하악 제 3대구치의 매복 양상과 하치조신경 주행경로에 따른 하치조신경 손상 위험 요소 평가

Abstract

The purpose of this study was to analyze the impaction pattern of the impacted mandibular third molar and the relationship with the inferior alveolar nerve in Koreans using panorama and CBCT, and to evaluate the factors influencing the inferior alveolar nerve injury. The subjects were patients who visited Chosun University Dental Hospital and had a mandibular third molar and had Panorama and CBCT taken together. A total of 6182 patients were examined for 10310 mandibular third molar teeth. Through panoramic radiographs and records of the patient, sex, age, tooth extraction, impact pattern of the mandibular third molars were investigated. The nerve pathway and the presence of symptoms of nerve damage after tooth extraction were investigated. also, patients who complained symptoms of the nerve damage after surgical extraction were investigated using medical records. There were 3220 males (52%), and 2962 (48%) females. Horizontal impaction (4343, 42%) were the most, followed by mesial impaction(3075, 30%), vertical impaction(2365, 23%), distal impaction (158, 2%), inverted impaction (280, 3%) and transverse impaction (89, 1%). In the Pell & Gregory classification, Class A (5509, 53.4%) was the most, followed by Class B (3503, 34%), and Class C (1298, 12.6%), also in I, II, III classification, Class II (5704, 55.3%) was the most, followed by Class III (3402, 33.0%), and Class I (1204, 11.7%). Inferior alveolar nerve injury was correlated with sex, age, and nerve pathways on CBCT. If the narrowing of the inferior alveolar nerve and the lingual driving pathway of the inferior alveolar nerve appear simultaneously on CBCT, the risk of inferior alveolar nerve damage is high. When these two factors appear together, clinicians will have to extract the mandibular third molar more carefully