Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Alt Çene Ön Bölge Nörovasküler Yapılarının Cerrahi Perspektifle Değerlendirilmesi: Bir Retrospektif Çalışma
Evaluation with Surgical Perspective of Neurovascular Structures in Anterior Mandible: A Retrospective Study
Anıl ÖZYURTa,c, Ersen BİLGİLİb,c
aDokuz Eylül Üniversitesi Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Cerrahisi ABD, İzmir, Türkiye
bİzmir Eğitim Diş Hastanesi, Ağız, Diş ve Çene Radyolojisi Kliniği, İzmir, Türkiye
cTrakya Üniversitesi Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Cerrahisi ABD, Edirne, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(3):496-501
doi: 10.5336/dentalsci.2021-86629
Article Language: TR
Full Text
ÖZET
 Amaç: Vasküler ve nöral yapıların zarar görmemesi için ağız cerrahisi operasyonlarından önce detaylı radyolojik değerlendirme yapmak esastır. Bu çalışmanın amacı, kadın ve erkek hastaların mental foramen ile sublingual kanal yapılarına ait mesafelerini radyolojik ölçümlerle inceleyerek, alt çene ön bölgenin güvenli kemik sahalarını cerrahi perspektifte değerlendirmektir. Gereç ve Yöntemler: Alt çene ön bölgesine implant cerrahisi planlanmış 106 hastaya ait konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleri bir radyolog ve çene cerrahı tarafından incelendi. Radyografi görüntülerinde mental foramenler ile sublingual arterlerin mesafeleri, sublingual arterin alveol kemik içerisindeki derinliği ve sublingual arterin çene ucuna olan dikey mesafeleri ölçüldü. Ölçüm değerleri bağımsız t-testi ile %95 güven aralığında istatistiksel olarak değerlendirildi. Bulgular: Aynı tarafa ait mental foramen ile lateral sublingual arter mesafesi ortalama olarak kadınlarda 20,479 mm (±1,452 mm), erkeklerde 21,030 mm (±1,5920 mm) olarak bulunsa da cinsiyet kıyaslamasında anlamlı farklılık göstermedi (p=0,066). İnferior sublingual kanalın alt çene bazisine olan mesafesi ile superior sublingual kanalın iz düşümsel mesafesi erkeklerde kadınlara kıyasla anlamlı olarak daha fazla (p<0,05) idi. Sonuç: Çalışmamızın sonuçlarına göre sublingual arter dalları referans alındığında, mental foramenin önünde poligonal olarak en fazla 17,5 mm'ye kadar ve alt çene bazisinin üzerinde vertikal olarak en fazla 5,1 mm'ye kadar güvenli kemik sahalarının olduğu görülmüştür. Güvenli kemik sahalarının her birey için farklılık göstereceği ve bahsi geçen yapıların mutlaka KIBT görüntüleriyle değerlendirilmesi gerektiği unutulmamalıdır.

Anahtar Kelimeler: Anatomi; konik ışınlı bilgisayarlı tomografi; oral cerrahi; radyografi
ABSTRACT
 Objective: Radiological evaluation before oral surgery operations is essential in order not to damage the vascular and neural structures. The aim of this study was to evaluate mental foramen and sublingual artery with radiographs for determining the safe surgical zone of the anterior mandible among female and male patients. Material and Methods: Cone-beam computed tomography (CBCT) images of 106 patients, who had planned implant surgery for the anterior mandible, were analyzed by a radiologist and a maxillofacial surgeon. The distance between the mental foramen and sublingual arteries, the depth of sublingual artery in alveolar bone, and vertical distance between sublingual artery and basis mandible were measured on the radiographs. Measurement values were statistically evaluated with the independent t-test at a 95% confidence interval. Results: Although the mean distance between the mental foramen and the lateral sublingual artery was 20.479 mm (±1.452 mm) in female patients and 21.030 mm (±1.5920 mm) in male patients, there was no significant difference in gender comparison (p=0.066). The distance of the inferior sublingual canal to the basis mandible and the projective distance of the superior sublingual canal was significantly higher in males than in females (p<0.05). Conclusion: According to the study, when the sublingual artery branches were taken as the ending reference point, there were safe bone areas up to at most 17.5 mm polygonally in front of the mental foramen and up to at most 5.1 mm vertically above the basis mandibula. The safe surgical zones may differ for each individual therefore the neurovascular structures must be evaluated via CBCT images.

Keywords: Anatomy; cone-beam computed tomography; oral surgery; radiography
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