한국인에서 턱뼈구멍과 턱뼈혀돌기의 형태계측적 연구
A Morphometric Study on the Mandibular Foramen and the Lingula in Korean
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초록
아래턱수술의 기술이 발전하면서 시술시 아래이틀신경과 혈관다발의 손상으로 나타나는 합병증을 줄이고 아래이틀신경전달마취의 효율성을 높이기 위해 턱뼈구멍과 턱뼈혀돌기의 위치와 구조에 관한 연구의 필요성이 증가되고 있다. 한국인 시신 104구(남자 65구, 여자 39구)의 아래턱뼈 208쪽을 대상으로 앞모서리패임, 교합면, 턱뼈패임, 턱뼈각점, 근육돌기점 그리고 관절돌기점을 기준으로 턱뼈구멍과 턱뼈혀돌기의 위치를 계측하였고, 턱뼈구멍의 직경, 턱뼈혀돌기의 높이와 방향을 계측하여 그 구조를 확인하였다. 또한 턱뼈가지의 두께와 턱뼈각을 계측하여다음과 같은 결과를 얻었다. 앞모서리패임에서 턱뼈가지 뒤모서리와 만나는 선의 위치는 턱뼈혀돌기와 일치하는 경우가 42.2%, 턱뼈구멍과 턱뼈혀돌기 꼭대기 사이에 위치하는 경우가 33.8%로 나타났다. 교합면 연장선은 턱뼈구멍과 턱뼈혀돌기 사이에 위치하는 경우가 47.7%이었고, 턱뼈혀돌기와 일치하는 경우가 35.6%이었다. 턱뼈패임에서 뒤모서리와 평행하게 그은 선이 턱뼈혀돌기와 일치하는 경우가 55.8%로 가장 많았다. 턱뼈구멍은 턱뼈가지 앞뒤너비의 중간보다 뒤쪽에 위치하였다. 앞모서리패임을 기준으로 턱뼈가지 앞뒤너비에서는 57.3% 지점에 위치하였고, 교합면이 기준인 경우는 56.5% 지점에 위치하였다. 턱뼈구멍은 턱뼈패임을 기준으로 턱뼈가지 전체 높이에서 48.0%지점으로 중간보다 약간 위쪽에 위치하였고, 턱뼈혀돌기는 35.7% 지점에 위치하였다. 턱뼈구멍은 턱뼈각점과 근육돌기점을 잇는 선의 40% 지점에 위치하였다. 이러한 결과들은 아래턱 대상의 수술시 유발되는 합병증을 감소시키고 새로운 시술법을 개발하는데 중요한자료가 될 것이라 생각된다.
Abstract
Interest in the correction of jaw deformities has increased due to the development of techniques and instruments of jaw operation. The accurate position of the mandibular foramen and lingula is important for the prevention of the complications and successful inferior alveolar nerve block. This study was conducted on 104dried mandibles (65 males, 39 females) from Korean cadaver. The positions of the mandibular foramen and lingula were measured on the coronoid notch, occlusal plane, mandibular notch, gonion, koronoid and kondylion. The structures of the mandibular foramen and lingula were determined and the thickness of ramus and the angle of mandible were measured. Independent t-tests and paired t-tests were performed to determine the statistically significant difference. The results as follows;The line between coronoid notch and posterior border of ramus was located on the same level with the tip of lingula in 42.2% of the cases, and in between the mandibular foramen and the tip of lingula in 33.8% of the cases. The occlusal plane was located on the level between the mandibular foramen and the tip of lingula in 47.7% of cases, and on the same level with the tip of lingula in 35.6% of the cases. The line between lower end of the mandibular notch to inferior border of the mandible, in parallel to the posterior border of the mandibles, met the tip of lingula in 55.8% of the cases. The mandibular foramen was located posteriorly to the midpoint on the anteroposterior (AP) width of the ramus. It was located at 57.3% of AP width from the coronoid notch and 56.5%from the occlusal plane. The mandibular foramen and the tip of lingula were located superiorly to the midpoint on the vertical height of the ramus, on the 48.5% and 35.7% of vertical distance from the coronoid notch,respectively. The mandibular foramen was located at 40% of the length on the line from the gonion to the koronion. The results of this study will provide important morphometric information to prevent the complications in mandibular surgery and also provide the basis for the development of the new techniques.
