下颌升支截骨手术相关下颌管解剖标志的多层CT测量研究

The measurement of position of the mandibular canal with multi-detector row helical CT in relation to the sagittal split ramus osteotomy

目的:应用多层CT影像测量下颌骨与升支矢状劈开截骨手术相关下颌管骨性解剖标志,为避免手术中损伤下齿槽神经血管提供指导。方法:选择60名正常成人下颌骨多层CT扫描图像,应用efilm1.94图像处理软件分别在第二磨牙远中的垂直线,磨牙后三角尖至下颌角连线及下颌孔下5 mm处取下颌骨断面,测量下颌管的解剖位置。结果:下颌管在下颌第二磨牙远中断面距颊侧骨面的距离为6.26±4.34 mm;在磨牙后三角尖至下颌角连线断面距颊侧骨面的距离为5.18±2.12 mm;在下颌孔下5 mm断面距颊侧骨面的距离为4.44±2.38 mm。结论:参照测量获得的解剖数据在术中能降低下齿槽神经血管损伤的发生率。

Objective： The aim of this study was to investigate the position and course of the mandibular canal through the mandibular ramus using multi-detector row helical computed tomographic imaging and to relate the findings to performing sagittal split ramus osteotomy. Method： Sixty adulty human were selected for multi-multi-detector row helical CT measurement and efilml. 94 softweare analysis, according with a vertical line from the postior margin of the 2 ed molar tooth, and a line from the postior triangle apex of molar teeth to mandibular angle, at 5 mm below the mandibular foramen, and mandibular canal was examined . Result： Thickness of the buccal side bone is 6.26 ± 4.34 mm with section through line drawn from the posterior point of the second molar . Thickness of the buccal side bone is 5.18 ± 2.12 mm from the posterior point of the second molar to the top point of the mandibuler angle. Thickness of the buccal side bone is 4.44 ± 2.38 mm at 5 mm below the mandibular foramen. Conclusion： The study is to provide further understanding of the mandibular canal anatomy in relation to the bone cut design of sagittal split ramus osteotomy and to create clinical safety guidelines in order to avoid damaging the inferior alveolar nerve and vessels.