下颌管的三维重建及临床意义

摘要/Abstract

摘要：

目的　为下颌牙种植术等临床口腔外科提供解剖学基础。方法　选取全牙志愿者20名，在螺旋CT机以眶耳线(OML)为基线连续扫描，采用ADW 4.2重建软件的曲面重组技术(CPR)重建下颌管，观察下颌管的位置、构造和测量下颌后牙牙根至下颌管上壁的距离；在Amira三维重建软件下重建下颌骨及下颌管的可视化模型，观察透明下颌骨内下颌管的走行及其与下颌后牙的关系。结果　下颌管壁由一薄层骨密质构成，自磨牙牙根尖舌侧和前磨牙牙根尖颊侧的下方走行；透明下颌骨内的下颌管可清晰显示其位置、形态及走行，下颌管与下颌体下缘、牙槽嵴及内、外侧骨板的距离。下颌后牙牙根至下颌管的距离以第2磨牙最近，由近及远依次为第2磨牙、第1磨牙、第3磨牙、第2前磨牙和第1前磨牙；下颌磨牙的远中根至下颌管的距离均较近中根近。第1前磨牙、第2前磨牙、第1磨牙、第2磨牙、第3磨牙牙根至下颌管上壁的最短距离分别为(8.38±1.04) mm(左)和(8.44±1.05) mm(右)、(7.51±0.85) mm、(3.40±　0.65) mm、(2.93±0.61) mm、(3.92±0.63) mm(左)和(3.97±0.63) mm(右)。结论　下颌管的三维重建对选择适宜长度的牙种植体，避免牙种植体损伤下牙槽神经等具有重要意义。

关键词: 下颌管, 三维重建, 可视化, 牙种植术

Abstract:

Objective　To provide anatomic basis for the mandibular dental implantation.　Methods　20 volunteers with healthy teeth were selected and scanned in series by spiral CT from the orbitomeatal line (OML). The mandibular canal was reconstructed by the curve-planar reconstruction(CPR) under the ADW 4.2 software. The position and composition of mandibular canal were observed, followed by the measurement of the distance from the dental root of mandibular posterior teeth to the superior wall of mandibular canal. The visual model of mandible and mandibular canal were reconstructed by the Amira 3D software. The course of mandibular canal in the diaphanous mandible and the relationship of mandibular posterior teeth with it were detected.　Results　The mandibular canal was composed of a thin compact bone and traveled through the bottom of lingual side of the molar and buccal side of the premolar. The lingual side of the madibular canal was thicker than that of other sides. In the diaphanous mandible, the mandibular canal could be clearly displayed, including its position, shape and course, and the distances from the mandibular canal to the inferior edge of mandibular body, alveolar crest and the medial, lateral plates of mandible respectively. The distance from the dental root of second molar to the mandibular canal was the nearest than that of the others, and the followed was the second molar, first molar, third molar, second premolar and first premolar by the near and far. The distance was nearer from the distal root of mandibular molar to the mandibular canal than that of the mesial root. The nearest distance from the dental root of first premolar, second premolar, first molar, second molar, third molar to the superior wall of mandibular canal were (8.38±1.04) mm(left) and (8.44±1.05) mm(right), (7.51±0.85) mm, (3.40±0.65) mm, (2.93±0.61) mm, (3.92±0.63) mm(left) and (3.97±0.63) mm(right) separately.　Conclusions　Three-dimensional reconstruction and analysis of mandibular canal is valuable for choosing appropriate length of dental implantation and avoiding to injury the inferior alveolar nerve during the operation.

Key words: Mandibular canal, Three-dimensional reconstruction, Visualization, Dental implantation

中图分类号:

R322.41

付升旗, 范锡印, 苗莹莹, 许　伟, 陶　晶, 邓晓慧. 下颌管的三维重建及临床意义[J]. 中国临床解剖学杂志, 2011, 29(4): 375-377.

FU Sheng-Qi, FAN Ti-Yi, MIAO Ying-Ying, HU 　Wei, DAO 　Jing, DENG Xiao-Hui. Three-dimensional reconstruction of the mandibular canal and its clinical significance[J]. Chinese Journal Of Clinical Anatomy, 2011, 29(4): 375-377.

参考文献

[1] 付升旗, 范锡印, 刘恒兴, 等. 下颌管与下颌后牙的位置关系及临床意义
[J]. 中国临床解剖学杂志, 2009, 27 (6): 651- 653.

[2] Obradovic O, Todorovic L, Pesic V, et al. Morphomtric analysis of mandibular canal: clinical aspect
[J]. Bull Goup Int Rech Sci Stomatol Odontol, 1998, 36 (1): 109 -113.

[3] 吴银洲，胡圣望. 100例下颌骨下颌管形态及其至牙槽嵴距离的观测研究
[J]. 中国口腔种植学杂志, 2005, 10(1): 15-17.

[4] Tsuji Y, Muto T, Kawakami J, et al. Computed tomographic analysis of the position and course of the mandibular canal: relevance to the sagittal spilt ramus osteotomy
[J]. Int J Oral Maxillofac Surg, 2005, 34 (3): 243-246.

[5] 赵保东，李宁毅，周仰光，等. 下颌骨的三维重建及实体解剖研究
[J]. 华西口腔医学杂志, 2002, 20(1): 21-23.

