上后牙缺失患者上颌窦窦口及毗邻结构与窦黏膜关系的CBCT研究

CBCT analysis of the relationship between maxillary sinus ostium and neighboring structure and sinus mucosa in post maxillary edentulous patients

目的:分析上颌窦窦口直径、钩突角度、中鼻道宽度、鼻中隔缺牙侧偏曲、剩余牙槽嵴高度、性别、年龄与上颌窦黏膜的关系。方法:收集有上颌后牙缺失的168例患者200侧上颌窦(男性82例,女性86例,年龄22~83岁)的CBCT影像资料。应用Invivo5软件对上颌窦窦口直径、钩突角度、中鼻道宽度、鼻中隔缺牙侧偏曲、剩余牙槽嵴高度、性别、年龄和上颌窦黏膜厚度进行观察、测量。用线性相关和多元线性回归分析方法进行统计分析。结果:线性相关分析显示:窦口含气直径(r=-0.250,P=0.000)、性别(r=0.176,P=0.013)、鼻中隔缺牙侧偏曲(r=-0.161,P=0.023)、剩余牙槽嵴高度(r=-0.156,P=0.028)与上颌窦黏膜厚度(MT)相关;钩突角度(r=0.039,P=0.585)、中鼻道宽度(r=-0.028,P=0.699)、年龄(r=-0.034,P=0.617)与上颌窦黏膜厚度无相关性。多元线性回归分析显示:上颌窦窦口直径(t=-3.971,P=0.000)、剩余牙槽嵴高度(t=-2.544,P=0.019)、鼻中隔缺牙侧偏曲(t=-2.361,P=0.012)是影响上颌窦黏膜厚度的关键因素(均P<0.05),其重要性由大到小依次为:上颌窦窦口直径、鼻中隔缺牙侧偏曲、剩余牙槽骨高度。结论:上颌窦窦口毗邻结构影响上颌窦黏膜厚度,术前对窦口毗邻结果进行准确评估,有利于保证手术预后良好,减少术后并发症的发生。

Objective:To analyze the relationship between the ostium diameter of maxillary sinus,angle of the uncinate,width of the middle meatus,deviation of the nasal septum towards the lateral of the missing tooth,and the height of the remaining alveolar ridge,sex,age and the maxillary sinus mucosa.Methods:CBCT images of 200 maxillary sinuses in 168 patients(82 males and 86 females,aged from 22-83 years)with missing maxillary posterior tooth were collected.The ostium diameter of maxillary sinus,angle of the uncinate process,width of the middle meatus,deviation of the nasal septum towards the lateral of the missing tooth,and the height of the remaining alveolar ridge,sex,age and the thickness of the maxillary sinus mucosa were observed and measured by Invivo5 software.Linear correlation and multiple linear regression were used for statistical analysis.Results:Linear correlation analysis showed that the ostium diameter of maxillary sinus(r=-0.250,P=0.000),gender(r=0.176,P=0.013),lateral deviation of the nasal septum(r=-0.161,P=0.023),and height of the remaining alveolar ridge(r=-0.156,P=0.028)were correlated with the mucosal thickness of the maxillary sinus.There were no significant differences in uncinate process angle(r=0.039,P=0.585),middle nasal meatus width(r=-0.028,P=0.699)and age(r=-0.034,P=0.617).Multiple linear regression analysis showed that the diameter of maxillary sinus mouth(t=-3.971,P=0.000),the height of residual alveolar ridge(t=-2.544,P=0.019)and the deviation of the nasal septum towards the lateral of the missing tooth(t=-2.361,P=0.012)were the key factors affecting the thickness of maxillary sinus mucosa.The order of importance was:ostia diameter of maxillary sinus,deviation of the nasal septum towards the lateral of the missing tooth,height of residual alveolar bone.Conclusion:The adjacent structures of maxillary sinus ostium affect the mucosal thickness of maxillary sinus.Accurate evaluation of the adjacent results before operation is beneficial to ensure the prognosis of surgery and reduce the incidence of postoperative complication.