임플란트 식립을 위한 비구개관의 형태학적 분석 = Morphological analysis of nasopalatine canal for dental implant placement

국문 초록 (Abstract)

비구개관은 상악 중절치 임플란트 식립 시 고려되어야 할 중요한 해부학적 구조물이다. 비구개관은 상악 중절치 후방, 구개의 정중선에 위치하며 구강과 비강을 연결하는 관으로 내부에는 비구개신경, 하행 비구개 동맥가지 및 섬유성 결합조직, 지방조직, 장·점액선을 포함한다. 임플란트 식립 과정에서 비구개관 내 신경 및 혈관과 접촉이 일어나면 혈종, 비구개관낭, 골유착의 실패 혹은 감각이상으로 이어질 수 있다. 많은 연구에서 비구개관의 해부학적 형태 및 위치, 그리고 나이, 성별, 상악 중절치의 유무가 비구개관의 형태 및 위치에 미치는 영향을 조사하였으나, 연구 기준이 상이하여 연구 결과를 서로 비교하기 어려웠다. 따라서 본 연구는 보고된 연구 결과를 토대로 기준을 재설정한 후, 상악 중절치 부위 임플란트 식립 시 비구개관에 대한 해부학적 고려사항 및 앞으로의 연구 방향을 제시하기 위하여 시도되었다. 연구 결과 비구개관은 상악 중절치 부위와 근접해 있고, 비구개관 형태의 다양성 및 비구개관 오목과 같은 형태적 변이 때문에 상악 중절치 부위 임플란트 식립 시 주의를 요하고 술전 Cone-beam computed tomography (CBCT)를 통한 비구개관에 대한 분석이 반드시 필요한 것으로 나타났다. 또한 나이, 성별, 상악 중절치의 유무가 비구개관 및 순측골에 미치는영향에 대해서는 연구마다 차이가 있어 변인 통제를 통한 추가적인 연구가 요구되는 것으로 사료되었다.

다국어 초록 (Multilingual Abstract)

Currently, the most functional and esthetic restoration for a missing central incisor is an implant. The nasopalatine canal is an important anatomical structure to consider when placing implants in the maxillary central incisor area. This study described the anatomical considerations for the nasopalatine canal when placing implants in the maxillary central incisor area and considered future research directions. In particular, we examined papers that investigated the anatomical shape and location of the nasopalatine canal and the effects of age, gender, and maxillary central incisors on its shape and location. Conclusively, it is essential to analyze the nasopalatine canal through CBCT before implant placement in the maxillary central incisor area due to the proximity of the maxillary central incisor to the nasopalatine canal, the diversity of nasopalatine canal shapes and other morphological variations, such as the nasopalatine concavity. The effects of age, gender, and the maxillary central incisors on the morphology and location of the nasopalatine canal and buccal alveolar bone differ from study to study. In the future, additional studies that control for different variables are warranted.

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