下颌骨偏斜畸形患者与正常人群下颌管三维走向及下颌骨形态的锥形束CT分析

摘要/Abstract

摘要： 目的采用锥形束CT（cone-beam computed tomography, CBCT）分析下颌骨偏斜患者下颌管的走行、位置及其与周围骨板的毗邻关系,下颌骨的形态特征,并与正常人群进行比较,为下颌骨手术提供解剖学依据。方法纳入下颌骨偏斜的成人患者29例作为病例组,个别正常▌成人29名为对照组。进行CBCT扫描,利用InVivo 5 软件对下颌骨进行三维重建,定位标记点,测量下颌骨形态以及下颌管在其内的三维走行。采用SPSS 17.0软件包对测量值进行统计学分析,确定不同人群下颌骨形态及下颌管走行特点及差异。结果 ①下颌支下颌管外侧壁到颊侧骨皮质的距离（BP）在0、1、2平面偏斜侧显著较对照组小（P<0.05）;舌侧骨皮质厚度（LC）在各层面测量值均为偏斜侧>偏斜对侧﹥对照组,在1、5平面偏斜侧与对照组差异有统计学意义（P<0.01）。②相对于偏斜对侧和对照组,偏斜侧下颌管更靠近颊侧而远离舌侧骨板,在第一磨牙处偏斜侧与对照组的差异有显著性（P<0.05）。③偏斜（对）侧与对照组的下颌孔位置、下颌支/体长度有显著差异（P<0.05）。④对照组下颌骨体截面高度、宽度、皮质骨厚度各测量值左右侧无显著差异（P>0.05）,三维形态左右基本对称,但病例组两侧部分测量值与对照组差异显著（P<0.05）。结论下颌骨偏斜畸形患者的下颌管整体走行较正常人更靠近颊侧;偏斜侧下颌支/体长度明显较对侧小,下颌骨偏斜畸形患者下颌骨形态发育不对称,在空间结构上发生了扭转变形。

关键词: 下颌骨偏斜, 下颌管, 下颌骨, 锥形束CT

Abstract: PURPOSE: To analyze the intramandibular course and its adjacent anatomic structure of mandibular canal（MC） through the data of cone-beam computed tomography(CBCT),as well as the mandibular morphology, and compare with the general population to provide anatomical basis for mandibular surgery. METHODS: Twenty nine adults with mandible deviation were selected as the case group, and compared with 29 individuals with normal occlusion. CBCT scans were conducted, InVivo 5 software was used to reconstruct the mandible, anchor the points, measure the jaw shape and the three-dimensional course of MC. All measurements were analyzed with SSPS 17.0 software package, to determine the characteristics and differences in the mandibular morphology and the course of MC between different cases. RESULTS: ①BP in 0,1 and 2 plane of oblique side was significantly smaller than the control group(P<0.05);the maximal measurement value of LC in each level was the oblique side and the control was the minimal, the difference between the oblique side and the control in plane 5 was significant (P<0.01).②Compared with the contralateral side and the control, MC of oblique side was more closer to the buccal side and away from the lingual bone plate, the difference between the oblique side and the control at the first molar was significant(P<0.05).③The mandibular foramen locations, the length of the ramus and the body were all significantly different(P<0.05) between the 2 groups.④There was no significant difference between left and right side in the height,the width and the thickness of the cortical bone of the mandibular body at cross sections and three dimensional shape symmetry in the control group, but significant difference(P<0.05) in some measured values between the 2 groups. CONCLUSIONS: Compared with normal adult,the course of MC in patients with mandibular deviation was closer to the buccal plate; the length of the ramus and the body of oblique side is smaller than the contralateral side, the mandibular morphogenesis in patients with mandibular deviation is asymmetric with torsional deformation on the spatial structure.

Key words: Mandibular deviation, Mandibular canal, Mandible, CBCT

中图分类号:

R782.2

曲卫国, 绳兰兰, 李阳, 屈振宇, 岳柏, 王吉. 下颌骨偏斜畸形患者与正常人群下颌管三维走向及下颌骨形态的锥形束CT分析[J]. 中国口腔颌面外科杂志, 2016, 14(4): 344-351.

QU Wei-guo, SHENG Lan-lan, LI Yang, QU Zhen-yu, YUE Bai, WANG Ji. Three dimensional survey of trend of inferior alveolar nerve canal and mandibular morphology by cone-beam CT between patients with mandibular deviation and normal individuals[J]. China J Oral Maxillofac Surg, 2016, 14(4): 344-351.

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