참고문헌 (23)
- Barker BC, "The applied anatomy of the pterygomandibular space", Br J Oral Surg, 10, pp.43~55 (1972)
- David HT, "Instrument retraction to avoid needle-stick injuries during intraoral local anesthesia", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 103, pp.e11~e13 (2007)
- Daw JL Jr, "The mandibular foramen: an anatomic study and its relevance to the sagittal ramus osteotomy", J Craniofac Surg, 10, pp.475~479 (1999)
- Fujimura K, "Anatomical study of the complications of intraoral vertico-sagittal ramus osteotomy", J Oral Maxillofac Surg, 64, pp.384~389 (2006)
- Fujimura K, "Advantages of intraoral verticosagittal ramus osteotomy in skeletofacial deformity patients with temporomandibular joint disorders", J Oral Maxillofac Surg, 62, pp.1246~1252 (2004)
- Guedes-Pinto AC, "Odontopediatria. 4th ed", pp.624~626 (2005), Livraria Santos Editora
- Hayward J, "The mandibular foramen: its anteroposterior position", Oral Surg Oral Med Oral Pathol, 44, pp.837~843 (1977)
- Hetson G, "Statistical evaluation of the position of the mandibular foramen", Oral Surg Oral Med Oral Pathol, 65, pp.32~34 (1988)
- Hwang TJ, "Age changes in location of mandibular foramen", Zhonghua Ya Yi Xue Hui Za Zhi, 9, pp.98~103 (1990)
- Jorgensen NB, "Sedation, local and general anesthesia in dentistry. 3rd ed" (1980), Lea & Febiger
- Kaffe I, "Location of the mandibular foramen in panoramic radiographs", Oral Surg Oral Med Oral Pathol, 78, pp.662~669 (1994)
- Kanno CM, "The mandibular lingula’s position in children as a reference to inferior alveolar nerve block", J Dent Child, 72, pp.56~60 (2005)
- Kim HJ, "Mandibular anatomy related to sagittal split ramus osteotomy in Koreans", Yonsei Med J, 38, pp.19~25 (1997)
- Kim MK, "A clinical and anatomical study on the mandible for inferior alveolar nerve conductive anesthesia in Korean", Korean J Phys Anthropol, 8, pp.157~173 (1995)
- Kositbowornchai S, "Shape of the lingula and its localization by panoramic radiograph versus dry mandibular measurement", Surg Radiol Anat, 29, pp.689~694 (2007)
- Mbajiorgu EF, "A study of the position of the mandibular foramen in adult black Zimbabwean mandibles", Cent Afr J Med, 46, pp.184~190 (2000)
- Mbajiorgu FE, "A pilot study of the mandibular angle in black Zimbabweans", Cent Afr J Med, 42, pp.285~287 (1996)
- Miller JA., "Studies on the location of the lingula, mandibular foramen, and mental foramen", Anat Rec, 115, pp.349~ (1953)
- Nicholson ML, "A study of the position of the mandibular foramen in the adult human mandible", Anat Rec, 212, pp.110~112 (1958)
- Oguz O, "Evaluation of location of mandibular and mental foramina in dry, young, adult human male, dentulous mandibles", West Indian Med J, 51, pp.14~19 (2002)
- Osaka N., "Studies on the position of the mandibular foramen", Shoni Shikagaku Zasshi, 27, pp.9~20 (1989)
- Shackelford LE, "An anatomic variation in the technique of mandibular anesthesia", J Nebr Dent Assoc, 60, pp.8~17 (1983)
- Tsai HH., "Panoramic radiographic findings of the mandibular foramen from deciduous to early permanent dentition", J Clin Pediatr Dent, 28, pp.215~219 (2004)