School of Dentistry, China Medical University, Taichung 404, Taiwan.
Department of Dentistry, China Medical University Hospital, Taichung 404, Taiwan.
Tomography. 2021 May 31;7(2):219-227. doi: 10.3390/tomography7020020.
The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.
磨牙后沟是一种发生在下颌骨的解剖变异。磨牙后沟通常起始于第三磨牙远侧的下颌管，并向前向上延伸至磨牙后孔（RMF），其中包含神经血管束。在拔除第三磨牙、牙种植手术或正颌外科手术中意外损伤磨牙后沟中的神经血管束可能导致随后出现局部麻醉不全、感觉异常和手术中出血等并发症。本研究旨在通过口腔锥形束 CT（CBCT）探讨台湾某医学中心人群 RMF 的发生率，并确定 RMF 在下颌骨中的位置。将 68 个半下颌骨的 CBCT 图像上传至医学成像软件 Mimics 15.1，以确定 RMF 在台湾人群中的发生率以及 RMF 在下颌骨中的三个位置参数：（1）RMF 的直径；（2）RMF 中点至第二磨牙远中牙骨质-釉质界的水平距离；（3）RMF 中点至下颌管上缘的垂直距离。在 68 个半下颌骨中观察到 7 个 RMF，因此 RMF 的发生率为 10.3%。此外，RMF 的直径为 1.41 ± 0.30mm（平均值 ± 标准差），RMF 中点至第二磨牙远中牙骨质-釉质界的水平距离为 12.93 ± 2.87mm，RMF 中点至第二磨牙下颌管上缘的垂直距离为 13.62 ± 1.3487mm。本研究确定了台湾某医学中心人群 RMF 的发生率及其在下颌骨中的相对位置。该信息可为临床医生提供下颌后牙区麻醉和手术的参考，以确保医疗安全。
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