下颌神经管在下颌角区的位置特征及其在下颌角骨折微创治疗中的意义

Location features of mandibular canal in mandibular angle area and its significance in minimally invasive treatment of mandibular angle fractures

目的通过测量下颌神经管在下颌角区的位置特征,初步探讨其在下颌角骨折微创治疗中的临床意义。方法选择在西安交通大学口腔医院拍摄CBCT的无颌骨病变的成年人100例,测量下颌角区下颌神经管距外斜线的距离(L1)、下颌神经管距下颌角点的距离(L2)及下颌神经管距颊侧骨皮质的距离(W3),通过统计分析探讨下颌神经管的位置规律及不同性别间的差异。结果下颌角区下颌神经管距外斜线平均距离为(14.37±2.12)mm,神经管处颊侧骨皮质平均厚度为(4.79±1.30)mm,下颌神经管距下颌角点的距离男女之间差异有统计学意义(P<0.05),下颌神经管距外斜线及颊侧骨皮质距离不存在性别间的统计学差异(P>0.05)。结论下颌神经管距外斜线的距离基本恒定,性别间无统计学差异。神经管与颊侧骨皮质间距离短,微创治疗下颌角骨折时,为避免下牙槽神经损伤,内固定螺钉与外斜线间距离应不少于17mm。

Objective To investigate the location features of mandibular canal in the angle of mandible and its clinical significance in the minimally invasive treatment of mandibular angle fractures.Methods Totally 100 healthy adults were chosen in the present study.CT scan was performed in all cases,then the distance between mandibular canal and the external oblique line of mandible(L 1),the distance between mandibular canal and the gonion(L 2),the distance between mandibular canal and the buccal cortex(W 3)were mea-sured in the mandibular angle area.In addition,the difference of the mandibular canal in different genders was investigated by statistical analysis.Results In mandibular angle area,the average distance between the mandibular canal and the external oblique line was(14.37±2.12)mm,and the average distance between the mandibular canal and buccal cortex was(4.79±1.30)mm.There was statistically significant difference in the distance between the mandibular canal and the gonion between male and female(P<0.05).There was no significant difference in the distance between the mandibular canal,the external oblique line of mandible and the buccal cortex between male and female(P>0.05).Conclusion The distance between the mandibular canal and the oblique line is basically constant and there is no significant difference between male and female.Since the distance between the mandibular canal and the buccal cortex is short,the distance between the internal fixation screw and the external oblique line should be no less than 17 mm in order to avoid the damage of the inferior alveolar nerve in the minimally invasive treatment of mandibular angle fracture.