Kuzin A V, Vedyaeva A P, Sogachyova V V, Gurin A N, Remizov G V
Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.
Stomatologiia (Mosk). 2023;102(6):16-21. doi: 10.17116/stomat202310206116.
Of the study is to reduce the risk of postoperative neuropathy of the inferior alveolar nerve by improving diagnostic methods, assessment of individual topographic and anatomical features and extraction technique of impacted teeth adjacent to the mandibular canal.
According to the CBCT examination, orthopantomography and macroscopic examination of removed third molars roots (=140) the relative position of the mandibular canal and the roots of the third molars were studied.
Three variants of close mandibular canal and third molars position have been identified. In the lateral and apical nerve position, the root surface depressions were detected. With inter-radicular position fit, the mandibular canal and the nerve bundle form a «bed» in between impacted tooth roots.
The injury of neurovascular bundle prognosis during extraction with an interadicular mandibular position depends on roots anatomy and their convergence degree. If the interradicular distance is less than the diameter of the mandibular canal, nerve injury during tooth extraction is inevitable, in such cases coronectomy is indicated.
本研究旨在通过改进诊断方法、评估个体的局部解剖特征以及下颌管附近阻生牙的拔除技术,降低下牙槽神经术后神经病变的风险。
根据锥形束计算机断层扫描(CBCT)检查、曲面断层片以及拔除的第三磨牙牙根(=140颗)的宏观检查,研究下颌管与第三磨牙牙根的相对位置。
已确定下颌管与第三磨牙位置紧密的三种变体。在神经位于外侧和根尖的位置,检测到牙根表面凹陷。当处于根间位置时,下颌管和神经束在阻生牙根之间形成一个“床”。
在下颌根间位置拔牙时,神经血管束预后的损伤取决于牙根解剖结构及其聚拢程度。如果根间距离小于下颌管直径,拔牙时神经损伤不可避免,在这种情况下建议进行牙冠切除术。