Suo Wu-cai, Gu Zhang-yu, Ruan Hong, Guo Xue-hua, Zhang Wen-bin, Shi Hui-min
Department of Stomatology, Zhongshan Hospital, School of Medicine, Fudan University. Shanghai 200032, China.
Shanghai Kou Qiang Yi Xue. 2011 Jun;20(3):308-13.
Using spiral computed tomography and Simplant software to measure the width and height of residual alveolar crest of agomphious upper molar region at different levels around bottom of low-set maxillary sinus. To evaluate the impact of sex, age, agomphious duration, and cause of tooth extraction on the width and height of residual alveolar crest.
Forty-three patients with missing uppers molar and residual alveolar bone height being 4 to 6mm showed by panoramic radiographs were scanned by spiral computed tomography. 3D model of the alveolar crest and maxillary sinus were reconstructed using the images from CT scan and Simplant software. The height and width of the residual alveolar crest of agomphious upper molar region at different levels around bottom of maxillary sinus were measured. The data was analyzed with SPSS16.0 software package for Student's t test, analysis of variance(ANOVA) and Kruskal-Wallis H test.
(1)The mean distance between the top of residual alveolar crest and the floor of sinus was (5.26±0.58)mm. (2)The difference between the width of internal bone wall and that of external bone wall at different levels above the bottom of maxillary sinus was significant(P<0.01), except for agomphious upper second molar at 3.75mm. (3)The height of residual crest and width of sinus floor decreased remarkably with age and agomphious duration(P<0.01) while the width of sinus lateral walls didn't change so much with them(P>0.05). (4)Height of residual crest of the tooth extracted due to periodontitis was obviously lower than that of the tooth extracted due to residual root(crown) or crown fracture(P<0.01).
The height and width of residual crest change significantly with age, agomphious duration and causes of tooth extraction. However, the width of lateral walls above sinus floor do not change so much with those factors. The internal wall of maxillary sinus floor is wider than the external wall at agomphious molar. This anatomic feature may be taken into consideration during implantation. The site and direction of implant can be adjusted equally according to the age, agomphious duration and causes of tooth extraction, so that maxillary sinus augmentation can be avoided in part of patients with low-set maxillary sinus.
运用螺旋计算机断层扫描技术及Simplant软件，测量低位上颌窦底部不同层面无牙上颌磨牙区剩余牙槽嵴的宽度和高度。评估性别、年龄、无牙持续时间及拔牙原因对剩余牙槽嵴宽度和高度的影响。
对43例全景片显示上颌磨牙缺失且剩余牙槽骨高度为4至6毫米的患者进行螺旋计算机断层扫描。利用CT扫描图像及Simplant软件重建牙槽嵴和上颌窦的三维模型。测量上颌窦底部不同层面无牙上颌磨牙区剩余牙槽嵴的高度和宽度。采用SPSS16.0软件包进行数据统计分析，运用Student's t检验、方差分析（ANOVA）及Kruskal-Wallis H检验。
（1）剩余牙槽嵴顶部与窦底的平均距离为（5.26±0.58）毫米。（2）上颌窦底部以上不同层面的内侧骨壁宽度与外侧骨壁宽度差异有统计学意义（P<0.01），除了无牙上颌第二磨牙在3.75毫米处。（3）剩余牙槽嵴高度和窦底宽度随年龄及无牙持续时间显著降低（P<0.01），而窦外侧壁宽度随年龄及无牙持续时间变化不大（P>0.05）。（4）因牙周炎拔牙患者的剩余牙槽嵴高度明显低于因残根（冠）或冠折拔牙患者（P<0.01）。
剩余牙槽嵴的高度和宽度随年龄、无牙持续时间及拔牙原因显著变化。然而，窦底以上外侧壁宽度随这些因素变化不大。无牙磨牙处上颌窦底的内侧壁比外侧壁宽。在种植时可考虑这一解剖学特征。可根据年龄、无牙持续时间及拔牙原因同等调整种植体的位置和方向，从而在部分低位上颌窦患者中避免上颌窦提升术。
