下颌骨血供系统的研究及其临床意义

Observation and clinical significance of blood supplies system to mandible in transparent specimen

目的 :研究下颌骨的血供 ,为有关下颌骨的外科临床提供解剖学基础。方法 :将 6例墨汁灌注的新鲜下颌骨标本制作成透明标本 ,对其血供系统的分布、走行及吻合情况进行观测分析。结果 :下牙槽动脉自上颌动脉发出后 ,由下颌孔进入下颌骨 ,走行于下颌管内 ,营养下颌骨体部和下颌孔以下的升支部分。每侧下牙槽动脉共发出 6条分支来营养牙齿和牙周组织。下颌骨表面骨膜内有大量的血管网 ,以嚼肌及翼内肌附丽部分最为丰富。下颌孔以上升支部分 ,包括髁突和冠突则完全由来自于骨膜的血管网营养。结论 :下颌骨血供主要由下牙槽动脉以及骨膜动脉网分布 ,两者之间存在丰富的吻合 ,为下颌骨炎症扩散以及口腔癌的下颌骨骨转移提供了血管途径 ;骨膜动脉网的存在亦是正颌外科中下颌骨游离骨段的营养保证。

Objective:To observe the blood supplies system of the lower jaw bone and provide anatomical basis for clinical surgery of mandible.Methods:Six specimens of mandible injected with Chinese ink were made into transparent specimens.The blood supply system of mandible were observed and analyzed. Results:The distribution of mandible arteries was distinctly demonstrated in transparent specimens.The inferior alveolar artery was the dominant,direct nutrient vessel.It supplied branches to the cortical bone of the mandibular body and alveolar dental branches to the teech and adjacent tissue.The dense meshwork of periosteal vessel played an important role in nutrition of mandible,particulary prominent in the ascending ramus and the angle. Conclusion:The normal mandible receives its blood supply from the inferior alveoar artery and the periosteal vessel meshwork.The intercommunicatio between these two vessels can be demonstrated.The anastomosis between inferior alveolar artery and periosteal vessel meshwork provides blood vessel path for the diffusion of inflammation of mandible and bony metastasis of oral carcinoma.The periosteal vessel meshwork is the nutritional reassurance of the free mandibular segment in orthognathic surgery.