Kapoor Vikram, Kumar Narendra, Dahiya Kirti, Sikka Rohan, Sirana Pallavi, Singh Abhinav
Department of Prosthodontics, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India, Phone: +918882981272, e-mail:
Department of Prosthodontics, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India.
J Contemp Dent Pract. 2018 Nov 1;19(11):1381-1385.
The accurate placement of implants in mandible requires consideration for angulations of the bone along with the vertical dimensions. The aim of this present study was to assess the variation of mandibular anatomy using computed tomography (CT) radiography and to evaluate the effect of presence and absence of teeth on the mandibular anatomy before planning an implant surgery.
The present population-based retrospective study was conducted using 167 digital CT scan images those selected from departmental archives. The samples were sub-divided two groups: group 1included digital CT of edentulous mandible while group 2 included digital CT of edentulous mandible. The axial height, vertical height, and angulations were recorded separately for each group.
The results of the present study showed a gradual increase in mandibular angle in both the groups with a statistically significant difference only in the canine-premolar area. The axial height showed a significant difference at canine and first premolar area and a second premolar and the first molar area. However, available height showed a significant difference in canine and first premolar area and distal to the second molar area. When both the sides were compared, no statistically significant difference was observed between right and left sides.
It was concluded that due to the variability of the mandibular anatomy and because of the effects of various imperative factors, 3D imaging like CT scans should be recommended for safer and secure presurgical planning.
In surgical osteotomies and implant placement especially in post-extraction sockets, two-dimensional (2D) image of panoramic radiographs should not be considered that reliable as these three-dimensional (3D) imaging radiographs. Therefore CT scans of various angulations and sections must be considered by the clinicians to rationally study the mandibular anatomy and their risk associated areas.
在下颌骨中准确植入种植体需要考虑骨的角度以及垂直尺寸。本研究的目的是使用计算机断层扫描（CT）影像学评估下颌骨解剖结构的变异，并在计划种植手术前评估有无牙齿对下颌骨解剖结构的影响。
本基于人群的回顾性研究使用了从科室档案中选取的167张数字化CT扫描图像。样本被分为两组：第1组包括无牙下颌骨的数字化CT，而第2组包括有牙下颌骨的数字化CT。分别记录每组的轴向高度、垂直高度和角度。
本研究结果显示两组下颌角均逐渐增大，仅在尖牙-前磨牙区域有统计学显著差异。轴向高度在尖牙和第一前磨牙区域以及第二前磨牙和第一磨牙区域有显著差异。然而，可用高度在尖牙和第一前磨牙区域以及第二磨牙远中区域有显著差异。当比较两侧时，左右两侧未观察到统计学显著差异。
得出的结论是，由于下颌骨解剖结构的变异性以及各种重要因素的影响，建议使用CT扫描等三维成像进行更安全可靠的术前规划。
在手术截骨术和种植体植入中，尤其是在拔牙后的牙槽窝中，全景X线片的二维（2D）图像不应被认为像这些三维（3D）成像X线片那样可靠。因此，临床医生必须考虑不同角度和层面的CT扫描，以合理研究下颌骨解剖结构及其相关风险区域。
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