THE STUDY ON COURSE OF THE INFERIOR ALVEOLAR CANAL IN THE MANDIBULAR RAMUS USING CONEBEAM CT

하악지에서의 하치조신경관 주행에 대한 Conebeam CT를 이용한 연구

  • Kim, Hyong-Woo (Department of Oral and Maxillofacial surgery, College of Dentistry, Wonkwang University) ;
  • Kwon, Kyung-Hwan (Department of Oral and Maxillofacial surgery, College of Dentistry, Wonkwang University) ;
  • Min, Seung-Ki (Department of Oral and Maxillofacial surgery, College of Dentistry, Wonkwang University) ;
  • Oh, Seung-Hwan (Department of Oral and Maxillofacial surgery, College of Dentistry, Wonkwang University) ;
  • Chee, Young-Deok (Department of Oral and Maxillofacial surgery, College of Dentistry, Wonkwang University) ;
  • Koh, Se-Wook (Department of Oral and Maxillofacial surgery, College of Dentistry, Wonkwang University) ;
  • Lee, Jae-Hwan (Department of Oral and Maxillofacial surgery, College of Dentistry, Wonkwang University) ;
  • Ohn, Byung-Hun (Department of Oral and Maxillofacial surgery, College of Dentistry, Wonkwang University)
  • 김형우 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 권경환 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 민승기 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 오승환 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 지영덕 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 고세욱 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 이재환 (원광대학교 치과대학 구강악안면외과학교실) ;
  • 온병훈 (원광대학교 치과대학 구강악안면외과학교실)
  • Published : 2009.09.30

Abstract

Objectives: This study was performed to evaluate course of the inferior alveolar canal in the mandibular ramus and to find safety zone when ramal bone is harvested. Patients and Methods: From January, 2009 to February, 2009, the 20 patients who visited in the Department of Oral and Maxillofacial Surgery, Sanbon Dental Hospital. Wonkwang University and the Conebeam CT was taken of various chief complaints, were selected. The patients who had left and right mandibular first molar and incisor missing, jaw fracture and bone pathology were excluded. The R point was defined as the point which occlusal plane was crossed to the mandibular anterior ramus(external oblique ridge). In the cross-sectional coronal and axial views, the inferior alveolar canal position to the R point, buccal bone width(BW), alveolar crest distance(ACD), distance from alveolar crest to occlusal plane(COD) and inferior alveolar canal to sagittal plane(CS) were measured and horizontal distance(HD), vertical distance(VD) and nearest distance(ND) were measured. Results: The inferior alveolar canal is located $6.19{\pm}1.21\;mm$ from the R point. Horizontal distance from the R point were $13.07{\pm}2.45\;mm$, vertical distance from the R point were $14.24{\pm}2.41\;mm$ and nearest distance from the R point were $10.12{\pm}1.76\;mm$. The course of the inferior alveolar canal was positioned within $0.61{\pm}0.68\;mm$. The distance from external buccal bone to the inferior alveolar canal was increased from the R point anteriorly. Conclusions: It is considered that the mandibular ramus from the R point to 10 mm anteriorly can be harvested safely at ramal bone grafting.

