Траектория канала нижней челюсти по данным конусно-лучевой компьютерной томографии

Abstract

За допомогою конусно-променевої комп’ютерної томографії вивчена топографія каналу нижньої щелепи щодо верхівок коренів нижніх молярів і другого премоляра. Використання цих даних при плануванні ендодонтичного лікування, операції видалення зубів, дентальної імплантації, мандибулярної анестезії дозволить знизити ризик ятрогенного пошкодження нижнього альвеолярного нерва, розташованого в каналі.

С помощью конусно-лучевой компьютерной томографии изучена топография канала нижней челюсти относительно верхушек корней нижних моляров и второго премоляра. Использование этих данных при планировании эндодонтического лечения, операции удаления зубов, дентальной имплантации и мандибулярной анестезии позволит снизить риск ятрогенного повреждения нижнего альвеолярного нерва, расположенного в канале.

Objective. The aim of this study was to establish the topography of the mandibular canal in relation to the root apices of the lower molars and the second premolar. Object and methods: 102 cone beam computed tomography scans were analyzed to classify the types of the vertical course of the mandibular canal. Sagittal, panoramic and formatted transverse tomograms were assessed using GALILEOS Viewer (Sirona, Bensheim, Germany). One thousand two hundred ninety nine roots were identified. The shortest distance from the upper border of the mandibular canal to the tooth root apices was measured by imaging software. The software package «Statistica 10.0» was used for the statistical analysis of the obtained data. The chi-Square test with Yates’s correction and Fisher’s exact test were used to compare observed groups. Results were considered statistically significant when the probability of faultless prognosis was calculated at 95.5% (p<0.05). Results. The vertical course of MC was classified into 3 types: straight projection (23%), catenary-like configuration (37%), and the most frequent variant – progressive descent from posterior to anterior (40%). In half of the patients, the apex of 50% of the roots of the third molars and 32.8% of the roots of the second molars were located less than 2 mm from the upper border of the mandibular canal. In present study, there were 23,4% of the roots of the teeth located at a distance less than 1 mm from the upper border of the mandibular canal. Conclusions. The use of the obtained data in the planning of endodontic treatment, extraction of teeth, dental implantation, mandibular anesthesia can reduce the risk of iatrogenic injury of the inferior alveolar nerve located in the canal.