Castro Mauricio Augusto Aquino, Vich Manuel Oscar Lagravere, Abreu Mauro Henrique Guimaraes, Mesquita Ricardo Alves
Department of Dentistry, Federal University of Juiz de Fora, Campus Governador Valadares, Rua Israel Pinheiro, 2000-Bloco D9, Bairro Universitário, Governador Valadares, MG, CEP: 35.020-220, Brazil.
Graduate Orthodontic Program, University of Alberta, 5-524 ECHA, 11405-87th Ave, Edmonton, T6G1C9, Canada.
Oral Radiol. 2018 Sep;34(3):229-236. doi: 10.1007/s11282-017-0305-9. Epub 2017 Oct 25.
Morphological variations of mandibular canals increase the risk of neurovascular damage and bleeding during surgical procedures by decreasing the predictability of the inferior alveolar neurovascular bundle location. To improve the predictability with such variations, the present study aimed to verify the possibility of a relationship between mandibular canal branches (MCBs) and tooth-related inflammatory lesions, using trough cone-beam computed tomography (CBCT) examinations.
The sample comprised 150 age and sex-matched examinations (50 cases and 100 controls) from two databases. The CBCT examinations were grouped by the presence of MCBs starting in the mandibular body regions as the outcome variable. Tooth-related inflammatory lesions and measurements of gray levels in the posterior region of the alveolar ridge were assessed in both groups. A multiple logistic regression analysis was applied to verify the relationships between MCBs and independent variables (p < 0.05).
Occurrence of tooth-related inflammatory lesions increased the risk of MCBs in the mandibular body regions (p < 0.001; OR 11.640; 95% CI 4.327-31.311). High-contrast images had a weaker association with MCBs (p = 0.002; OR 1.002; 95% CI 1.002-1.003). The most frequent tooth-related inflammatory lesions in both groups were endodontic (34 lesions; 45.94% of the total lesions). Most of the tooth-related inflammatory lesions related to MCBs were endodontic (20 cases) and combined endodontic and periodontal inflammation (20 cases).
An association was observed between MCBs in the mandibular body regions and tooth-related inflammatory lesions. Inflammatory lesions of endodontic origin are most often associated with MCBs.
下颌管的形态变异会降低下牙槽神经血管束位置的可预测性，从而增加手术过程中神经血管损伤和出血的风险。为提高对这种变异的可预测性，本研究旨在通过槽型锥形束计算机断层扫描（CBCT）检查，验证下颌管分支（MCB）与牙齿相关炎性病变之间存在关联的可能性。
样本包括来自两个数据库的150例年龄和性别匹配的检查（50例病例和100例对照）。CBCT检查按在下颌体区域开始出现MCB进行分组，将其作为结果变量。对两组患者均评估了牙齿相关炎性病变以及牙槽嵴后部的灰度测量值。应用多元逻辑回归分析来验证MCB与自变量之间的关系（p < 0.05）。
牙齿相关炎性病变的发生增加了下颌体区域出现MCB的风险（p < 0.001；比值比11.640；9５%置信区间4.327 - 31.311）。高对比度图像与MCB的关联较弱（p = 0.002；比值比1.002；9５%置信区间1.002 - 1.003）。两组中最常见的牙齿相关炎性病变为牙髓病变（34例；占总病变的45.94%）。与MCB相关的大多数牙齿相关炎性病变为牙髓病变（20例）以及牙髓和牙周联合炎症（20例）。
观察到下颌体区域的MCB与牙齿相关炎性病变之间存在关联。牙髓源性炎性病变最常与MCB相关。
