因种植治疗前来就诊患者上颌后牙区无牙颌部位的解剖特征及尺寸

Anatomical characteristics and dimensions of edentulous sites in the posterior maxillae of patients referred for implant therapy.

作者信息

Nunes Leandro Soeiro de Souza, Bornstein Michael M, Sendi Pedram, Buser Daniel

机构信息

Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.

出版信息

Int J Periodontics Restorative Dent. 2013 May-Jun;33(3):337-45. doi: 10.11607/prd.1475.

Abstract

The purpose of this study was to analyze the width and height of edentulous sites in the posterior maxilla using cone beam computed tomography (CBCT) images from patients referred for implant therapy. A total of 122 CBCT scans were included in the analysis, resulting in a sample size of 252 edentulous sites. The orofacial crest width was measured in coronal slices, perpendicular to the alveolar ridge. The bone height was analyzed in the respective sagittal slices. Additionally, the following secondary outcome parameters were evaluated: the morphology of the sinus floor, the presence of septa in the maxillary sinus, and the thickness of the sinus membrane. The mean crest width for all analyzed sites was 8.28 mm, and the mean bone height was 7.22 mm. The percentage of patients with a crest width of less than 6 mm was 27% in premolar sites and 7.8% in molar sites. The bone height decreased from premolar to molar areas, with a high percentage of first and second molar sites exhibiting a bone height of less than 5 mm (54.12% and 44.64%, respectively). Regarding the morphology of the sinus floor, 53% of the edentulous sites exhibited a flat configuration. A septum was present in 67 edentulous sites (26.59%). Analysis of the sinus membrane revealed 88 sites (34.9%) with increased mucosal thickness (> 2 mm). For the crest width, the location of the edentulous site and the morphology of the sinus floor were both statistically significant variables. For the crest width and mean bone height, the location of the edentulous site and the morphology of the sinus floor were both statistically significant variables. The study confirmed that a high percentage of edentulous sites in the posterior maxilla do require sinus floor elevation to allow the placement of dental implants. Therefore, a detailed three-dimensional radiograph using CBCT is indicated in most patients for proper treatment planning.

摘要

本研究的目的是使用接受种植治疗患者的锥形束计算机断层扫描(CBCT)图像,分析上颌后牙区无牙颌部位的宽度和高度。分析共纳入122例CBCT扫描,得到252个无牙颌部位的样本量。在垂直于牙槽嵴的冠状面切片中测量口面嵴宽度。在相应的矢状面切片中分析骨高度。此外,还评估了以下次要结局参数:窦底形态、上颌窦中隔的存在情况以及窦膜厚度。所有分析部位的平均嵴宽度为8.28mm,平均骨高度为7.22mm。前磨牙部位嵴宽度小于6mm的患者百分比为27%,磨牙部位为7.8%。骨高度从前磨牙区到磨牙区降低,第一和第二磨牙部位骨高度小于5mm的比例较高(分别为54.12%和44.64%)。关于窦底形态,53%的无牙颌部位呈现平坦形态。67个无牙颌部位(26.59%)存在中隔。窦膜分析显示88个部位(34.9%)黏膜厚度增加(>2mm)。对于嵴宽度,无牙颌部位的位置和窦底形态均为具有统计学意义的变量。对于嵴宽度和平均骨高度,无牙颌部位的位置和窦底形态均为具有统计学意义的变量。该研究证实,上颌后牙区中很大比例的无牙颌部位确实需要进行窦底提升以允许植入牙种植体。因此,对于大多数患者,为了进行适当的治疗计划,建议使用CBCT进行详细的三维影像学检查。

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