Kang Sung Hyun, Kim Bom Sahn, Kim Yemi
Department of Conservative Dentistry, Ewha Womans University School of Medicine, Seoul, Korea.
Department of Radiology, Ewha Womans University School of Medicine, Seoul, Korea.
J Endod. 2015 Nov;41(11):1839-46. doi: 10.1016/j.joen.2015.08.011. Epub 2015 Sep 26.
The aims of this study were to evaluate the vertical and horizontal relationships between the maxillary sinus floor (MSF) and the root apices of maxillary posterior teeth with various root configurations and the distance from the root apex to the MSF and the buccal cortical plate.
Serial axial, coronal, sagittal, and paraxial cone-beam computed tomographic images of 132 Korean patients with fully erupted bilateral maxillary posterior teeth were analyzed. The vertical and horizontal relationships between the roots of maxillary posterior teeth and the MSF were determined. Distances from the apex to the MSF and the buccal bone plate were measured. The data were correlated with age, sex, side, and tooth type.
In total, 2159 apices in 1056 teeth were evaluated. For the vertical relationships, the frequency in group 1, in which a root apex protruded into the MSF, significantly increased toward the posterior (first premolars: 1.5%, second premolars: 14.8%, first molars: 40.5%, second molars: 44.7%, P < .001). The apices of the mesiobuccal roots of the second molars were found frequently in group 1 (35.8%) and had the shortest mean vertical distance to the MSF (0.18 mm) and the thickest mean horizontal distance to the buccal cortical plate (4.99 mm) among buccal roots of 3-rooted molars (P < .001). The frequency of group 1 differed significantly by age (P < .05). No statistically significant difference was found in sex or side analysis. For the horizontal relationship between the molar roots and the MSF, most teeth were in group BP, in which the lowest point of the MSF was located centrally, relative to the roots (94.3% for first molars, 81.0% for second molars). For the first molars, no significant difference according to sex or side was found. However, the right side (P = .003) and males (P = .005) showed higher incidences for second molars.
The data in this study highlight the close proximity between the root apex of maxillary posterior teeth and the MSF and provide estimated distances from the root apex to the buccal cortical plate. Special care must be taken in treatment planning in the maxillary posterior region.
本研究的目的是评估上颌窦底（MSF）与具有不同牙根形态的上颌后牙牙根尖之间的垂直和水平关系，以及牙根尖到MSF和颊侧皮质骨板的距离。
分析了132例双侧上颌后牙完全萌出的韩国患者的系列轴向、冠状、矢状和近轴锥形束计算机断层扫描图像。确定上颌后牙牙根与MSF之间的垂直和水平关系。测量牙根尖到MSF和颊侧骨板的距离。将数据与年龄、性别、侧别和牙齿类型进行关联分析。
共评估了1056颗牙齿中的2159个牙根尖。对于垂直关系，第1组（牙根尖突入MSF）的频率向后显著增加（第一前磨牙：1.5%，第二前磨牙：14.8%，第一磨牙：40.5%，第二磨牙：44.7%，P <.001）。第二磨牙近中颊根的根尖在第1组中出现频率较高（35.8%），在三根磨牙的颊根中，其到MSF的平均垂直距离最短（0.18 mm），到颊侧皮质骨板的平均水平距离最厚（4.99 mm）（P <.001）。第1组的频率在年龄上有显著差异（P <.05）。在性别或侧别分析中未发现统计学上的显著差异。对于磨牙牙根与MSF之间的水平关系，大多数牙齿属于BP组，即MSF的最低点相对于牙根位于中央（第一磨牙为94.3%，第二磨牙为81.0%）。对于第一磨牙，在性别或侧别方面未发现显著差异。然而，第二磨牙右侧（P =.003）和男性（P =.005）的发生率较高。
本研究中的数据突出了上颌后牙牙根尖与MSF之间的紧密接近程度，并提供了从牙根尖到颊侧皮质骨板的估计距离。在上颌后牙区的治疗计划中必须特别小心。
