曲面体层片与锥形束CT比较分析上颌后牙牙根与上颌窦的关系

Comparison of diagnosing the relationship between the root of maxillary posterior tooth and maxillary sinus between panoramic radiography and cone beam computer tomography

目的研究曲面体层片与锥形束CT(cone beam computer tomography,CBCT)判断上颌后牙牙根与上颌窦关系的准确性,为临床医师根据曲面体层片信息治疗上颌后牙区相关疾病提供参考。方法纳入80例符合标准的患者(牙根数671个),以锥形束CT为标准,在曲面体层片及锥形束CT片上测量上颌后牙根尖到上颌窦的距离。结果当曲面体层片显示上颌窦的皮质骨连续,牙根距上颌窦存在明显距离、与上颌窦相切时,曲面体层片判断上颌后牙牙根与上颌窦关系的准确率分别为82.0%、70.0%;当曲面体层片显示上颌窦皮质骨中断,牙根突入上颌窦内时,曲面体层片判断上颌后牙牙根与上颌窦关系的准确率为48.5%。曲面体层片、锥形束CT均显示牙根突入上颌窦时,曲面体层片测量上颌后牙牙根突入上颌窦距离为(2.19±1.82)mm,而锥形束CT测量距离为(1.47±1.01)mm,两者差异具有统计学意义(P<0.05)。结论曲面体层片判断上颌后牙牙根未进入上颌窦的准确率较高,但判断上颌后牙牙根突入上颌窦的准确率较低。

Objective To study the diagnostic accuracy and the distance between the root of maxillary posterior tooth and the maxillary sinus using panoramic radiography and cone beam computer tomography;to provide basic infor⁃mation for clinicians to treat diseases in the maxillary posterior region.Methods Eighty patients were included in this study.A total of 671 specimens were measured for the distance between the root tip and the maxillary sinus floor in both imaging modalities.Results The roots that did not contact the sinus floor or contacted but did not project into the sinus cavity showed an agreement of 82%and 70%when using panoramic radiography.Forty⁃eight percent of the roots that projected into the sinus cavity in panoramic radiography showed protrusion into the sinus with cone beam computer tomography(CBCT).For panoramic radiography and CBCT showing root projections into the sinus cavity,the average distances were 2.19±1.82 mm and 1.47±1.01 mm,respectively.There was a significant difference between the two values(P<0.05).Conclusion Panoramic radiography is more accurate when roots of maxillary posterior teeth do not contact the sinus floor or contact it.However,it has a lower accuracy rate when the tooth roots protrude into the sinus.