摘要目的 根据锥形束CT(CBCT)测量下牙槽神经管(inferior alveolar nerve canal,IANC)特定位点,分析IANC的走行规律.方法 本研究为回顾性资料分析.对符合纳入标准的检查者选择130例,其中按年龄分组,中年组和青年组各65例;按性别分组,男女各65例.对入选者行CBCT测量IANC.测量方法在KaVo3D eXam CT的植入物屏幕上的失状向截面上,自颏孔区近中起,颏孔刚刚完全突破颊侧皮质骨的截面定为S1,自S1起向同侧远中方向每隔l cm为一截面,依次在l、2、3 cm处,分别定为截面S2、S3、S4.在截面上测量IANC外壁上特定点到牙槽嵴顶、舌侧皮质骨外壁、下颌骨最下缘、颊侧皮质骨外壁的距离,分别定为L1、L2、L3、L4测距位点.对测量结果依性别、年龄分类比较.对数据做正态分析,均为正态分布.不同性别与年龄间的比较采用两独立样本t检验,P＜0.05为差异有统计学意义.结果 本研究显示,在男女间右侧IANC的S2L1、S3L1、S4L1、S2L2、S3L2、S4L2、S1L3、S3L4这8个位点上测得的8组L值及左侧IANC的S1L1、S2L1、S3L1、S4L1、S1L2、S3L2、S4L2、S2L3、S3L3、S4L4这10个位点测的L值,差异均有统计学意义(均为P＜0.05);右侧IANC S2L4位点及左侧IANC SlL3位点上测得的L值,在中青年组间差异有统计学意义(P＜0.05).L值由S1到S4有一定的变化规律:L1值和I4值的变化规律为先增大再减小、再减小;L2值和L3值的变化规律为先减小再减小、再增大.结论 性别对个体间L值的影响作用较大,年龄对个体间L值的影响作用很小.参照对应侧下颌骨长轴,S1到S4,IANC的走行为先向下,然后转向上再逐渐向上;在水平方向上的走行为先向舌侧而后转向颊侧.这一结果可为临床提供自颏孔起至下颌第2磨牙根尖区IANC相关解剖的参考数据.

abstractsObjectives To investigate the specific site for measuring inferior alveolar nerve canal (IANC) by cone beam computed tomography (CBCT),and to provide reference data of the course of the IANC of the crowd.Methods This study was a retrospective data analysis.One hundred and thirty CBCT cases were measured and compared after classification by gender and age (65 men and 65 women,65 middle age and 65 youth).Since the proximal center of the mental foramen area,the cross-section at which the mental hole just completely breaks the buccal cortical bone was defined as S1,and S2,S3,S4 were defined as cross-sections with 1-cm apart from each other since S1.L1,L2,L3,and L4 were measured as the distance from specific sites on the outer wall of the IANC to the alveolar crest,the outer wall of lingual lateral cortical bone,the mandibular minimum margin,and the outer wall of buccal cortical bone.The results were analyzed using independent samples t test,with P＜0.05 being considered statistically significant.Results On the right IANC S2L1,S3L1,S4L1,S2L2,S3L2,S4L2,S1L3,S3L4,the 8 groups of L values measured on these 8 sites,all showed differences between genders (P＜0.05).So did the 10 groups of L values measured on the left IANC S1L1,S2L1,S3L1,S4L1,S1L2,S3L2,S4L2,S2L3,S3L3,S4L4 (P＜0.05).The middle age group and the youth group were statistically different for the data measured on the right IANC S2L4 (P＜0.05).This was the same case for the data measured on the left IANC S1L3.When classified according to gender,L1 in the S1 to S4 sections firstly increased and then decreased,and eventually decreased.The change pattern of L3 was opposite to that of L1.L2 in the S1 to S4 sections firstly decreased and then decreased,and eventually increased.The change pattern of L4 was opposite to that of L2.When the samples were classified according to age,the change pattern L value in the S1 to S4 sections was the same as that under gender classification.Conclusions The effect of gender on the L value of individuals is relatively great,while the effect of age on the L value of individuals value is very small.Setting the corresponding long axis of mandible as a reference,the change pattern of IANC in the mandible can be deduced based on the change of L value from S 1 to S4:from S1 to S4,the course of IANC on the vertical direction is firstly downward,tben turns to upward and goes upward;from S1 to S4,the trend of IANC on the horizontal direction is firstly toward the side of tongue,and eventually turns towards the buccal side.The current study provides reference data for IANC-related anatomy from the mandibular foramen to the mandibular second molars.