下颌管的应用解剖及临床意义

Applied Anatomy and Clinical Significance of the Mandibular Canal

目的：为下颌牙种植术等临床口腔外科提供解剖学基础.方法：选取下颌骨标本10例、新鲜下颌骨标本10例和成人全牙下颌骨标本20例,分别暴露出下颌管截面、下牙槽神经血管束和下颌管与下颌后牙牙根.观察下颌管的形态、走行和下牙槽神经、血管的排列关系,用游标卡尺测量下颌后牙牙根尖至下颌管上壁的距离.结果：下颌管呈椭圆形,自磨牙牙根尖舌侧和前磨牙牙根尖颊侧的下方走行;下颌管内的下牙槽血管位于下牙槽神经上方.下颌后牙牙根至下颌管的距离以第2磨牙最近,由近及远依次为第2磨牙、第1磨牙、第3磨牙、第2前磨牙和第1前磨牙;下颌磨牙的远中根至下颌管的距离均较近中根近.第1前磨牙、第2前磨牙、第1磨牙、第2磨牙、第3磨牙牙根至下颌管上壁的最短距离分别为（8.19±0.87） mm（左）和（8.29±0.88） mm（右）、（7.38±0.85） mm、（3.30±0.66） mm、（2.98±0.77） mm（左）和（2.92±0.75） mm（右）、（3.82±0.63） mm（左）和（3.86±0.64） mm（右）.结论：下颌管的应用解剖对选择适宜长度的牙种植体,避免牙种植体损伤下牙槽神经等具有重要意义.

Objective： To provide anatomical basis for the mandibular dental implant operation of the clinical oral surgery. Methods： 10 mandibles, 10 fresh mandibles and 20 mandibles with teeth of adult were selected, and exposed the sectional shape of mandibular canal, the inferior alveolar neurovascular bundle, the mandibular canal and the dental root of mandibular posterior teeth respectively. The shape and course of man- dibular canal, the relationship of the inferior alveolar nerve with the inferior alveolar vessels were observed, and the distance from the dental root of mandibular posterior teeth to the superior wall of mandibular canal with the vernier caliper was measured. Results ：The mandibular canal was ellipse and traveled from the bottom of lingual side of the molar and buccal side of the premolar. The inferior alveolar vessels were laid above the inferior alveolar nerve in the mandibular canal. The distance from the dental root of second molar to the mandibular canal was the nearest than that of the others, from near to far was the second molar, first molar, third molar, second premolar and first premolar. The distance was nearer from the distal root of mandibular molar to the mandibular canal than the mesial root. The nearest distance from the dental root of first premolar, second premolar, first molar, second molar, third molar to the superior wall of mandibular canal were （8.19 ±0.87）mm（left） and （8.29±0.88）mm（right）, （7.38 ±0.85）mm, （3.30±0.66）mm, （ 2. 98 ±0. 77 ） mm （ left ） and （2.92±0.75 ） mm （ right）, （ 3.82 ±0.63 ） mm （left） and （ 3.86 ±0.64 ） mm （right） separately. Conclusions： There is great significance for choosing appropriate length of dental implantation and avoiding dental implantation to injury the inferior alveolar nerve of the microanatomy of mandibular canal.