动态实时导航技术在拔除周围伴有囊性病变的复杂下颌第三磨牙中的应用

Application of dynamic navigation technology in the extraction of complex mandibular third molars with surrounding cystic lesions

目的:探讨动态实时导航系统(dynamic navigation system,DNS)技术在手术治疗复杂下颌第三磨牙伴有囊性病变中的应用效果。方法:回顾性分析西安交通大学口腔医院2022年12月15日至2023年4月15日入院治疗的下颌第三磨牙低位阻生患者的临床资料,根据纳入标准选择7例患者,术前诊断为下颌第三磨牙低位埋伏阻生,冠周伴囊性病变,病变范围累及下牙槽神经管。术前将螺旋CT数据导入DNS完成导航设计,术中在DNS实时引导下进行手术治疗。分析手术情况及术后恢复状态,重点关注下牙槽神经损伤(inferior alveolar nerve injury,IANI)症状。结果:所有应用DNS的患者术后即日及术后1个月术区愈合良好,未出现IANI症状。结论:DNS技术可以实时明确手术操作位置,减少下牙槽神经管骨壁破坏,降低下牙槽神经损伤风险。

Objective:To explore the feasibility of extraction of mandibular third molars with cystic lesions under the guidance of a dynamic navigation system(DNS).Methods:Retrospectively analyzed hospitalized patients with lower impacted mandibular third molars in Hospital of Stomatology,Xi'an Jiaotong University from December 15,2022 to April 15,2023.According to the inclusion criteria,seven patients with the complex mandibular third molars accompanied cystic lesions,which was tightly adjacent to the inferior alveolar canal were included.All the CT imaging data were imported into the DNS and completed the navigation design.Then the molar were extracted,and cyst was removed under the guidance of navigation.The surgical condition and postoperative recovery state were further analyzed,focusing on the symptoms of postoperative inferior alveolar nerve injury(IANI).Results:All patients'wounds healed uneventfully with the application of DNS and the patients had no symptoms of IANI.Conclusion:The DNS technology determines the operation position in real time,which reduces the damage of the inferior alveolar neural canal and reduces the risk of inferior alveolar nerve damage.