上颌窦底黏膜增厚与牙槽骨高度及上颌窦解剖结构的关联性

Correlation between maxillary sinus floor mucosal thickening,alveolar bone height and maxillary sinus anatomy

目的通过观测上颌后牙缺失患者的锥形束CT,研究上颌窦底黏膜增厚与缺牙区部分解剖结构的关系,为上颌窦底黏膜增厚患者的上颌窦提升术与缺失牙种植治疗提供临床参考。方法收集2013年1月—2022年5月于天津医科大学附属口腔医院牙周科与广州医科大学附属口腔医院牙周科拍摄锥形束CT的患者资料,筛选出上颌单侧单颗后牙缺失的患者103例,通过CBCT三维重建,并以上颌窦底黏膜是否增厚(>2 mm)作为分组标准,测量牙槽骨高度、宽度、上颌窦外侧壁血管至窦底距离、上颌窦外侧壁厚度,以同一患者自身两侧指标的差值为统计值,分析上颌窦底黏膜增厚是否对缺牙区部分解剖结构存在影响。结果最终纳入上颌窦底黏膜增厚组56例,非上颌窦底黏膜增厚组47例。对其指标进行统计,其中两组患者的牙槽骨高度差值存在差异,上颌窦底黏膜增厚组大于非上颌窦底黏膜增厚组,差异有统计学意义(P=0.0246)。两组间的牙槽骨宽度、上颌窦外侧壁厚度、上颌窦外侧壁血管至窦底距离的差值,差异无统计学意义(P>0.05)。结论持续存在的上颌窦底黏膜增厚可能与缺牙后牙槽骨高度的变化存在关联。

Objective This study aimed to assess the association between thickening of mucosa of floor of maxillary sinus and the anatomical structure of edentulous region by cone beam CT(CBCT),offering important information for maxillary sinus lift and dental implant treatment.Methods The cone beam CT images taken at the Department of Periodontics in the Stomatological Hospital of Tianjin Medical University and Guangzhou Medical University from January 2013 to May 2022 were used for measurement.A total of 103 patients met the inclusion criteria for evaluation thickening of mucosa of floor of maxillary sinus(>2mm).On the CBCT images,the alveolar bone height and width,the distance from the lateral wall blood vessels to floor of maxillary sinus,together with the anterolateral thickening of maxillary sinus to study the influence of thickening of mucosa of floor of maxillary sinus on the anatomical structure of edentulous region.Results There were 56 patients in the maxillary sinus floor mucosal thickening group and 47 patients in the non-maxillary sinus floor mucosal thickening group.The study showed that the maxillary sinus floor mucosal thickening group had larger height of alveolar bone than the non-maxillary sinus floor mucosal thickening group(P=0.0246).However,no statistically significant differences were observed in the alveolar bone width(P=0.1184),the anterolateral thickening of maxillary sinus(P=0.907)and the lateral wall blood vessels to floor of maxillary sinus(P=0.4718).Conclusion From the result of this study,it can be concluded that there is an association between increasing maxillary sinus mucosal thickening and changes in alveolar bone height after tooth extraction.