Reconstruction and Localization of Mandibular Foramen Using CT Image in Taiwanese

利用電腦斷層影像重建及定位台灣人下颚孔的研究

毛念平(Lian-Ping Mau) ； 廖世忠(Shih-Chung Liao) ； 陳俊榮(Chun-Jung Chen) ； 黃國精(Kuo-Ching Huang) ； 溫敏杰(Miin-Jye Wen) ； 彭玉秋(Iok-Chao Pang) ； 曾春祺(Chuen-Chyi Tseng)

《臺灣牙周病醫學會雜誌》 15卷2期 (2010/06) Pp. 149-159

摘要

背景：對於下颚區所有牙科的治療，經常需要進行下頓齒糟神經的局部阻斷麻醉。所以下颚局部阻斷麻醉技術在牙科日常行醫中是絕對必要的技法。下颚孔是局部麻藥溶液沉積的地方，爲了要達到有效的局部麻醉，下顎孔便是非常重要的解剖構造。本實驗的目的則是探討國人下顎孔與齒列的相對關係。
材料與方法：從資料庫選出80筆成年人的牙科電腦斷層影像，其中包括38位男性及42位女性，平均年齡爲45.96歲。利用Implant Max軟體重組電腦斷層影像。首先訂定兩側後牙與地面平行的平面爲咬合平面，然後重建下齒槽神經及定位下穎孔的位置，再從平行於咬合平面的下顎小舌平面計算出其相對應的前後及上下距離並量測下顎孔的標記做統計分析。
實驗結果：(1)下顎小舌位於內側前緣枝後方12.91毫米，位於外側前緣枝後方19.01毫米以及位於後枝前方17.49毫米。(2)下顎小舌位於咬合平面上方6.54毫米。(3)下顎孔最下緣位於咬合平面下方1.07毫米。(4)下顎小舌的位置在男性女性及右倒左側並沒有顯著的差別。
結論：本實驗的結果顯示下顎小舌位於下顎枝中間偏後方及高於咬合平面的位置。這可以讓臨床操作者在實施下顎齒槽神經阻斷麻醉時有一個更精準且更有效率的參考解剖構造。

關鍵字

下顎孔 ； 牙科電腦斷層

並列摘要

Background
To perform dental treatments in the lower jaw, there are quite often need inferior alveolar nerve block. Therefore, inferior alveolar nerve block is an absolutely important skill for a dentist in daily practice. Mandibular foramen (MF) is the place where local anesthesia solution is deposited. In order to achieve adequate local anesthesia, MF becomes an important landmark structure. The aim of this study was to determine the relationship between dentition and ME in Taiwanese adult population.
Material and Methods
80 mandibular dental CT images were selected from our data bait. There are 38 males and 42 females. The average age is 45.96 years old. CT images were reconstructed using Implant Max(superscript ®) software. The Occlusal plane (OP) is defined as the horizontal plane of bilateral mandibular posterior teeth parallel to the floor. The inferior alveolar nerve was reconstructed and the MF was located. Then the cross section over the lingula parallel to the OP was located, the anteroposterior and superoinferior relationship of the lingula was measured and analysed.
Results
The results showed (1) Lingula is 12.91mm posteriorly to the intemal anterior ramus (JAR), 19.01mm posteriorly to the external anterior ramus (EAR) and 17.49mm anteriorly to the posterior ramus (PR). (2) Lingula is 6.54mm above the occlusal plane (OP). (3) Inferior ME is 1.07mm below the OP. (4) The position of lingula between males and females and right and left side is not statistically significant
Conclusion
This study demonstrated that lingula is located just posterior to the middle of the ramus correspond to the EAR to PR and just above the occlusal plane. This identify the landmarks that would provide the most reliable and predictable indicators of the exact position of the ME to the clinician during the inferior alveolar nerve block procedure.

並列關鍵字

Mandibular foramen ； dental CT