Вариабельность отверстий на верхних и нижней челюстях в зависимости от формы черепа

Abstract

Наявність додаткових (подвійних) отворів на верхніх та нижній щелепах впливає на якість місцевої анестезії. Варіабельність кількості, форми та локалізації додаткових отворів, які виявлені нами у 3-х формах черепа, склала 50% від загального числа та не мала прямої залежності від антропометричних показників черепа. Однак, варіативність їх кількості та локалізації домінує у брахіцефалічної формі черепа. Подвоєні отвори у 3-х формах черепа на верхніх щелепах зустрічаються частіше (60% випадків), ніж на нижній (40% випадків). Їх наявність впливає на топографію судинно-нервового пучка, розширює зони і нервації кісток та м’яких тканин; Наличие дополнительных (удвоенных) отверстий на верхних и нижней челюстях влияет на качество местной анестезии. Вариабельность количества, формы и локализации удвоенных отверстий, выявленные нами в 3-х формах черепа, составила 50% от общего числа и не имела прямой зависимости от антропометрических показателей черепа. Однако вариативность их количества и локализации доминирует в брахицефалической форме черепа. Удвоенные отверстия в 3-х формах черепа на верхних челюстях встречаются чаще (60% случаев), чем на нижней челюсти (40% случаев). Их наличие влияет на топографию сосудисто-нервного пучка, расширяет зоны иннервации кости и мягких тканей; The dentist is often guided by the typical structure of the skull bones, sometimes forgets about the existence of their individual topographic and anatomical features of the structure. Exactly the presence of additional (double) holes on the skull of the patient may complicate the technique of local anesthesia. The purpose of work – to study the variability of the holes on the upper and mandible lower jaws, depending on the shape of the skull. Materials and methods of research. The work is done on the 30 skulls (20 male and 10 female) of people aged 30-60 years from the cranial collection of human anatomy department and operative surgery department with topographic anatomy of the Higher State Educational Establishment of Ukraine “Ukrainian Medical Stomatological Academy”. They measured the transverse and anteroposterior sizes of the skull with the help of calipers for the cranial index calculating with the help of the formula of cross-correlation of the diameter (width) in the anteroposterior (length) multiplied by a factor 100. Results of the research and its discussion. Our research has shown that on 30 skulls the number of doubled holes in the 3 forms of the skull was 50% of the total. The number of doubled holes in 3 forms of skull in the upper jaws was found by us more frequently (in 60% of cases) than in the mandible lower jaw (40% of cases). We found that the doubled holes encountered in dolichocephalic form of the skull in 3.33% of cases, in brachycephalic shape of skull – in 36.66% of cases and in mesaticephalic shape of skull – in 10.0% of cases. On the 5 dolichocephalic form of the skull (cranial index averaged 72.9) they observed only in the first case bilateral tripling of infraorbital foramen. On the 15 skulls of brachycephalic form (cranial index corresponds to the average of 83.8), we have identified: the unilateral doubling of infraorbital hole (in 4 cases), bilateral (in 2 cases), and intracanal doubling of this hole in the first case. Intracanal doubling of incisive hole was observed in 2 cases, tripling in the first case. There was also two cases of unilateral doubling and tripling of mental foramen. Doubling bilateral of mandibular hole was found in the first case. On the 10 mesaticephalic shape of skull (cranial index was 77.9) they observed the doubling of the infraorbital foramen on the right upper jaw only in the first case. Thus, in the first case they revealed unilateral doubling of mental foramen with the right side of the mandible and in 2 cases unilateral doubling of mandible lower jaw. Conclusions. We have identified that this variability of the holes (50% of the total) on the upper and mandible lower jaws is independent of anthropometric indices, but the variety of their localization and quantity dominates in the brachycephalic form, which significantly influences on the topography of neurovascular bundle extending innervation of zone of boundary of bone and surrounding soft tissues. The number of doubled holes in 3 forms of skull in the upper jaws was found by us more frequently (in 60% of cases) than in the mandible lower jaw (40% of cases). Additional (doubled) holes are located above the ground and a little bit away (more lateral or more medial). They are generally of circular shape and smaller in size compared with the main hole. This fact must be considered during performing of local anesthetic in dentistry.