Walter Clemens, Dagassan-Berndt Dorothea C, Kühl Sebastian, Weiger Roland, Lang Niklaus P, Zitzmann Nicola U
Department of Periodontology, Endodontology and Cariology, University of Basel, Basel, Switzerland; Department of Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, UK.
Clin Oral Implants Res. 2014 Dec;25(12):1352-8. doi: 10.1111/clr.12275. Epub 2013 Oct 21.
The aim of this pilot study was to analyze the interfurcal bone height in relation to the possible need for subsequent sinus floor elevation in patients with advanced periodontitis and furcation involvement of first and/or second maxillary molars.
Seventeen dentate patients, who received cone beam computed tomography (CBCT) for detailed preoperative diagnosis and planning of surgical interventions at periodontally involved maxillary molars (17 first and 15 second molars), were consecutively recruited for the study. The minimal bone height in the interfurcal region was measured from CBCT and related to furcation involvement, residual bone above the root tips, and the clinical probing pocket depth (PPD).
The minimal interfurcal bone height measured 4.1 ± 2.6 mm on average with 75% of maxillary molars having ≤ 6 mm and almost 60% having only ≤ 4 mm bone height left below the sinus floor. A higher risk for reduced interfurcal bone height of ≤ 4 mm was given when residual PPD of ≥ 6 mm was remaining at two or more tooth sites (OR 0.10; 0.11).
The majority of periodontally involved maxillary molars had a substantially reduced interfurcal bone height, particularly with at least two sites with residual PPD ≥ 6 mm. This was a predictor for a subsequent need for sinus floor elevation when tooth replacement with a dental implant is desired.
本初步研究的目的是分析晚期牙周炎且上颌第一和/或第二磨牙存在根分叉病变的患者的根分叉区骨高度，以及后续可能需要进行上颌窦底提升术的情况。
连续招募了17名有牙患者，这些患者接受了锥形束计算机断层扫描（CBCT），用于对上颌磨牙牙周病变（17颗第一磨牙和15颗第二磨牙）进行详细的术前诊断和手术干预规划。从CBCT测量根分叉区的最小骨高度，并将其与根分叉病变、根尖上方的剩余骨以及临床探诊袋深度（PPD）相关联。
根分叉区的最小骨高度平均为4.1±2.6mm，75%的上颌磨牙骨高度≤6mm，近60%的上颌磨牙在窦底下方仅剩≤4mm的骨高度。当两个或更多牙齿部位的剩余PPD≥6mm时，根分叉骨高度≤4mm降低的风险更高（OR 0.10；0.11）。
大多数牙周受累的上颌磨牙根分叉区骨高度显著降低，尤其是至少有两个部位的剩余PPD≥6mm时。当希望用牙种植体进行牙齿替换时，这是后续需要进行上颌窦底提升术的一个预测指标。
