Sghaireen Mohammed G, Srivastava Kumar Chandan, Shrivastava Deepti, Ganji Kiran Kumar, Patil Santosh R, Abuonq Anas, Mousa Mohammed Assayed, Dar-Odeh Najla, Sghaireen Ghazi M, Kamal Mohammad Amjad, Alam Mohammad Khursheed
Prosthodontics, Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakakah 72345, Saudi Arabia.
Oral Medicine & Radiology, Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakakah 72345, Saudi Arabia.
Diagnostics (Basel). 2020 Jun 14;10(6):406. doi: 10.3390/diagnostics10060406.
A high rate of nerve injury and related consequences are seen during implant placement in the posterior mandibular arch. An approach has been proposed to avoid nerve injury by dodging the inferior alveolar nerve (IAN) while placing an implant. A prospective study with a total of 240 CBCT (cone beam computed tomography) images of patients with three dentate statuses, namely, edentulous (group I), partially edentulous (group II) and dentate (group III) were included in the study. The nerve path tracing was done on CBCT images with On-demand 3D software. The three dimensions, i.e., the linear distance from the outer buccal cortical plate to the inferior alveolar nerve (BCPN), linear distance from the outer lingual cortical plate to the inferior alveolar nerve (LCPN) and linear distance from the midpoint of the alveolar crest to the inferior alveolar nerve (ACN) were assessed. The data were presented and analyzed between variables using one-way ANOVA and independent -test in SPSS version 21.LCPN of the right 1st premolar region ( < 0.05) was significantly different among the groups with edentulous subjects recorded with the minimum value (6.50 ± 1.20 mm). Females were found to have significantly ( < 0.05) less available bone (6.03 ± 1.46 mm) on the right side of the mandibular jaw compared to males in edentulous group of patients. On comparing age groups for partially edentulous subjects, LCPN of the right 1st premolar region had significantly ( < 0.05) less available bone (6.03 ± 0.38 mm) in subjects with age ≥54 years. The IAN follows a lingual course in the molar region and later flips to the buccal side in the premolar region. The LCPN dimension in the 1st and 2nd premolar region was found to be more than 6 mm irrespective of age, gender and side of the jaw. Thus, it can be considered as a suitable site for placing implants while bypassing the IAN with CBCT assessment remaining as the mainstay in the pre-surgical phase.
在下颌后牙弓种植体植入过程中，神经损伤及相关后果的发生率较高。有人提出了一种在植入种植体时避开下牙槽神经（IAN）以避免神经损伤的方法。一项前瞻性研究纳入了共有240张CBCT（锥形束计算机断层扫描）图像的患者，这些患者具有三种牙列状态，即无牙（I组）、部分无牙（II组）和有牙（III组）。使用On-demand 3D软件在CBCT图像上进行神经路径追踪。评估了三个维度，即从颊侧皮质骨板外侧到下牙槽神经的线性距离（BCPN）、从舌侧皮质骨板外侧到下牙槽神经的线性距离（LCPN）以及从牙槽嵴中点到下牙槽神经的线性距离（ACN）。在SPSS 21版本中使用单因素方差分析和独立样本t检验对变量之间的数据进行呈现和分析。右第一前磨牙区域的LCPN（P<0.05）在各组之间存在显著差异，无牙受试者记录的最小值为（6.50±1.20mm）。发现在无牙患者组中，女性下颌右侧的可用骨量（6.03±1.46mm）明显（P<0.05）少于男性。在比较部分无牙受试者的年龄组时，年龄≥54岁的受试者右第一前磨牙区域的LCPN可用骨量明显（P<0.05）较少（6.03±0.38mm）。IAN在磨牙区域走行于舌侧，随后在前磨牙区域转向颊侧。发现第一和第二前磨牙区域的LCPN维度无论年龄、性别和颌骨侧别均大于6mm。因此，在绕过IAN的情况下，它可被视为种植体植入的合适部位，而CBCT评估仍是术前阶段的主要手段。
