应用多层螺旋CT测量下颌神经管解剖学位置的价值探讨

doi:10.19439/j.sjos.2023.03.018

上海口腔医学 ›› 2023, Vol. 32 ›› Issue (3): 314-317.doi: 10.19439/j.sjos.2023.03.018

应用多层螺旋CT测量下颌神经管解剖学位置的价值探讨

谭智¹, 沈锂¹, 杨晶¹, 刘萍²

1.川北医学院附属医院口腔颌面外科,2.口腔科,四川南充 637003

收稿日期:2022-11-04 修回日期:2023-01-11 出版日期:2023-06-25 发布日期:2023-06-28
通讯作者: 刘萍,E-mail： liuping@nsmc.edu.cn
作者简介:谭智（1980-）, 男,硕士,主治医师,E-mail： tanweb@163.com

The clinical value of multislice CT for measuring the anatomical position of the mandibular nerve canal

TAN Zhi¹, SHEN Li¹, YANG Jing¹, LIU Ping²

1. Department of Oral and Maxillofacial Surgery, 2. Department of Stomatology, Affiliated Hospital of North Sichuan Medical College. Nanchong 637003, Sichuan Province, China

Received:2022-11-04 Revised:2023-01-11 Online:2023-06-25 Published:2023-06-28

摘要/Abstract

摘要： 目的：探讨下颌后牙区种植时应用多层螺旋CT（MSCT）测量下颌神经管解剖学位置的临床价值。方法：纳入109例行下颌后牙区种植患者。种植前应用MSCT及CBCT测量种植牙区域牙槽嵴与下颌神经管之间的线性距离,比较MSCT及CBCT的精度差异。将109例患者分为MSCT导航组和CBCT导航组,将2组患者的影像数据导入动态导航系统进行种植设计,并行实时动态导航种植治疗。术后测量种植体的实际位置与术前设计位置的偏离情况,治疗结束后评估临床效果。采用 SPSS 21.0 软件包对数据进行统计学分析。结果：MSCT及CBCT测量待种植牙区域不同种植牙的牙槽嵴顶与下颌神经管上壁之间的线性间距偏差较小,无统计学差异。2组术后种植体位置与术前种植体设计位置无显著差异。此外,CBCT导航组与MSCT导航组患者下牙槽神经功能损伤发生率也无显著差异。结论：MSCT可实现对下颌神经管解剖结构的精确定位,在动态实时导航牙种植术中按MSCT导航操作,可避免损伤下牙槽神经。

关键词: 多层螺旋CT, 种植牙, 下颌神经管

Abstract: PURPOSE: To investigate the clinical value of multislice CT(MSCT) for measuring the anatomical position of the mandibular nerve canal during implantation in the posterior mandibular regions. METHODS: A total of 109 patients with mandibular posterior dental implants were included,and the linear distance between the alveolar ridge and the mandibular nerve canal in the posterior mandibular region to be implanted was measured by MSCT and CBCT before implantation. All 109 patients were divided into the MSCT navigation group and CBCT navigation group, and the imaging data from both groups were imported into the dynamic real-time navigation system for implant design, in parallel and in real time. The patients in both groups underwent MSCT or CBCT to measure the deviation of the actual position of the implant from the preoperative design position, including the deviation of the cervical centrum and apical part of the implant and the deviation of the distance between the implant and the mandibular nerve canal, and to assess their clinical results after treatment. The data were statistically analyzed with SPSS 21.0 software package. RESULTS: The deviations from the linear spacing between the top of the alveolar ridge and the upper arm of the mandibular nerve canal of the different dental implants in the area to be implanted were detected by MSCT as well as CBCT methods with no significant difference. In addition, there was no significant difference in the cervical deviation, tip deviation, depth deviation, angular deviation and deviation of the spacing between the implant and the mandibular nerve canal in the postoperative implant position in MSCT navigation group compared to the preoperative implant design position in CBCT navigation group. There was also no significant difference in the incidence of functional impairment of the inferior alveolar nerve between CBCT-guided and MSCT-guided group of patients. CONCLUSIONS: MSCT can achieve precise localization of the anatomical structures of the mandibular nerve canal, and the operation according to MSCT navigation during dynamic real-time guided dental implant surgery can avoid damage to the inferior alveolar nerve.

Key words: Multislice CT, Mandibular canal, Dental implant

中图分类号:

R782.1

谭智, 沈锂, 杨晶, 刘萍. 应用多层螺旋CT测量下颌神经管解剖学位置的价值探讨[J]. 上海口腔医学, 2023, 32(3): 314-317.

TAN Zhi, SHEN Li, YANG Jing, LIU Ping. The clinical value of multislice CT for measuring the anatomical position of the mandibular nerve canal[J]. Shanghai Journal of Stomatology, 2023, 32(3): 314-317.

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应用多层螺旋CT测量下颌神经管解剖学位置的价值探讨

The clinical value of multislice CT for measuring the anatomical position of the mandibular nerve canal

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