Sechenov University, Department of Operative Surgery and Topographic Anatomy, Moscow, Russia.
Sechenov University, Department of Operative Surgery and Topographic Anatomy, Moscow, Russia; Friedrich Alexander University Erlangen-Nürnberg, Institute of Functional and Clinical Anatomy, Erlangen, Germany.
Ann Anat. 2020 Sep;231:151512. doi: 10.1016/j.aanat.2020.151512. Epub 2020 Mar 30.
The classical anatomical representation of the lingual relief of the mental region of the mandible reflects the presence of geniohyoid as well as genioglossus attachment areas, which are divided into two or single areas. The International Anatomical Terminology (contains references to the presence of upper and lower spinae mentales, but the terminology does not reflect the content of these structures. The aim of this study was to examine and classify the lingual canals of the mental region.
Using a Sirona ORTHOPHOS XG 3D tomograph (isotropic voxel size 0.1 in high-resolution mode) and KaVo 3D eXam cone beam computed tomography, the mental region of the mandible was analyzed in 561 patients aged 18-75 years with regard to bone density and the occurrence of a canal opening on the lingual side of the mandible. In order to visualize the mental spine area, another 50 mandibles were analyzed, divided into two groups of 25 mandibels each: 25 native and 25 dry preparations.
By prevalence the following channel types were classified: in 33% type I (narrow); in 32% type II (double) and of these in 17.5% (convergent) and type IIb in 14.5% a type IIb subtype (non-convergent); in 14% type III (wide); in 12% type IV (hook-shaped) and in 9% type V (diverging channel), identifying three combined components: the system of channels of the superior and inferior mental spine, and the transversal intraosseous canal of the mental region of the mandible.
Our anatomical and radiological approach allowed us to suggest a new classification of intraosseous organization of the anterior part of the human mandible. As a result of studying X-ray anatomical and anatomical-topographical, constitutional-based, structural features of the mandible, intraosseous structures of the anterior mandible were clarified and classified, which solve not only terminological disputes, but also are important clinical guidelines for bone surgery, prosthetics, traumatology, endodontic treatment, dental implantation and local anesthesia.
经典的颏舌肌舌隆凸解剖学描述反映了下颌颏舌肌和颏舌骨肌附着区的存在，这些附着区可分为两个或单个区域。国际解剖学术语（包含颏下和舌下棘的参考，但该术语并未反映这些结构的内容。本研究旨在检查和分类颏舌肌舌隆凸的舌管。
使用 Sirona ORTHOPHOS XG 3D 断层扫描仪（高分辨率模式下的等像素大小为 0.1）和 KaVo 3D eXam 锥形束计算机断层扫描，对 561 名 18-75 岁患者的下颌颏舌肌舌隆凸进行了骨密度分析，并观察了下颌舌侧的管腔开口情况。为了可视化颏舌棘区域，另外分析了 50 个下颌骨，分为两组，每组 25 个：25 个天然下颌骨和 25 个干燥下颌骨。
按流行程度分类如下：33%为 I 型（狭窄）；32%为 II 型（双），其中 17.5%为（会聚），14.5%为 IIb 型（非会聚）；14%为 III 型（宽）；12%为 IV 型（钩状），9%为 V 型（发散通道），并确定了三个联合成分：上下颏舌棘的通道系统和下颌颏舌肌的骨内横向通道。
我们的解剖学和影像学方法使我们能够提出一种新的人类下颌骨前部分骨内组织的分类方法。通过研究 X 射线解剖学和解剖拓扑学、基于体质的、结构性的下颌骨特征，阐明并分类了下颌骨前部分的骨内结构，不仅解决了术语争议，而且为骨外科、修复学、创伤学、牙髓治疗、牙种植和局部麻醉提供了重要的临床指导。
