Jung Soyeon, Yun Hyunjong, Chung Chul Hoon, Kim Kuylhee, Chang Yongjoon
Department of Plastic and Reconstructive Surgery, Kangdong Sacred Heart Hospital, Seoul, Korea.
Arch Craniofac Surg. 2022 Jun;23(3):103-110. doi: 10.7181/acfs.2022.00150. Epub 2022 Jun 20.
The primary objectives of mandibular surgery are to achieve optimal occlusion, low sensory disturbance, and adequate fixation with early movement. In-depth knowledge of the mandibular structure is required to achieve these goals. This study used computed tomography (CT) to evaluate the mandibular cortical thickness and cancellous space according to age and sex.
We enrolled 230 consecutive patients, aged 20 to 50 years, who underwent CT scanning. The cortex and cancellous space centered around the inferior alveolar nerve (IAN) canal were measured at two specific locations: the lingula and second molar region. Statistical analysis of differences according to increasing age and sex was performed.
The t-test revealed that the cancellous space and cortical thickness differed significantly with respect to the threshold of 35 years of age. Both cortical thickness and cancellous space in the molar region were negatively correlated with age. Meanwhile, both cortical thickness and cancellous space in the lingula region showed a positive correlation with age. With respect to sex, significant differences in the cancellous space at the molar region and the cortical thickness at the lingula were observed. However, no further statistically significant differences were observed in other variables with respect to sex. The sum of each measurement on the mandibular body reflected the safe distance from the surface of the outer cortex to the IAN canal. The safe distances also showed statistically significant differences between those above and below 35 years of age.
Knowledge of the anatomical structure of the mandible and of changes in bone structure is crucial to ensure optimal surgical outcomes and avoid damage to the IAN. CT examination is useful to identify changes in the bone structure, and these should be taken into account in the planning of surgery for older patients.
下颌骨手术的主要目标是实现最佳咬合、低感觉障碍以及早期活动时的充分固定。要实现这些目标，需要深入了解下颌骨结构。本研究使用计算机断层扫描（CT）根据年龄和性别评估下颌骨皮质厚度和松质骨间隙。
我们纳入了230例年龄在20至50岁之间连续接受CT扫描的患者。在下牙槽神经（IAN）管周围的两个特定位置测量皮质和松质骨间隙：舌骨和第二磨牙区域。对年龄增长和性别差异进行了统计分析。
t检验显示，松质骨间隙和皮质厚度在35岁阈值时存在显著差异。磨牙区域的皮质厚度和松质骨间隙均与年龄呈负相关。同时，舌骨区域的皮质厚度和松质骨间隙均与年龄呈正相关。关于性别，观察到磨牙区域的松质骨间隙和舌骨处的皮质厚度存在显著差异。然而，在其他变量方面，未观察到关于性别的进一步统计学显著差异。下颌骨体上每次测量的总和反映了从外皮质表面到IAN管的安全距离。35岁以上和以下人群的安全距离也显示出统计学显著差异。
了解下颌骨的解剖结构和骨结构变化对于确保最佳手术效果和避免损伤IAN至关重要。CT检查有助于识别骨结构变化，在老年患者手术规划中应考虑这些因素。
