Moskow B S
Center for Clinical Research in Dentistry, Columbia University, School of Dental and Oral Surgery, New York, NY.
J Periodontol. 1992 Aug;63(8):674-81. doi: 10.1902/jop.1992.63.8.674.
Twenty blocks of human jaws obtained at autopsy and containing maxillary molar teeth with the contiguous maxillary sinus intact were prepared utilizing conventional histopathologic techniques and were studied by light microscopy. The purpose of this investigation was to confirm earlier clinical reports suggesting a close association between human periodontitis and maxillary sinus thickening and to morphologically document the nature of the sinus changes. Seventeen of 20 jaw specimens demonstrated moderate to advanced periodontal destruction with pervasive extension of the inflammatory infiltrate through the alveolar process beyond the apices of the teeth and extending to the region of the antrum. Of the 20 histologic specimens, 10 showed extensive thickening of the sinus membrane, 9 had moderate hyperplastic changes, and only 1 specimen demonstrated a normal appearing sinus. Pathologic changes in the sinus membrane included inflammatory cell infiltration, edema, fibrosis of the tunica propria, mucous-serous gland proliferation, interstitial pseudo-cyst formation, polyp formation, hyalinization of the connective tissue lining, thrombosis of blood vessels, and metaplastic and degenerative changes in the epithelial lining. This study, based on histopathologic changes, suggests an apparent direct relationship between moderate and severe periodontitis of the maxillary molar teeth and pathologic changes resulting in thickening of the maxillary sinus mucosa.
通过尸检获取了20块人类颌骨，这些颌骨包含上颌磨牙且相连的上颌窦完整无损，利用传统组织病理学技术对其进行制备，并通过光学显微镜进行研究。本研究的目的是证实早期临床报告中提出的人类牙周炎与上颌窦增厚之间存在密切关联，并从形态学上记录窦腔变化的性质。20个颌骨标本中有17个显示出中度至重度牙周破坏，炎症浸润广泛蔓延至牙槽突，超出牙齿根尖并延伸至窦腔区域。在20个组织学标本中，10个显示窦膜广泛增厚，9个有中度增生性改变，只有1个标本的窦腔外观正常。窦膜的病理变化包括炎症细胞浸润、水肿、固有层纤维化、黏液-浆液性腺增生、间质假性囊肿形成、息肉形成、结缔组织衬里玻璃样变、血管血栓形成以及上皮衬里的化生和退行性改变。基于组织病理学变化的这项研究表明，上颌磨牙的中度和重度牙周炎与导致上颌窦黏膜增厚的病理变化之间存在明显的直接关系。
