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一种用于牙种植体植入的下牙槽神经重新定位手术的新分类。

A New Classification of Inferior Alveolar Nerve Repositioning Procedures for Dental Implant Placement.

作者信息

Kablan Fares

机构信息

Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel.

The Azrieli Faculty of Medicine, Bar Ilan University, Safad 1311502, Israel.

出版信息

Dent J (Basel). 2025 Jun 16;13(6):267. doi: 10.3390/dj13060267.

DOI:10.3390/dj13060267
PMID:40559170
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12192414/
Abstract

: Tooth loss significantly impacts the quality of life for adults. Inferior alveolar nerve (IAN) repositioning has garnered interest as a treatment for facilitating dental implant placement in the severely atrophic posterior mandible. However, there remains a need for standardization and classification of these techniques to improve outcomes. This study aims to propose a new clinical classification system for IAN repositioning procedures based on anatomical and procedural parameters. : This study retrospectively analyzed preoperative radiographic records and surgical procedure documents over a 15-year period (2008-2023) for patients who underwent implant placement combined with IAN repositioning in the posterior atrophic mandible. Cases were classified into four categories according to bone availability, nerve location, and type of surgical intervention. : The study analyzed 142 edentulous posterior mandibles in 105 patients (77 women, 28 men; age range: 20-75). The cases were divided into four categories: Category 1 (58 patients, 78 sites), treated with one surgery; Category 2 (15 patients, 15 sites), treated in two stages; Category 3 (20 patients, 25 sites); and Category 4 (12 patients, 24 sites), with Categories 3 and 4 treated in a single surgery. Across all 132 sites, 411 dental implants were placed and restored with implant-supported fixed prostheses. : This proposed classification provides a structured systematic framework for assessing and planning IAN repositioning procedures. It facilitates better diagnosis, treatment planning, and prediction of surgical stages in patients needing IAN repositioning for dental implant placement.

摘要

牙齿缺失对成年人的生活质量有显著影响。下牙槽神经(IAN)重新定位作为一种促进严重萎缩的下颌后牙区牙种植体植入的治疗方法,已引起关注。然而,仍需要对这些技术进行标准化和分类以改善治疗效果。本研究旨在基于解剖学和手术参数,提出一种新的IAN重新定位手术临床分类系统。

本研究回顾性分析了15年期间(2008 - 2023年)在萎缩性下颌后牙区接受种植体植入联合IAN重新定位手术的患者的术前影像学记录和手术过程文件。根据骨量、神经位置和手术干预类型将病例分为四类。

该研究分析了105例患者(77名女性,28名男性;年龄范围:20 - 75岁)的142个无牙下颌后牙区。病例分为四类:第1类(58例患者,78个部位),接受一次手术治疗;第2类(15例患者,15个部位),分两阶段治疗;第3类(20例患者,25个部位);第4类(12例患者,24个部位),第3类和第4类在一次手术中治疗。在所有132个部位共植入411颗牙种植体,并用种植体支持的固定修复体进行修复。

该提议的分类为评估和规划IAN重新定位手术提供了一个结构化的系统框架。它有助于对需要进行IAN重新定位以植入牙种植体的患者进行更好的诊断、治疗规划和手术阶段预测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/2a47b54fab1a/dentistry-13-00267-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/c0d164f6e5d8/dentistry-13-00267-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/3e9afad6e1ce/dentistry-13-00267-g002a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/6d42de306188/dentistry-13-00267-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/d3e45af39b59/dentistry-13-00267-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/5f0922918a51/dentistry-13-00267-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/2a47b54fab1a/dentistry-13-00267-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/c0d164f6e5d8/dentistry-13-00267-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/3e9afad6e1ce/dentistry-13-00267-g002a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/6d42de306188/dentistry-13-00267-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/d3e45af39b59/dentistry-13-00267-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/5f0922918a51/dentistry-13-00267-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9d9/12192414/2a47b54fab1a/dentistry-13-00267-g006.jpg

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本文引用的文献

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Free buccal fat pad graft for the bone defect filling of medication-related osteonecrosis of the jaws: A novel surgical approach.游离颊脂垫移植用于颌骨药物性骨坏死骨缺损填充:一种新颖的手术方法。
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