利用錐束電腦斷層剖析國人下顎切齒管之出現及形態位置

Investigation of the occurrence , anatomy, and location of the mandibular incisive canal in Taiwanese patients using Cone-Beam CT

郭芯妤(Hsin-Yu Kuo)

指導教授 ： 洪純正

高雄醫學大學/口腔醫學院/牙醫學研究所/碩士(2011年)

https://doi.org/10.6832/KMU.2011.00036

摘要

研究目的: 錐束電腦斷層影像能提供牙科植體手術精確的術前影像評估，然而學者研究多只針對下顎後牙區及頦孔，忽略前牙區植牙時也有神經血管損傷風險，本研究利用錐束電腦斷層掃描系統，欲分析下顎切齒管出現率及走向。
材料方法: 35名欲植牙病患，在術前接受Picasso-Trio (Vatech, Korea) 錐束電腦斷層掃描，並利用Ezimplant 3D software影像操作軟體量測下顎切齒管於國人之出現率，線延伸長度，至下顎骨體最底緣、頰、舌側邊緣距離，水平、垂直寬徑，並比較左右側、性別及缺牙情況有無之分組差異。
研究結果:下顎切齒管於影像下出現率為85.71％，向前延伸長度平均為14.9±3.09mm(標準差)，水平、垂直寬徑平均範圍為0.8~2.42mm，下顎切齒管延伸越往前靠近下顎中線，呈現向下且遠離頰側近舌側的走向。在比較左右側、性別及缺牙分組情況，統計結果顯示分組內大多無達顯著性差異，但仍不可忽略個體之間的差異。
結論:下顎切齒管在國人電腦斷層影像下有高出現率，為降低前牙區手術後神經損傷之風險，建議臨床醫師利用錐束電腦斷層掃描進行術前相關解剖構造之分析。

關鍵字

下顎切齒管 ； 錐束電腦斷層 ； 前牙區手術造成神經感覺異常

並列摘要

Objective: The cone-beam computed tomography (CBCT) provides precise images and has been widely used in preoperative implant planning. The aim of the study is to analyze the visibility and to trace the course of the mandibular incisive canals (MIC) by application of CBCT.
Material and Method: 35 subjects received mandibular CBCT (Picasso-Trio, Vatech, Korea) as pre-implant examination. Two inspectors define and locate each mandibular incisive canal’s visibility on the CBCT images through the Picasso Ezimplant 3D software. Average lengths from center of MIC to vertical inferior, horizontal buccal and lingual border of mandible body were recorded. The average MICs’ diameters and lengths of mesial extension were also measured. Statistical analysis were carried out to study MIC differences between age, bilateral side, and edentulous factors.
Result: The incisive canal was visible in 85.71% of the scans, the mean extension is 14.9±3.09mm(SD) and the diameter ranged from 0.8 to 2.42mm. MIC proceeds from the buccal plate towards the lingual plate with slightly downward direction.
Conclusion: The high detection rate of the mandibular incisive canal at the anterior region of mandible indicated the potential high preoperative value of CBCT scan for surgical procedure in the anterior mandible. Although the differences between sides of mandibular incisive canal were not statistically significant, the variance still exist and even higher among individuals.

並列關鍵字

mandibular incisive canal ； cone-beam computed tomography ； nerve disturbance due to surgery in anterior mandible

參考文獻

1. Olivier. The inferior dental canal and its nerve in the adult. British Dental Journal 1928;49:356-58.

2. Mraiwa N. Presence and course of the incisive canal in the human mandibular interforaminal region: two-dimensional imaging versus anatomical observations. Surg Radiol Anat 2003;25:416-23.

3. Pires CA. Mandibular Incisive Canal: Cone Beam Computed Tomography. Clinical Implant Dentistry and Related Research 2009;13:1-7.

4. R M-S. Clinical evaluation of overdenture restorations supported by osseointegrated titanium implants: A retrospective study. Journal of Oral Maxillofacial Implants 1990;5:375-83.

5. G K. Effects of osseointergrated implants on psychological and social well being: A literature review. Journal of Prosthetics Dentistry Journal of Prosthetics Dentistry 1992;68:515-18.