Intramandibular course of the mandibular nerve; clinical significance for distraction and implantology

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• 作者：N. Lautner^a ; ^{nora.lautner@pmu.ac.at} ; M. McCoy^b ; ^c ; ^{ma.mccoy@salk.at} ; A. Gaggl^c ; ^{a.gaggl@salk.at} ; C. Krenkel^c ; ¹ ; ^{christian.krenkel@endodistractor.at}
• 关键词：Distraction osteogenesis ; Dental implants
• 刊名：Revue de Stomatologie et de Chirurgie Maxillo-faciale
• 出版年：2012
• 期刊代码：pca338_00351768
• 类别：med
• 出版时间：June, 2012
• 卷：113
• 期：3
• 页码：161-168
• 文件大小：669 K

摘要

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Summary

Objective

Loss of teeth is accompanied with loss of function and therefore reduction of alveolar bone height. Insufficient bone height can jeopardize the anchorage of implants or surgical procedures such as distraction osteogenesis, because of possible mandibular nerve damage. The goal of this investigation was to determine the exact course of the intramandibular nerve in edentulous mandibles.

Material and method

The study samples included 37 dry human edentulous mandibles. A dental CT scan analysis was performed and four cross sectional views were investigated for each mandible. The Cawood classification was used to assess the grade of atrophy. Implantation simulation was performed in every case.

Results

There was no bilateral symmetry in edentulous mandibles, whatever the cross-section studied. A rate of 38.7%were classified Cawood class IV, the most common group in edentulous patients. Our study results led us to place the distraction osteogenesis device in the posterior edentulous mandible. Implant placement was not possible in every case.

Discussion

Our findings allow better understanding from the pathway of the mandibular canal close to the first and second molar in edentulous mandibles. This anatomical data and surgical techniques such as implant insertion and distraction osteogenesis allow finding solutions for 鈥渕andibular edentulism鈥? Distraction is essential for a successful implantology.