| Objective To study the safety distance between the implant end and mandibular tube in the area of posterior teeth.Methods From January 2015 to December 2016,a total of 38 patients in Dental Implant Center were selected for dental implants,and the distance between the end of the implant and the mandibular canal was less than 2.0mm.It met the inclusion criteria of 53 implants,measured and recorded the distance between the end of the implant and the mandibular tube,postoperative implant for mobility,and postoperative 3~4 months after the exercise of normal function and the upper denture inferior alveolar nerve function,38 cases of patients with follow-up and record abnormal lower lip and chin feels.Results 1.Among the 38 patients in this study,the ratio of male and female was1:1(19:19),and the age was 24~77 years old,with an average of 48.3 ± 9.9 years old,and 53 implants.In accordance with the inclusion criteria of the study,53 implants included four types of implant systems(Nobel,Straumann,Osstem and Dentium),and the number of patients with the choice of Osstem planting system was the largest,accounting for 64.15%(34/53).2.Specification of implant: length specification 8.0mm,8.5mm,10.0mm,11.0mm,11.5mm,12.0mm,diameter specification 4.0mm,4.1mm,4.5mm,4.8mm,5.0mm.3.The implants were divided into 2 implants for 35,15 implants for 36,10 implants for 37,2 implants for 45,12 implants for 46,12 implants for 47.4.There was no loss of 53 implants,and after 3 to 4 months after surgery,the upper denture was repaired,and no acid distention and irritation were found after normal function,and the lower alveolar nerve function was normal.5.The position and distance between the end of 53 implants and the mandibular tube were divided into three groups: the end of the first the implant was in the outer mandibular tube and the spacing was 1.0mm?D < 2.0mm(mean1.36mm).The end of the second implant was outside the mandibular tube and the spacing was 0mm?D<1.0mm(mean 0.31mm);The end of the third implant was in the mandibular tube and the distance was D<0mm(mean-0.83mm).6.Group 1 was 14.8%(4/27),group 2 was 45.5%(10/22),and group 3accounted for 100%(4/4).7.6 of 38 cases,Postoperative day the incidence of alveolar nerve damage symptoms was 18.4%(7/38),half a month after the incidence of alveolar nerve damage symptoms was 5.3%(2/38),after a month,three months,half a year and a mid alveolar nerve function were normal.8.Group one after the first day incidence of alveolar nerve damage symptoms accounted for 7.9%(3/38),postoperative incidence was 5.3%(2/38)half month,after a month,three months,six months and one year was 0%(0/38).Group two of the first day after surgery was 7.9%(3/38),half a month after surgery,one month,three months,six months,and one year 0%(0/38).Group three of the first day after surgery was 2.6%(1/38),half a month after surgery,one month,three months,six months,and one year 0%(0/38).Conclusion 1.In this study,the postoperative patients showed symptoms of lower alveolar nerve injury in the short term,but the nerve function of the lower alveolar nerve was completely restored within one month.2.According to preoperative accurate measurement,design,used in maxillary sinus lifting drill,stop ring,and performer of gentle movements,this study confirmed that the good control accurate implant depth,avoid causing irreversible damage to inferior alveolar nerve.3.After review of the literature middle tooth area planting bed under the condition of sufficient bone height,most scholars advocated implant should keep away from the mandibular canal between 2.0 mm at the end of the remaining bone mass,to avoid damage to inferior alveolar nerve.According to the results of this study,when the distance between the implant end and the mandibular tube was between-1.3mm and 1.8mm,the patient did not experience permanent neurological impairment after surgery.Therefore,it is reasonable to think that the safe distance between the implant end and the mandibular tube can be less than2.0mm. |
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