上颌磨牙与上颌窦黏膜增厚发生的相关性分析

Analysis of correlation between maxillary molars and maxillary sinus mucosal thickening

目的:采用锥形束CT(cone-beam CT,CBCT)探讨上颌磨牙对上颌窦黏膜增厚的影响。方法:根据纳入、排除标准,选择72例牙周炎患者,测量137个上颌窦的相关参数,包括部位、牙位、最大黏膜厚度、牙槽骨丧失、垂直骨下袋和最小剩余骨高度。将上颌窦最大黏膜厚度大于2 mm定义为增厚状态,评估可能影响上颌窦黏膜增厚的因素。采用SPSS 25.0软件包对数据进行单因素分析和二元Logistic回归分析。结果:137个上颌窦中,77个黏膜增厚,占56.2%。随着牙槽骨丧失程度的加重,黏膜增厚的发生率增加(轻度21.1%,中度56.1%,重度69.2%),上颌窦黏膜增厚发生的风险增加6~7倍(中度OR=7.13,95%CI:1.37~37.21;重度OR=6.29,95%CI:1.06~37.37)。垂直骨下袋的严重程度与黏膜厚度发生呈正相关(无骨下袋38.7%,Ⅰ类骨下袋63.4%,Ⅱ类骨下袋79.4%),上颌窦黏膜增厚发生的风险增加(Ⅰ型OR=3.72,95%CI:1.01~13.70;Ⅱ型OR=5.39,95%CI:1.15~25.30)。最小剩余骨高度与黏膜厚度呈负相关(最小剩余骨高度≤4 mm OR=99.00,95%CI:17.42~562.79,P<0.05)。结论:上颌磨牙牙槽骨丧失、垂直骨下袋和最小剩余骨高度与上颌窦窦底黏膜增厚有显著相关性。

PURPOSE:To investigate the influence of maxillary molars on the thickening of maxillary sinus mucosa by cone-beam CT(CBCT).METHODS:A total of 72 patients with periodontitis were included in the study and 137 cases of maxillary sinus were evaluated using CBCT for the following parameters:location,tooth,maximal mucosal thickness,alveolar bone loss,vertical intrabony pockets and minimal residual bone height.The maxillary sinus mucosal thickness≥2 mm was defined as mucosal thickening.The parameters that could influence the dimensions of the maxillary sinus membrane were assessed.The data were analyzed using univariate analysis and binary logistic regression by SPSS 25.0software package.RESULTS:Mucosal thickening was present in 56.2%of 137 cases and increased in frequency as the alveolar bone loss of the corresponding molar progressed from mild(21.1%)to moderate(56.1%)to severe(69.2%),and the risk of maxillary sinus mucosal thickening increased by 6-7 times(moderate OR=7.13,95%CI:1.37-37.21;severe OR=6.29,95%CI:1.06-37.37).The severity of vertical intrabony pockets was correlated with the presence of mucosal thickness(no intrabony pockets 38.7%;typeⅠ63.4%;typeⅡ79.4%),with an increased risk of maxillary sinus mucosal thickening(typeⅠOR=3.72,95%CI:1.01-13.70;typeⅡOR=5.39,95%CI:1.15-25.30).The minimal residual bone height was negatively correlated with the presence of mucosal thickness(≤4 mm OR=99.00,95%CI:17.42-562.79).CONCLUSIONS:Alveolar bone loss,vertical intrabony pockets and the minimal residual bone height in maxillary molars were significantly associated with mucosal thickening of the maxillary sinus.