Shahbazian Maryam, Vandewoude Charlotte, Wyatt Jan, Jacobs Reinhilde
Oral Imaging Center, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium,
Clin Oral Investig. 2014 Jan;18(1):293-300. doi: 10.1007/s00784-013-0963-x. Epub 2013 Mar 24.
The purpose of this study was to assess whether and how the information obtained by means of cone beam computed tomography (CBCT) on maxillary posterior teeth differs from that obtained by panoramic radiography.
From 157 subjects (mean age 48 years, range 19-84 years; 89 females) referred to the oral imaging center, a pair of panoramic and CBCT images was selected for further analysis. Both imaging modalities were analyzed to determine the topographic relationship of maxillary teeth to the sinus floor. Pathologic conditions, apical periodontitis, and presence of soft tissue thickening were also examined with both techniques.
CBCT showed an intimate relationship of the first and second molar with the maxillary sinus in 54 and 38%, respectively. Thirty-nine apical periodontitis lesions causing reactive changes in the maxillary sinus were detected by CBCT, while just six of them were diagnosed with panoramic imaging. A total of 26 teeth with apical extension to the maxillary sinus were detected with CBCT, from which two could be identified with panoramic radiography.
This study emphasizes that anatomical and pathological involvement of the maxillary sinus in relation to posterior teeth is considerably high. It is of clinical importance that the 3D nature of CBCT imaging allowed a better assessment of the relationship between the maxillary sinus and posterior root apices compared to the low detection on panoramic radiographs.
CBCT imaging can be a valuable adjunct in radioanatomical and radiodiagnostic observations in the posterior maxilla. It may better visualize maxillary sinus involvement for posterior upper teeth than panoramic radiography.
本研究旨在评估通过锥形束计算机断层扫描（CBCT）获得的上颌后牙信息是否以及如何不同于全景X线摄影所获得的信息。
从转诊至口腔影像中心的157名受试者（平均年龄48岁，范围19 - 84岁；89名女性）中，选取一对全景和CBCT图像进行进一步分析。对两种成像方式进行分析，以确定上颌牙齿与鼻窦底的地形关系。还使用这两种技术检查了病理状况、根尖周炎和软组织增厚情况。
CBCT显示第一磨牙和第二磨牙与上颌窦的密切关系分别为54%和38%。CBCT检测到39个导致上颌窦反应性改变的根尖周炎病变，而全景成像仅诊断出其中6个。CBCT共检测到26颗根尖延伸至上颌窦的牙齿，其中两颗可通过全景X线摄影识别。
本研究强调上颌窦与后牙的解剖和病理累及程度相当高。CBCT成像的三维特性与全景X线摄影的低检测率相比，能够更好地评估上颌窦与后牙根尖之间的关系，这具有临床重要性。
CBCT成像在对上颌后部的放射解剖和放射诊断观察中可以是一种有价值的辅助手段。与全景X线摄影相比，它可能更好地显示上颌后牙的上颌窦累及情况。
