Fares Raissa Dias, Leal João Victor Borges, Areas Manuella Zanela da Silva, Valentim da Rocha Hernando, de Moraes Sylvio Luiz Costa, Homsi Nicolas, Ribeiro da Silva Jonathan
Department of Oral and Maxillofacial Surgery, Centro Universitário Serra dos Órgãos (UNIFESO), Rio de Janeiro, Brazil.
Master's Student of Oral and Maxillofacial Surgery, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil.
Craniomaxillofac Trauma Reconstr. 2024 Sep;17(3):181-185. doi: 10.1177/19433875231213892. Epub 2023 Nov 3.
Original Article. The surgical treatment of mandibular fractures has undergone several changes over the past 100 years, since the use of wires and intermaxillary fixation, until today where most of the fractures are treated with internal fixation using plates and screws. For the correct use of this hardware, the surgeon must have adequate knowledge of jaw anatomy to prevent complications during the insertion of screws like in fractures of the mandibular body and angle, when the screws of the plate installed in the compression zone can damage the inferior alveolar nerve within the mandibular canal. To minimize this complication, 66 hemimandibles of adult patients were analyzed in CT scans and manipulated with Dental Slice® software, (BioParts®, Brazil) and measured the shortest distance from the inferior cortex of the mandibular canal to the inferior cortex of the mandibular body during the path of the inferior alveolar nerve, since the mandibular foramen until the mental foramen. The result obtained showed a wide variation of the shortest distance measured (3.52 mm-11.5 mm) with an average of 7.99 mm. The conclusion demonstrated a minimum distance of 3.52 mm below the cortical mandibular canal to the lower border of the mandible and should be considered as a safety margin during the application of fixing the material in the region of the mandibular body.
原创文章。在过去100年里，下颌骨骨折的手术治疗经历了几次变革，从使用金属丝和颌间固定，到如今大多数骨折采用钢板和螺钉进行内固定。为正确使用这种硬件，外科医生必须充分了解颌骨解剖结构，以防止在螺钉植入过程中出现并发症，如下颌骨体部和角部骨折时，安装在加压区的钢板螺钉可能会损伤下颌管内的下牙槽神经。为尽量减少这种并发症，对66例成年患者的半侧下颌骨进行了CT扫描，并使用Dental Slice®软件（巴西BioParts®公司）进行处理，测量了在下牙槽神经走行过程中，从下颌孔至颏孔，下颌管下皮质到下颌骨体部下皮质的最短距离。所获结果显示，测量的最短距离变化范围很大（3.52毫米至11.5毫米），平均为7.99毫米。结论表明，下颌管皮质下方至下颌骨下缘的最小距离为3.52毫米，在在下颌骨体区域应用固定材料时应将其视为安全边界。
