-Molina M, Avila-Ortiz G, García-Delgado R, Catena A, Galindo-Moreno P
School of Dentistry, University of Granada, 18071 Granada, Spain,
Med Oral Patol Oral Cir Bucal. 2017 Sep 1;22(5):e630-e635. doi: 10.4317/medoral.21905.
Injury of the inferior alveolar nerve (IAN) is a serious intraoperative complication that may occur during routine surgical procedures, such as dental implant placement or extraction of impacted teeth. Thus, the purpose of this study was to analyze the trajectory of the mandibular canal (MC), the location of the mental foramen (MF) and the presence and extension of an anterior loop of the mental nerve (AL).
In this cross-sectional study, a total of 348 CBCTs were analyzed. Distances from MC to the surface of the basal, medial and lateral cortical of the mandible were measured at the level of the second molar, first molar and second premolar. Location of the MF relative to the apices of the premolars, as well as incidence and anterior extent of the AL were also determined.
Significant and clinically relevant correlations were found between the position of the MC in women, which was located more caudal (r=-0.219, p=0.007; r=-0.276, p<0.001; right and left, respectively) and lateral (r=-0.274, p=0.001; r=-0.285, p<0.001; right and left, respectively), particularly at the level of the premolars. Additionally, the presence (r=-0.181, p=0.001; r=-0.163, p=0.002; right and left, respectively) and anterior extension (r=-0.180, p=0.009; r=-0.285, p=0.05; right and left, respectively) of the AL was found to be inversely correlated with the age of the patient.
This analysis of a Caucasian population has found that the older the patient, the lower the incidence of the loop and the shorter its anterior extension.
下牙槽神经(IAN)损伤是一种严重的术中并发症,可能发生在常规外科手术过程中,如牙种植体植入或阻生牙拔除。因此,本研究的目的是分析下颌管(MC)的走行轨迹、颏孔(MF)的位置以及颏神经前袢(AL)的存在情况和延伸范围。
在这项横断面研究中,共分析了348例锥形束计算机断层扫描(CBCT)。在下颌第二磨牙、第一磨牙和第二前磨牙水平测量MC到下颌骨基底、内侧和外侧皮质表面的距离。还确定了MF相对于前磨牙根尖的位置,以及AL的发生率和向前延伸情况。
发现女性MC的位置与更靠尾侧(分别为r = -0.219,p = 0.007;r = -0.276,p < 0.001;右侧和左侧)和更外侧(分别为r = -0.274,p = 0.001;r = -0.285,p < 0.001;右侧和左侧)存在显著且具有临床相关性的关联,特别是在前磨牙水平。此外,发现AL的存在(分别为r = -0.181,p = 0.001;r = -0.163,p = 0.002;右侧和左侧)和向前延伸(分别为r = -0.180,p = 0.009;r = -0.285,p = 0.05;右侧和左侧)与患者年龄呈负相关。
对白种人群的这项分析发现,患者年龄越大,袢的发生率越低,其向前延伸越短。