上颌后牙缺牙区上颌窦解剖结构的锥形束CT研究

The anatomy of maxillary sinus in single maxillary posterior edentulous area based on cone-beam CT

目的 通过锥形束CT观测上颌单侧单颗后牙缺失患者缺牙区和对侧非缺牙区的上颌窦解剖结构,了解缺牙对上颌窦的影响,为临床提供参考.方法 分析2013年1月至2015年3月于天津医科大学口腔医院牙周科拍摄锥形束CT的上颌单侧单颗后牙缺失患者128例,对比同一患者缺牙侧与对侧（对照侧）锥形束CT上颌窦外侧壁厚度、窦底黏膜厚度、窦内骨分隔数,并分析缺牙侧窦嵴距与上颌窦外侧壁血管至窦底距离的关系.结果 缺牙侧上颌窦外侧壁厚度和窦底黏膜厚度[分别为1.59（1.22）、1.61（1.95）mm]均显著小于对照侧[分别为1.76（1.10）、1.91（2.23）mm]（P＜0.05）;两侧上颌窦内骨分隔数差异无统计学意义（P＞0.05）.缺牙区窦嵴距与上颌窦外侧壁血管至窦底距离呈负相关（r=-0.343,P＜0.01）.结论 上颌窦外侧壁厚度、窦底黏膜厚度受牙缺失的影响较大,上颌窦内骨分隔数的变化受牙缺失影响不明显;上颌单侧单颗后牙缺失患者的窦嵴距越大,上颌窦外侧壁血管至窦底距离可能越小.

Objective To compare the anatomy of maxillary sinus in single maxillary posterior edentulous area and the contralateral side without loss of tooth,and to investigate the effect of tooth loss on the anatomy of maxillary sinus by cone-beam CT（CBCT）.Methods A total of 128 patients with single unilateral single maxillary tooth loss were included in the study.CBCT was taken in these patients and the thickness of the maxillary lateral wall,mucosa thickness of sinus floor and sinus septa of the maxillary sinus were recorded and compared with the contralateral side.The bone height from the sinus floor to the ridge crest and the distance between maxillary sinus floor and the vascular anastomosis of maxillary lateral wall were analyzed.Results The thickness of maxillary sinus lateral wall and maxillary sinus mucosa were 1.59 （1.22）,1.61（1.95） mm in the maxillary posterior edentulous area and significantly less than those of the contralateral side（1.76[1.10],1.91[2.23] mm）（P〈0.05）,and the data was demonstrated using median（quartile range）.The difference of the mean number of maxillary sinus septa between the two sides was not statistically significant（P〉0.05）.There was a negative correlation between the bone height from the sinus floor to the ridge crest and the distance between maxillary sinus floor and the vascular anastomosis of maxillary lateral wall （r=-0.343,P〈0.01）.Conclusions The changes of the thickness of lateral wall of maxillary sinus and maxillary sinus mucosa are closely related to tooth loss.The change of the number of maxillary sinus septa is not related to tooth loss.There is a negative correlation between the bone height from the sinus floor to the ridge crest and the distance between maxillary sinus floor and the vascular anastomosis of maxillary lateral wall.