摘要
目的上牙槽前神经管(canalis sinuosus,CS)是从眶下神经管延伸至上颌骨前部的骨管,内含有上牙槽前神经血管束,CS在上颌骨前部出现的解剖变异分支称为副管(accessory canals,ACs)。准确识别CS及其ACs可以降低上颌前部手术时神经血管并发症发生的可能性,改善预后。本研究的目的是评估CS及其ACs的主要形态学和形态计量学特征,以便为种植手术提供解剖学指导。方法收集2021年6月—2022年6月至山西医科大学第一医院口腔科就诊的336例患者的锥形束CT(cone beam computed tomography,CBCT)数据,利用NNT viewer软件测量CS及其ACs的形态计量学特征,根据性别、年龄和鼻腭管(nasopalatine canal,NPC)类型分组进行统计学分析。结果CBCT测量分析显示ACs发生率为46.73%(157/336),ACs多呈双侧分布,垂直走行,侧切牙(51.77%)和中切牙(22.70%)的腭侧是ACs分布的主要区域。CS距中切牙根尖距离与年龄之间存在显著的线性相关性(R2=0.353,P<0.001)。圆柱型NPC患者的CS直径明显大于香蕉型(P<0.05)、沙漏型(P<0.01)和漏斗型(P<0.01)NPC的患者。沙漏型NPC患者与香蕉型NPC患者对比,CS距中切牙根尖距离的差异有统计学意义(P<0.05)。结论本研究结果表明,ACs在山西人群上颌骨前部有很高的发生率,NPC类型对CS及其ACs的形态计量学特征有显著影响。根据这项研究的结果,同时评估CS及其ACs和NPC是合理的,并有助于预防种植手术过程中的并发症,临床医师在术前应更加仔细评估风险并采取合适的预防措施。
Objective Canalis sinuosus(CS)is a bony canal that extends from the infraorbital nerve canal to the anterior part of the maxilla and contains prealveolar neurovascular bundles.The anatomical variations of CS in the anterior part of the maxilla are called accessory canals(ACs).Accurate identification of CS and ACs can reduce the possibility of neurovascular complications during anterior maxillary surgery and improve the prognosis.The aim of this study was to evaluate the main morphological and morphometric features of CS and its ACs in order to provide anatomical guidance for implant surgery.Methods Cone-beam computed tomography(CBCT)data of 336 patients who visited the Department of Stomatology,the First Hospital of Shanxi Medical University from June 2021 to June 2022 were collected.Software of NNT viewer was used to measure the morphometric characteristics of CS and its ACs.Statistical analysis was performed according to gender,age and nasopalatine canal(NPC)type.Results CBCT measurement analysis showed that the incidence of ACs was 46.73%.Most of the ACs were distributed bilaterally and vertically.The palatal side of lateral incisors(51.77%)and central incisors(22.70%)were the main areas of ACs distribution.There was a significant linear correlation between the distance from CS to the root apex of central incisor and age(R2=0.353,P<0.001).The CS diameter of cylindrical-type NPC patients was significantly larger than that of banana-type(P<0.05),hourglass-type(P<0.01)and funnel-type(P<0.01)NPC patients.There was significant difference between hourglass-type and banana-type patients in the distance between CS and the root apex of central incisor(P<0.05).Conclusion Results of this study indicate that ACs has a high incidence in the anterior maxilla of the Shanxi population and that NPC types have a significant impact on the morphometric characteristics of CS and its ACs.Based on the results of this study,simultaneous evaluation of CS with its ACs and NPC is reasonable and helpful in preventing complications during
作者
程傲然
王珏
范亚伟
CHENG Aoran;WANG Jue;FAN Yawei(School and Hospital of Stomatology,Shanxi Medical University,Taiyuan 030001,China)
出处
《口腔医学》
CAS
2023年第10期903-909,共7页
Stomatology
基金
山西省重点研发计划项目(201903D321090)。