Nam Yoo-Sung, Lee Seung-Eun, Che Sung-Ah, Park Sang-Yoon, Byun Soo-Hwan, Yang Byoung-Eun, Yi Sangmin
Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
Graduate School of Clinical Dentistry, Hallym University, Chuncheon, Korea.
J Korean Assoc Oral Maxillofac Surg. 2024 Dec 31;50(6):367-372. doi: 10.5125/jkaoms.2024.50.6.367.
The submandibular displacement of a mandibular third molar residual root presents major challenges to oral and maxillofacial surgeons due to the proximity to critical anatomical structures such as the lingual nerve and sublingual artery. Preoperative imaging can approximate the location of the residual tooth root; however, accurately determining its exact position is difficult because of the dynamic nature of the mandible and the difficulty of real-time synchronization of imaging. This study presents the successful extraction of a residual mandibular third molar root in a 67-year-old female patient achieved using a magnetic field-based navigation system. The sublingually-displaced residual root was localized using the navigation system, marked using a virtual implant placement, and positioned by a hand piece using synchronized real-time sensor data. The root was successfully removed with a minimally-invasive approach. No complications occurred postoperatively, and follow-up showed no major issues. Due to the small size of the marker, ease of calibration, and independence from visual obstacles, magnetic field-based navigation systems are a promising tool for the removal of residual roots displaced into adjacent soft tissue.
下颌第三磨牙残根的下颌下移位给口腔颌面外科医生带来了重大挑战，因为其靠近舌神经和舌下动脉等关键解剖结构。术前成像可以大致确定残留牙根的位置；然而，由于下颌骨的动态特性以及成像实时同步的困难，准确确定其确切位置很困难。本研究展示了使用基于磁场的导航系统成功拔除一名67岁女性患者下颌第三磨牙残根的过程。使用导航系统定位舌下移位的残根，通过虚拟种植体植入进行标记，并使用同步实时传感器数据通过手持器械进行定位。采用微创方法成功取出牙根。术后未发生并发症，随访未发现重大问题。由于标记物尺寸小、易于校准且不受视觉障碍影响，基于磁场的导航系统是拔除移位至相邻软组织的残留牙根的一种有前景的工具。
