以成人体外下颌骨标本进行下颌管多断面数据观测

背景：近年牙种植以及正颌外科手术日益普及,下颌管及邻近组织的解剖结构越来越受到人们重视。但国内外实体标本测量数据报道相对较少。目的：观察实体下颌骨标本,经过测量明确下颌管及邻近组织的解剖数据,为临床进行牙槽外科手术、牙种植以及正颌外科手术提供可靠的参考数据以及解剖学依据。设计、时间及地点：对比观察,于2007-03/ 09在吉林医药学院解剖实验室完成。材料：完整下颌骨标本20具。方法：选取16具牙列完整的成人离体下颌骨标本和4具无牙下颌骨标本,测量下颌骨,在矢状剖面和颏孔后区每个牙位截面上有关磨牙、牙槽嵴以及下颌管的相关数据,然后进行统计学分析。主要观察指标：颏孔的位置、颏孔前缘到颏管前缘水平距离、下颌孔的位置、下颌管与磨牙根尖及各方向上骨板的距离。结果：下颌管位于下颌骨体内下方走行中偏舌侧,并近下颌骨下缘,与下颌第三磨牙根尖距离最近,在颏孔前方转向后外和颊侧出颏孔。下颌管在无牙下颌骨上与牙槽嵴顶距离明显缩小。结论：通过对下颌骨离体标本做多断面的观察和测量,为口腔颌面外科手术前设计提供了准确可靠的依据,使得临床医师能更好的制定手术方案,预防术中大量出血、神经损伤以及下颌角骨折和颌骨的侧壁穿孔等并发症的发生。

Multi-section measurements of mandibular canal of adult, ex vivo mandibles

BACKGROUND: Recently, with the increasing popularity of dental implant and orthognathic surgery, more and more people pay attention to the structure of mandibular canal and adjacent tissues. However, there are few reports addressing specimen measurements at home and abroad. OBJECTIVE: To measure the anatomical data of mandibular canal and adjacent tissue of mandible specimen to provide reliable reference data and anatomical evidence for alveolus surgery, tooth implantation, and orthognathic surgery. DESIGN, TIME AND SETTING: A controlled observation was performed at the Laboratory of Anatomy, Jilin Medical College between March 2007 and September 2007. MATERIALS: Twenty complete mandible specimens. METHODS: Sixteen adult, ex vivo mandibles with complete dentition and 4 edentulous mandibles were measured in every dental position of sagittal profile and posterior mental foramen in terms of molar, alveolar crest, and mandibular canal. Data were statistically analyzed. MAIN OUTCOME MEASURES: Mental foramen location, horizontal distance from anterior border of mental foramen to anterior border of mental canal, mandibular foramen location, distances from mandibular canal to molar root tip, lingual bone plate of mandible, inferior border of mandible, mandibular buccal bone plate, and alveolar ridge crest.RESULTS: Mandibular canal, located in the inferior region of the mandible body, ran towards the lingual side and was close to the inferior border of mandible and most close to the mandibular molar root tip. It turned towards posterolateral and buccal side in front of mental foramen and then passed through mental foramen. The distance of mandibular canal between edentulous mandible and alveolar ridge crest was obviously shortened. CONCLUSION: Multi-section observation and measurement of ex vivo mandible specimens provide precise, reliable evidence for preoperative design of orthognathic surgery, facilitate surgeons to better formulate surgical proposals, and prevent some complications, including intraoperative massive hemorrhage, interior alveolar nerve injury, mandibular angle fracture, and mental bone lateral wall perforation.