锥形束CT扫描测量不同矢状骨面型青少年上颌窦大小

Evaluation of maxillary sinus sizes in adolescence of different sagittal skeletal patterns on cone-beam computed tomography images

目的利用锥形束CT(CBCT)比较Ⅰ、Ⅱ、Ⅲ类矢状骨面型青少年患者上颌窦大小的差异,探讨上颌窦大小与颅面部骨骼形态的关系。方法将60例12～16岁的青少年患者按ANB角大小分为Ⅰ、Ⅱ、Ⅲ类三种矢状骨面型组,每组男、女各10例,垂直骨面型皆为均角型。患者接受颅面部CBCT扫描,对上颌窦的长度、宽度、高度、截面积及容积进行测量分析,比较三组间的差异。以CBCT生成的头颅侧位片测量分析颌面部骨骼形态,对上颌窦大小与颌面部骨骼形态的相关性进行研究。结果不同矢状骨面型青少年患者的上颌窦长度、高度、宽度、截面积和容积的差异具有统计学意义。上颌窦容积Ⅱ类大于Ⅰ类,Ⅱ类大于Ⅲ类。上颌窦容积与前颅底长、全颅底长、ANB角、上中切牙-前鼻嵴点距离及前上面高呈正相关关系,与SNB角呈负相关关系。结论Ⅱ类骨面型患者具有较大的上颌窦容积,青少年患者上颌窦大小与上下颌骨的矢状关系及颅底长度有一定的相关性。

Objective To compare the maxillary sinus size in adolescence with different sagittal skeletal patterns and to investigate correlations between the maxillary sinus sizes and the dentofacial morphology by cone-beam computed tomography （CBCT）. Methods The CBCT radiographs were derived from subjects with skeletal Class Ⅰ , Class Ⅲ , and Class m malocclusions, classified on the basis of the ANB angle. Each group consisted of 10 boys and 10 girls ranging in age from 12 to 16 years old. Each subject presented a normodivergent skeletal pattern. Three-dimensional maxillary sinus volumes and cross-sectional areas were measured by CBCT volume scans, and two-dimensional lateral cephalograms were created and analyzed. Maxillary sinus lengths, widths, heights, cross sectional areas and volumes were compared among the three groups. Analysis of variance and Pearson＇s correlation analysis about maxillary sinus size with the dentofacial variables were performed for statistical comparison. Results Significant differences in the maxillary sinus lengths, height, widths, cross sectional areas and volumes were shown in different sagittal skeletal groups, with Class Ⅱ 〉 Class Ⅰ （P 〈 0.05） and Class Ⅱ 〉 Class Ⅲ （P〈 0.05）. The maxillary sinus size had positive correlation with S-N, N-Ar, ANB, U1-ANS, UAFH （P 〈 0.05）, and had negative correlation with SNB （P〈 0.05）. Conclusions The patients in Class Ⅱ sagittal skeletal groups had larger maxillary sinus. The dimension of the maxillary sinus had correlation with the sagittal skeletal jaw relationship and the lengths of the cranial bases to some extent.