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种植牙治疗前对上颌骨和下颌骨的解剖结构及变异情况进行评估。

Evaluation of anatomical structures and variations in the maxilla and the mandible before dental implant treatment.

作者信息

Genç Tolga, Duruel Onurcem, Kutlu Hüseyin Burak, Dursun Erhan, Karabulut Erdem, Tözüm Tolga Fikret

机构信息

Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.

Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

出版信息

Dent Med Probl. 2018 Jul-Sep;55(3):233-240. doi: 10.17219/dmp/94303.

Abstract

BACKGROUND

Cone beam computed tomography (CBCT) allows a detailed visualization of the anatomic structures of the jaw. There have been presented variations of the anatomic structures between genders after evaluating the structures in detail.

OBJECTIVES

The aim of this study was to investigate the anatomic variations of the jaws according to gender and age in an effort to avoid complications during implant surgeries.

MATERIAL AND METHODS

In this retrospective study, a total of 159 scans (87 of the maxilla, 72 of the mandible) were evaluated in order to analyze the effect of age and gender on these anatomic variations.

RESULTS

According to statistical analysis, gender affected the crestal dimensions above the mandibular canal and sinus mucosal thickening. The mean value of the width of the mandibular canal, the distance between the mandibular canal and the superior border of the mandible, the distance between the mandibular canal and the inferior border of the mandible, the diameter of the mental foramen, the distance between the mental foramen and the inferior border of the mandible, and the distance between the lingual foramen and the inferior border of the mandible were significantly greater in female patients than in male subjects (p < 0.001). However, sinus mucosal thickening and the diameter of the posterior superior alveolar artery (PSAA) were significantly greater in males as compared to females (p < 0.001). While the configuration of the nasopalatine canal was funnel-shaped in female patients, this configuration was found to be cylinder-shaped in male subjects. A high prevalence of sinus septa (43.7%) and PSAA (87.4%) was detected in the scans.

CONCLUSIONS

When planning dental implants, radiographic examinations, alongside clinical examinations, have become necessary to reduce the risk of implant surgery failure and complications. The CBCT imaging is a valuable tool to determine the anatomic structures before carrying out any surgeries, including implant surgery. Gender affects anatomical variations and dimensions significantly, even when they are not affected by age. Large population focused and multicenter studies may provide a better understanding of the need to evaluate the anatomical structures in detail.

摘要

背景

锥形束计算机断层扫描(CBCT)能够详细显示颌骨的解剖结构。在对这些结构进行详细评估后,已发现不同性别之间存在解剖结构的差异。

目的

本研究旨在根据性别和年龄调查颌骨的解剖变异,以避免种植手术期间出现并发症。

材料与方法

在这项回顾性研究中,共评估了159次扫描(上颌87次,下颌72次),以分析年龄和性别对这些解剖变异的影响。

结果

根据统计分析,性别影响下颌管上方的牙槽嵴尺寸和窦黏膜增厚情况。女性患者下颌管宽度、下颌管与下颌骨上缘之间的距离、下颌管与下颌骨下缘之间的距离、颏孔直径、颏孔与下颌骨下缘之间的距离以及舌孔与下颌骨下缘之间的距离的平均值显著大于男性受试者(p < 0.001)。然而,男性的窦黏膜增厚和后上牙槽动脉(PSAA)直径显著大于女性(p < 0.001)。女性患者的鼻腭管形态为漏斗形,而男性受试者的鼻腭管形态为圆柱形。扫描中检测到高比例的鼻窦间隔(43.7%)和PSAA(87.4%)。

结论

在计划种植牙手术时,影像学检查以及临床检查对于降低种植手术失败和并发症的风险已变得必不可少。CBCT成像在进行包括种植手术在内的任何手术之前,都是确定解剖结构的宝贵工具。即使不受年龄影响,性别也会显著影响解剖变异和尺寸。聚焦大量人群的多中心研究可能会更好地理解详细评估解剖结构的必要性。

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