下顎智歯と下顎管の関係-CTによる術前評価-

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The mandibular canal is often closely related to the lower third molars. During the surgical removal of the third molar, the inferior alveolar nerve in the canal is sometimes damaged leading to impaired sensation in the lower lip. This is one of the most unpleasant postoperative complications.<BR>The buccolingual relationship between the lower third molar and the mandibular canal cannot be diagnosed by orthopantomography although preoperative evaluation must be carried out radiologically. In present study, the relationship was determined by using CT scan.<BR>Forty-seven lower third molars of 35 patients were evaluated preoperatively by CT scan. The mandibular canal of all cases overlapped with the third molar on orthopantomography. CT scan was taken in two ways. The first was the Tragion-Menton plane which was nearly parallel to the canal at the apex of the third molar. The second was the plane of the axis of the third molar. Axial CT scan was taken when the third molar erupted hoiizontally, and coronal CT scan was done when the molar erupted vertically.<BR>CT scan examination exactly revealed the position of the mandibular canal in relation to the root of the third molar. The canal was located bucccally to the roots in 55 percent of cases, apicobuccally in 6 percent, apically in 23 percent, apicolingually in 6 percent, lingually in 2 percent, and between roots in 6 percent. The results of the present study were consistent with previous reports.<BR>In 12 cases, the inferior alveolar neurovascular bundle was visible during operation. It was visible in only 2 of 22 cases when the canal was located buccally. It was visible, on the other hand, in all cases in which the canal was located apicolingually, lingually, and between roots. It also tended to be visible when the canal overlapped more strongly with the third molar on preoperative orthopantomography.
社団法人日本口腔外科学会の論文

下顎智歯と下顎管の関係-CTによる術前評価-

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