下颌升支垂直/斜行骨切开术涉及骨性标志的测量分析

目的测量分析成年人下颌升支与垂直或斜行骨切开术相关的骨性标志。方法收集成年离体下颌骨标本105例(男54例,女51例)。测量下颌孔最下点、下颌孔后点与升支后缘的水平距离;并观察下颌孔最下点与下颌第二磨牙牙合平面的垂直向关系,翼肌粗隆最上点与下颌孔最下点的垂直向关系,以及下颌升支外侧隆突存在的比例。结果下颌孔最下点到升支后缘的平均距离男性为16.12mm,女性为16.03mm;最小距离男性为11.20mm,女性为10.68mm。下颌孔后点到升支后缘的水平距离男性为13.50mm,女性为13.60mm;最小距离男性为10.06mm,女性为10.18mm。90.17%的标本下颌孔最下点低于下颌第二磨牙牙合平面;85.34%的标本下颌升支翼肌粗隆最上点超越下颌孔最下点平面;72.41%的升支外侧隆突明显存在。结论下颌孔最下点及后点到升支后缘的水平距离男女相似,无性别差异。在下颌第二磨牙牙合平面水平距升支后缘8~10mm作骨切开线一般可以避开下齿槽神经血管束;升支内侧翼内肌附着有利于近心骨段的血液供应。

Anatomic analysis of ramus for intraoral vertical ramus osteotomy

Objective To study the anatomic sites on ramus relating to intraoral vertical or oblique ramus osteotomy and provide valuable anatomic data for determining osteotomy line. Methods 105 adult mandibles were used in this study to locate the foramen,analyze the difference between males and females,and observe the vertical relationship between the attachment of medial pterygoid and inferior point of foramen and positive ratio of external carina of ramus. Results The average distance of the inferior point of foramen to posterior margin of ramus is 16.12 mm in males and 16.03 mm in females. The minimal distance ranged from 10.68 mm in females to 11.20 mm in males. The average distance of the back point of foramen to the posterior margin of ramus was 13.50 mm in males and 13.60 mm in females. The minimal distance was 10.06 mm and 10.18 mm in males and females,respectively. In 90.17% cases the inferior point of foramen was below the occlusal surface of the second mandibular molar,and the mandibular attachment of medial pterygoid was observed above the inferior point of foramen in 85.34% cases. The positive ratio of external carina was 72.41%. Conclusion No significant differences were observed in above anatomic measurements between males and females. The osteotomy line 8 to 10 mm before the posterior border of ramus was considered to be safe for vertical or oblique osteotomy,and the attachment of medial pterygoid was beneficial to keeping blood supply of near bone segment.