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目的:应用CBCT(Cone Beam Computed Tomography)分析下颌阻生第三磨牙牙根与下颌管的位置关系。方法:从2010-04—2012-04在我院口腔外科诊断为下颌第三磨牙阻生且需拔除的7 751例(15 174个牙)患者中,选择X线片示牙根与下颌管有重叠影像的患者401例(518个中低位下颌阻生第三磨牙)为对象,通过CBCT分析下颌管与牙根的位置关系;并在拔牙术中对X线片和CBCT显示的不同位置关系时下牙槽神经暴露情况进行检查;采用χ2检验对结果进行统计分析。结果:X线片显示有重叠影像的518个牙,CBCT观察显示有343个(66.22%)的牙根与下颌管接触;其中下颌管位于根间者接触发生率最高,依次为根间﹥舌侧﹥根尖下方﹥颊侧(P﹤0.05)。术中检查显示:X线片示有重叠影像的牙术中下牙槽神经暴露者87例牙(16.80%);CBCT显示牙根与下颌管接触时下牙槽神经暴露率为25.36%(87/343),明显高于前者(P﹤0.05)。结论:关于下颌管与下颌阻生第三磨牙牙根的解剖关系,CBCT较X线片能提供更准确的信息。
Objective: To analyze the relationship between mandibular impacted third molars root and mandibular canal by CBCT (Cone Beam Computed Tomography). METHODS: From July 2010 to April 2012, of 7 751 patients (15 174 teeth) diagnosed as impacted mandibular third molar by oral surgery in our hospital, we selected X-ray films to overlap with mandibular canal 401 patients (518 middle and low mandibular impacted third molars) were included in this study. The CBCT was used to analyze the relationship between the mandibular canal and the root of the tooth. The different positions of the X-ray film and CBCT during extraction were analyzed. Nerve exposure was checked; χ2 test results were statistically analyzed. Results: There were 518 teeth with overlapping images on X-ray and 343 teeth (66.22%) on mandibular canal with CBCT observation. The incidence of mandibular canal root contact was the highest > Apex below buccal side (P <0.05). The intraoperative findings showed that 87 teeth (16.80%) were exposed on the X-ray film with overlapping images of the inferior median alveolar nerve. The exposure of the inferior alveolar nerve was 25.36% (87/343) when the root was contacted with the mandibular canal by CBCT ), Significantly higher than the former (P <0.05). Conclusion: The anatomical relationship between the mandibular canal and mandibular third molar roots provides more accurate information than X-ray films.