[6] Jiro N, Kensaku M, Takayuki K, et al. Quantification and visualization of alveolar bone resorption from 3D dental CT image
[J]. Int J Comput Assist Radiol Surg, 2007, 2(1): 43-53.

[7] Emanuela D, Erik B. Anatomic research on the perioral muscles, functional matrix of the maxillary and mandibular bones
[J]. Surg Radiol Anat, 2006, 28(3): 261-266.

[8] 张庆福, 吕春堂, 刘国勤, 等. 下颌骨三维重建效果的测量分析研究
[J]. 解放军医学杂志, 2006, 31 (11): 1050-1052.

[9] Spitzer V, Ackerman MJ, Scherzinger AL, et al. The visible human male: A technical report
[J]. J Am Med Inform Assoc, 1996, 3(1): 118-130.

[10] 李宁毅，马彦博，谷芳，等. 数字化可视下颌骨的初步研究
[J]. 华西口腔医学杂志，2007, 25(1): 83-85.

[11] 孟翔峰，陈建刚，李清，等. 牙种植体植入方向在修复设计与颌骨骨量间的差异
[J]. 临床口腔医学杂志, 2002, 18(1): 38-39.

[12] 徐明, 章作玲. 螺旋CT三维重建用于正畸埋伏牙定位的临床研究
[J]. 广东牙病防治, 2008, 16 (1): 25-27.

[1]	江剑宏, 段仁鹏, 李晓锋. 国人胆道三维重建解剖变异应用研究[J]. 中国临床解剖学杂志, 2024, 42(1): 1-4.
[2]	陈瑞欣, 苗靖榆, 张翼, 柳澄, 孟海伟, 刘树伟. 肝静脉引流形式的双源CT三维成像研究[J]. 中国临床解剖学杂志, 2023, 41(6): 647-651.
[3]	徐浩铜, 徐万宇, 吴毅, 何明静, 雷秀兵, 田伏洲. 慢性胰腺炎脾门假性囊肿分类及其与SPH关系的影像学研究[J]. 中国临床解剖学杂志, 2023, 41(6): 652-656.
[4]	孙建宇, 蔡康希, 邢帅, 夏岩, 付伟伟. SD大鼠乳胶灌注脑动脉可视化技术的改良[J]. 中国临床解剖学杂志, 2023, 41(5): 614-618.
[5]	李佳伟, 高明杰, 仝玲, 刘清华, 康志杰, 张凯, 王海燕, 李筱贺. 内蒙古地区蒙古族人群髋臼数字解剖学研究[J]. 中国临床解剖学杂志, 2023, 41(4): 390-394.
[6]	廖晓霜, 鲁辉, 刘融, 魏在荣, 周健, 陈伟, 蒋海芳, 聂开瑜. 基于三维测量的颞浅动脉干解剖学研究[J]. 中国临床解剖学杂志, 2023, 41(3): 263-269.
[7]	吴世源, 何浩强, 陈正和, 牟永告, 李严兵, 黄文华, 钟世镇. 多模态融合技术三维重建岩上静脉[J]. 中国临床解剖学杂志, 2023, 41(3): 270-276.
[8]	何艾岭, 王清, 李广州. 骨质疏松性椎体压缩骨折患者腰椎椎基静脉孔的CT影像解剖学研究[J]. 中国临床解剖学杂志, 2023, 41(3): 283-287.
[9]	卢逸嘉, 陈春林, 刘云鹭, 冯婕, 刘萍 . 三维可视化探究广泛性全子宫切除术后阴道轴向长期变化差异[J]. 中国临床解剖学杂志, 2023, 41(2): 137-142.
[10]	周芮灵, 李盈, 黄迪情, 赵增江, 丁慧, 张慧, 陈伟. 256排螺旋CT三维重建右半肝门静脉和肝静脉及其解剖关系的临床应用研究[J]. 中国临床解剖学杂志, 2023, 41(2): 150-155.
[11]	杨静怡, 胡昕, 姚洁, 徐洲, 杨智, 陈志, 吴毅. 基于中国数字化人体的支气管树三维模型构建及纤维支气管镜手术模拟仿真[J]. 中国临床解剖学杂志, 2023, 41(1): 1-7.
[12]	李梓瑜, 李琨, 郭燕, 越洒, 曲星月, 刘宇航, 张凤珍, 王星, 徐以发, 李志军, 李筱贺, 张少杰. 数字儿童颅底及颈部可视化模型建立研究[J]. 中国临床解剖学杂志, 2022, 40(6): 639-643.
[13]	冯培勋, 李桂军, 赵永红, 程明亮, 李立国. 基于结构光三维重建的成人第3指蹼间隙的形态学分型及临床意义[J]. 中国临床解剖学杂志, 2022, 40(6): 644-648.
[14]	李泽宇, 肖钊明, 刘畅, 吴坤成, 许广威, 骆宝华, 骆世文, 马梓玮, 骆建恒, 贺善礼, 梁海彬, 曾伊琳, 欧阳钧. 精囊腺和射精管3D打印模型制作[J]. 中国临床解剖学杂志, 2022, 40(3): 366-368.
[15]	胡定祥, 李长辉, 陈亮, 马晨曦, 黄河, 郑瑞清. 基于CT三维重建的肩胛骨关节盂形态学分型及临床意义[J]. 中国临床解剖学杂志, 2022, 40(2): 150-153.