背景:这项体内研究旨在阐明舌下动脉(SLA)相对于下颌骨的位置,并推断在种植牙手术过程中受伤的潜在风险。
方法:回顾了在德岛大学医院接受治疗的50例无牙患者(100侧)的口腔的对比增强计算机断层扫描图像。对垂直于牙槽脊的弯曲平面重建图像进行处理,并将其分类为磨牙,前磨牙,犬,和门牙区域。确定了SLA及其分支机构,测量下颌骨到SLA的距离。
结果:SLA位于磨牙中的下颌骨附近(<2mm),前磨牙,犬,和门牙段在12.0%(95%置信区间5.6%-18.4%),20.6%(12.6%-28.7%),30.5%(21.3%-39.8%),和41.8%(28.8%-54.9%)的病例,分别。在50%的病例中,SLA位于磨牙和前磨牙区域的颅尾至下颌管上壁±3mm范围内,在其他病例中,在犬科和门牙区域的颅尾至肌舌骨脊±5mm范围内,没有性别或年龄差异。由于肺泡吸收,从牙槽到SLA的垂直距离受性别和年龄的影响,表明牙槽脊不是预测SLA位置的可靠参考。
结论:由于在种植牙期间一直存在SLA损伤的风险,并且无法确认患者的SLA途径,临床医生必须避免损伤舌下软组织。
BACKGROUND: This in vivo study aimed to clarify the position of the sublingual artery (SLA) relative to the mandibular bone and to infer the potential risk for injury during dental implant surgery.
METHODS: Contrast-enhanced computed tomography images of the mouth of 50 edentulous patients (100 sides) treated at Tokushima University Hospital were reviewed. Curved planar reconstructed images perpendicular to the alveolar ridge were processed and classified into molar, premolar, canine, and incisor regions. The SLA and its branches were identified, and the distance from the mandible to the SLA was measured.
RESULTS: The SLA was located close to the mandible (<2 mm) in the molar, premolar, canine, and incisor segments in 12.0% (95% confidence interval 5.6%-18.4%), 20.6% (12.6%-28.7%), 30.5% (21.3%-39.8%), and 41.8% (28.8%-54.9%) cases, respectively. The SLA was located within ±3 mm craniocaudally to the upper wall of the mandibular canal in the molar and premolar regions in 50% of cases and within ±5 mm craniocaudally to the mylohyoid ridge in the canine and incisor regions in the other cases, with no sex or age-related differences. The vertical distance from the alveolar ridge to the SLA was influenced by sex and age owing to alveolar resorption, indicating that the alveolar ridge is not a reliable reference for predicting SLA position.
CONCLUSIONS: As the risk of SLA injury always exist during dental implant placement and there is no way to confirm the SLA pathways in a patient, clinicians must avoid injuring the sublingual soft tissue.