مجله دانشکده دندان‌پزشکی اصفهان

ویژگی‌های رادیولوسنسی مجاور اپیکال به عنوان عامل خطر آسیب به عصب آلوئولار تحتانی

نوع مقاله : مقاله‌های پژوهشی

چکیده

مقدمه: رادیولوسنسی اپیکال مجاور JAR (Juxta-apical radiolucency)، به عنوان یک عامل خطر جدید آسیب به عصب آلوئولار تحتانی؛ بعد از خارج کردن مولر سوم مطرح است. هدف از مطالعه‌ی حاضر، بررسی ارتباط JAR با عصب (Inferior alveolar nerve canal) IAN، صفحه‌ی کورتیکال، موقعیت آن نسبت به IAN و زاویه‌ی دندان بود.
مواد و روش‌ها: در مطالعه‌ی مورد- شاهدی حاضر، از تعداد 545 نمونه‌ی سی‌تی با دسته‌ی اشعه‌ی مخروطی CBCT (Cone-beam computed tomography) از دندان مولر سوم فک پایین، 75 مورد JAR و 75 مورد شاهد بررسی گردید. رابطه‌ی JAR با عصب آلوئولار تحتانی، موقعیت JAR نسبت به IAN، نازک‌شدگی صفحه‌ی کورتیکال لینگوال، موقعیت دندان و زاویه‌ی آن مورد بررسی قرار گرفت. تجزیه و تحلیل توصیفی به کمک آزمون‌های Fisher's exact test و Chi-square در سطح معنی‌داری (0/05 = p value) تجزیه و تحلیل گردید.
یافته‌ها: مزیوآنگولار، شایع‌ترین موقعیت دندانی در هر دو گروه بود. از نظر زاویه‌ی دندان، تفاوت معنی‌داری میان دو گروه مشاهده نشد (0/346 =p value). هیچ‌گونه اختلاف معنی‌داری میان دو گروه بر اساس JAR و مجاورت دندان با IAN مشاهده نشد (0/578 = p value). اگرچه شایع‌ترین موقعیت در گروه JAR لینگوال و در گروه شاهد فوقانی بود، اما تفاوت معنی‌داری میان آن‌ها مشاهده نشد (0/122 =p value ). اغلب نمونه‌ها در هر دو گروه JAR (84 درصد) و شاهد (77/3 درصد) دچار درجاتی از نازک‌شدگی کورتیکال لینگوال بودند. بر این اساس، تفاوت معنی‌داری میان دو گروه JAR و شاهد مشاهده نشد (0/626 =p value ).
نتیجه‌گیری: در بیشتر موارد JAR با IAN در تماس است و درجاتی از نازک‌شدگی کورتیکال نیز دیده می‌شود. این یافته‌ها بیانگر احتمال افزایش خطر آسیب عصبی هنگام بیرون‌ کشیدن دندان‌های آسیای سوم می‌باشد.
کلید واژه‌ها: عصب مندیبولار، مولار سوم، توموگرافی کامپیوتری با دسته‌‌ی اشعه‌ی مخروطی.

عنوان مقاله [English]

Characteristics of Juxta-apical Radiolucency as Risk Factor of Inferior Alveolar Injury

چکیده [English]

Introduction: Juxta-apical radiolucency (JAR) is introduced as a new risk factor for inferior alveolar nerve (IAN) injury; following the removal of the third molar. Thus, the aim of the present study was to examine the relationship of JAR to IAN, cortical plates, and its position with regards to IAN and tooth angulation.
Materials and Methods: The present case-control study comprising a sample of 545 Cone Beamed CT scans of mandibular third molars examined 75 JAR cases and 75 control teeth. The relationship of JAR to IAN, its position with regards to IAN, lingual cortical plate thinning, teeth position and angulation were investigated. Descriptive analyses, chi-square and fisher exact tests were performed with a value of 0.05 considered significant.
Results: Mesioangular teeth were the most common in both groups. Based on tooth angulation, no significant difference was detected between case and control groups (p value = 0.346). There was no significant difference between the two groups, with regards to JAR and tooth proximity to IAN (p value = 0.578). Although, the most prevalent position in the JAR group was lingual and superior in the control group, but no significant difference was observed between them (p value = 0.122). Most cases of JAR (84.0%) and most cases of control group (77.3%) showed some degree of cortical thinning. Based on this, no significant difference was present between the JAR and control groups (p value = 0.626).
Conclusion: JAR is generally in contact with mandibular canal and some degree of cortical thinning manifest in most of these cases. These findings suggest a possible increase in the risk of nerve injury during surgical removal of third molars.
Keywords: Mandibular nerve, Third molar, Cone-beam computed tomography.

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مجله دانشکده دندان‌پزشکی اصفهان
دوره 17، شماره 4 - شماره پیاپی 4
دی 1399
صفحه 343-350