Cone beam computed tomography analysis of accessory canals of the canalis sinuosus: A prevalent but often overlooked anatomical variation in the anterior maxilla
Cone beam computed tomography analysis of accessory canals of the canalis sinuosus: A prevalent but often overlooked anatomical variation in the anterior maxilla
复制标题
窦管副管的锥形束计算机断层扫描分析：上颌前牙中常见但经常被忽视的解剖变异
DOI：
10.1016/j.prosdent.2020.05.028
复制
发表时间：
2021-10-02
影响因子：
4.6
通讯作者：
Gu, Lisha
中科院分区：
文献类型：
--
作者：
Shan, Tiantian;Qu, Yang;Gu, Lisha
问题陈述。鼻窦副管是一种承载前上牙槽神经和血管的骨性管道，在上颌前牙常可见但被忽视。如果不仔细识别这种解剖变异，在该区域种植牙可能会损害神经血管分支，导致意外的并发症。本研究的目的是明确中国人鼻窦管的副神经管，并分析其与鼻窦终末和上颌前骨的关系，为上颌前牙外科手术提供警示。对1007名中国患者进行了锥束计算机体层摄影(CBCT)扫描，以确定直径至少1.0 mm的副根管的患病率和大小。根据鼻腔和邻近牙齿对该管的轴向位置进行分类。其矢状位置由窦管分叉处至颊牙槽顶的距离和管口至腭槽顶的距离决定。在所有扫描上测量鼻窦末端的直径、末端鼻窦到颊牙槽顶的距离和上颌前牙的体积。采用二元Logistic回归和Spearman等级相关系数进行患病率和直径分析。副牙管发生率为36.9%，与上颌前体积呈正相关(OR 1.408)，与鼻窦末端至颊牙槽突间的距离呈负相关(OR 0.921)。平均管径为1.1±-0.1 mm，男性明显高于男性，且与鼻窦末端直径呈正相关(r(S)=0.163)，与管口至腭槽突间的距离呈正相关(r(S)=0.192)。所有副牙管起始于颊皮质骨下方，距颊牙槽突缘19.3+/-2.7 mm。61.9%的副根管开放于中切牙与侧切牙之间。与侧切牙和尖牙之间的开孔相比，这里和中切牙区的开孔更接近牙槽骨(P
Statement of problem. Accessory canals of the canalis sinuosus, a bony canal carrying the anterior superior alveolar nerve and vessels, can often be present but overlooked in the anterior maxilla. Dental implant placement in this area may damage neurovascular branches if this anatomic variation is not carefully identified, resulting in unexpected complications.Purpose. The purpose of this retrospective study was to identify accessory canals of the canalis sinuosus and analyze their relationship to the terminal canalis sinuosus and anterior maxilla in Chinese patients to provide a warning for surgeons operating in the anterior maxilla.Material and methods. Cone beam computed tomography (CBCT) scans of 1007 Chinese patients were examined to identify the prevalence and size of accessory canals with at least 1.0-mm diameter. Axial position of this canal was classified referring to the nasal cavity and adjacent teeth. Its sagittal position was determined by the distance from the bifurcation site of canalis sinuosus to the buccal alveolar crest and the distance from the canal opening to the palatal alveolar crest. Diameter of the terminal canalis sinuosus, distance from the terminal canalis sinuosus to the buccal alveolar crest, and anterior maxillary volume were measured on all scans. Binary logistic regression and the Spearman rank correlation coefficient were used for prevalence and diameter analysis.Results. The prevalence of the accessory canal was 36.9%, positively correlated the anterior maxillary volume (OR 1.408) and negatively correlated with the distance from the terminal canalis sinuosus to the buccal alveolar crest (OR 0.921). Average diameter of such canal was 1.1 +/- 0.1 mm, significantly higher in men, positively correlated with the diameter of terminal canalis sinuosus (r(s) =0.163) and the distance from the canal opening to the palatal alveolar crest (r(s) =0.192). All accessory canals started below the buccal cortical bone, 19.3 +/- 2.7 mm away from the buccal alveolar crest. There were 61.9% accessory canals opened between the central and the lateral incisors. Openings here and in the central incisor region were closer to the alveolar crest than that between the lateral incisor and and the canine (P