Keywords

References

  1. Misch CE, Dietsh F : Bone-grafting materials in implant dentistry. Implant Dent 2 : 158, 1993 https://doi.org/10.1097/00008505-199309000-00003
  2. Koole R, Bosker H, van der Dussen FN : Late secondary autogenous bone grafting in cleft patients comparing mandibular (ectomesenchymal) and iliac crest (mesenchymal) grafts. J Craniomaxillofac Surg 1 : 28, 1989 https://doi.org/10.1016/S1010-5182(89)80036-8
  3. Misch CM : Ridge augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique. Pract Periodontics Aesthet Dent 8 : 127, 1996
  4. Garg AK : Lateral proximal tibia bone harvest for use in augmentation procedures. Dent Implantol Update 12 : 33, 2001
  5. Misch CM : Comparision of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants 12 : 767, 1997
  6. Nkenke E : Morbidity of harvesting of retromolar bone grafts: a prospective study. Clin Oral Impl Res 13 : 514, 2002 https://doi.org/10.1034/j.1600-0501.2002.130511.x
  7. Honig JF : The coronoid process as a new donor source for autogenous bone grafts for reconstructing orbital and midface defects. Bull Group Int Rech Sci Stomatol Odontol 39 : 49, 1996
  8. Von Arx, T. & Kurt B : Endoral donor bone removal for autografts. A comparative clinical study of donor sites in the chin area and the retromolar region. Schweizer Monatsschrift Zahnmedizin 108 : 446, 1998
  9. Bataineh AB : Sensory nerve impairment following mandibular third molar surgery. J Oral Maxillofac Surg 59 : 1012, 2001 https://doi.org/10.1053/joms.2001.25827
  10. Westermark A, Bystedt H, von Konow L : Inferior alveolar nerve function after mandibular osteotomies. Br J Oral Maxillofac Surg 36 : 425, 1998 https://doi.org/10.1016/S0266-4356(98)90457-0
  11. Silva FM, Cortez AL, Moreira Rw et al : Complications of intraoral donor site for bone grafting prior to implant placement. Implant Dent 15 : 420, 2006 https://doi.org/10.1097/01.id.0000246225.51298.67
  12. Gowgiel JM : The position and course of the mandibular canal. J Oral Implantol 18 : 385, 1992
  13. Li N, Zhao B, Tan C : Intramandibular course and anatomic structure of the inferior alveolar nerve canal. Zhonghua Kou Qiang Yi Xue Za Zhi 36 : 446, 2001
  14. Kambur$\check{o}$glu K, Kilic C, Ozen T et al : Measurements of mandibular canal region obtained by cone-beam computed tomography: a cadaveric study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107 : 34, 2009 https://doi.org/10.1016/j.tripleo.2008.10.012
  15. Levine MH, Goddard AL, Dodson TB : Inferior Alveolar Nerve Canal Position: A Clinical and Radiographic Study. J Oral Maxillofac Surg 65 : 470, 2007 https://doi.org/10.1016/j.joms.2006.05.056
  16. Nakamori K : Clinical Assessment of the Relationship Between the Third Molar and the Inferior Alveolar Canal Using Panoramic Images and Computed Tomography. J Oral Maxillofac Surg 66 : 2308, 2008 https://doi.org/10.1016/j.joms.2008.06.042
  17. Yamamoto R, Nakamura A, Ohno K et al : Relationship of the Mandibular Canal to the Lateral Cortex of the Mandibular Ramus as a Factor in the Development of Neurosensory Disturbance After Bilateral Sagittal Split Osteotomy. J Oral Maxillofac Surg 60 : 490, 2002 https://doi.org/10.1053/joms.2002.31843
  18. Lo LJ, Wong FH, Chen YR : The Position of the Inferior Alveolar Nerve at the Mandibular Angle: An Anatomic Consideration for Aesthetic Mandibular Angle Reduction. Ann Plast Surg 53 : 50, 2004 https://doi.org/10.1097/01.sap.0000112282.94585.44
  19. Ha SY : A computerized tomographic study on the location of the mandibular canal and the cortical thickness of the mandible. J Korean Academey of Dental Radiology 27 : 217, 1997
  20. Reich RH : Anatomical studies on the course of the mandibular canal. Deutsche Zahn$\ddot{a}$rztliche Zeitschrift 35 : 972, 1980
  21. Smith BR, Rajchel JL, Waite DE et al : Mandibular anatomy as it relates to rigid fixation of the sagittal ramus split osteotomy. J Oral Maxillofac Surg 49 : 222, 1991 https://doi.org/10.1016/0278-2391(91)90209-5
  22. Levelle : Preliminary study of mandibular shape after tooth loss. J Prosthet Dent 53 : 726, 1985 https://doi.org/10.1016/0022-3913(85)90033-2
  23. Vercellotti T : Piezoelectric surgery in implantology: A case report-A new piezoelectric ridge expansion technique. Int, J Periodontics Restorative Dent 20 ; 358, 2000
  24. Schlee M, Steigmann M, Bratu E et al : Piezosurgery: Basics and Possibilities. Implant Dent 15 : 334, 2006 https://doi.org/10.1097/01.id.0000247859.86693.ef