Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Inonu University, Malatya, Turkey.
J Craniofac Surg. 2021;32(2):694-697. doi: 10.1097/SCS.0000000000007502.
This study aimed to evaluate the mandibular canal course in individuals with cleft lip palate (CLP) and mandibular prognathism in terms of the sagittal split-ramus osteotomy using cone-beam computed tomography.
Individuals with CLP older than 16 years of age and planned to undergo Le fort I + SSR osteotomies and those with class III occlusion planned to undergo Le fort I + SSR osteotomies were included. The measurements on the cleft side of CLP patients were compared with both their noncleft sides and those with class III occlusion. The course of the inferior alveolar nerve and its position in the mandible were evaluated starting from the mandibular foramen, the first entrance to the mandible, to the mental foramen, the exit from the mandible.
The distance between the mandibular canal and the buccal surface of the mandible (B3) on the plane tangent to the distal of the mandibular first molar and perpendicular to the occlusal plane was found to be greater in individuals with CLP (P = 0.011). Buccal cortex thickness (C4) at the level of the mandibular canal on the plane tangent to the distal of the mandibular second molar and perpendicular to the occlusal plane was found to be lower in individuals with CLP (P = 0.021).
The buccal cortex thickness of the mandible corpus and the distance of the mandibular canal to the buccal surface is different in patients with CLP compared to class III individuals' posterior to the mandible. Surgeons should take these differences into consideration during mandibular osteotomy.
本研究旨在通过锥形束 CT 评估唇腭裂(CLP)伴下颌前突患者在行下颌升支矢状劈开截骨术(split-ramus osteotomy,SSR)时下颌管的走行。
纳入年龄大于 16 岁且计划行 Le fort I + SSR 截骨术的 CLP 患者和计划行 Le fort I + SSR 截骨术治疗 III 类错颌的患者。将 CLP 患者患侧的测量值与非患侧以及 III 类错颌患者进行比较。评估下颌管的位置从下颌孔开始,经下颌管的第一入口到颏孔。
在与下颌第一磨牙远中相切且垂直于咬合平面的平面上,下颌管至下颌骨颊侧表面(B3)的距离在 CLP 患者中更大(P=0.011)。在与下颌第二磨牙远中相切且垂直于咬合平面的平面上,下颌管水平处的颊侧皮质厚度(C4)在 CLP 患者中较低(P=0.021)。
与 III 类错颌患者相比,CLP 患者下颌体颊侧皮质厚度和下颌管至颊侧表面的距离在后牙区存在差异。外科医生在行下颌骨截骨术时应考虑到这些差异。