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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:选取新鲜下颌骨标本10例、成人全牙下颌骨标本18例和20名全牙志愿者,分别暴露出下牙槽神经血管束、下颌管与下颌后牙牙根和CT连续扫描后进行三维重建。观察下牙槽神经、血管的排列关系,用游标卡尺和CT三维重建工作站分别测量下颌后牙牙根至下颌管上壁的距离。结果:下颌管自牙槽窝下方走行,其舌侧骨板较厚;下颌管内的下牙槽血管位于下牙槽神经上方。下颌磨牙的远中根至下颌管的距离均较近中根近。在标本及影像上的第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距离分别为(8.36±2.34)mm和(8.42±2.42)mm、(7.36±2.21)mm和(7.52±2.18)mm、(3.22±1.40)mm和(3.36±1.85)mm、(2.96±1.54)mm和(2.84±1.55)mm、(3.64±1.72)mm和(3.88±1.76)mm。结论:(1)下颌后牙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。(2)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。
Objective: To provide anatomical basis for clinical oral surgery such as mandibular dental implant. Methods: Ten cases of fresh mandibular specimens, 18 adult mandibular specimens and 20 whole-tooth volunteers were enrolled. The inferior alveolar nerve bundles were exposed. The mandibular canal and mandibular posterior teeth of the mandible and CT were scanned continuously for three-dimensional reconstruction. Observe the relationship between the inferior alveolar nerve and blood vessels, and measure the distance between the root of mandibular posterior teeth and the upper wall of mandibular canal with vernier caliper and CT three-dimensional reconstruction workstation respectively. Results: The mandibular canal walked from the bottom of the alveolar fossa, and its lingual plate was thicker. The inferior alveolar vessels in the mandibular canal were located above the inferior alveolar nerve. The distance between the distal root of the mandibular molars and the mandibular canal is closer than that of the proximal root. The distance from the root to the upper wall of mandibular canal in the first premolar, the second premolar, the first molars, the second molars and the third molars in specimens and images were (8.36 ± 2.34) mm and (8.42 ± 2.42) mm , (7.36 ± 2.21) mm and (7.52 ± 2.18) mm, (3.22 ± 1.40) mm and (3.36 ± 1.85) mm, (2.96 ± 1.54) mm and (3.88 ± 1.76) mm. Conclusion: (1) The distance between the mandibular posterior teeth and the mandibular canal is the second molars, the second molars, the first molars, the third molars, the second premolar and the first premolar are the most proximal and the distal. (2) It is of great significance to choose the appropriate length of dental implants, to prevent the dental implants from damage to the alveolar nerve.