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牙源性疾病与上颌窦黏膜增厚的相关性:一项回顾性 CBCT 研究。

Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study.

机构信息

Department of Endodontics, Faculty of Dentistry, Near East University, Dikmen, Lefkosa, 90392, Mersin 10, Turkey.

Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Besevler, 06500, Ankara, Turkey.

出版信息

Clin Oral Investig. 2019 Jan;23(1):123-131. doi: 10.1007/s00784-018-2418-x. Epub 2018 Mar 17.

Abstract

OBJECTIVES

This study aimed to assess the maxillary sinus mucosal thickening and to associate them with odontogenic conditions using cone-beam computed tomographic (CBCT) images.

MATERIALS AND METHODS

CBCT images of 294 patients (143 female, 151 males; age range 18-78 years) with 588 maxillary sinuses were evaluated retrospectively. The anatomic relationship between maxillary sinuses and teeth was determined and classified. The presence of root canal fillings and the periapical lesions of these teeth was also recorded. Sinus mucosal thickenings were classified as grade 1 (normal) (< 2 mm), grade 2 (moderate) (2-10 mm), and grade 3 (severe) (> 10 mm). Alveolar bone loss was measured on all maxillary premolar/M teeth.

RESULTS

More than 2-mm mucosal thickening (grade 2 and grade 3) in either one or both maxillary sinuses was found in 172 (58.5%) of the patients. The prevalence of mucosal thickening (> 2 mm) for maxillary sinuses with and without any periapical lesions was 42.1 and 53.6%, respectively (p < 0.05). The prevalence of mucosal thickening increased in patients with periodontal alveolar bone loss (p < 0.05). There was a significant correlation between mucosal thickening with age, gender and missing teeth (p < 0.05).

CONCLUSIONS

Multiple conditions, including periapical infection, root canal treatment, and close relationship maxillary teeth and sinus, may have a precursor effect on the occurrence of mucosal thickening in the maxillary sinus. Periodontal status and its role as a risk factor in triggering maxillary sinus infections should be also considered by not only dental professionals but also the medical professionals to plan for the treatment of maxillary sinus lesions.

CLINICAL RELEVANCE

Maxillary sinuses are significantly influenced by various odontogenic conditions, including periodontal bone loss, periapical lesions, and missing teeth, which may result in thickening of the maxillary sinus mucosa.

摘要

目的

本研究旨在通过锥形束 CT(CBCT)评估上颌窦黏膜增厚,并将其与牙源性疾病相关联。

材料和方法

回顾性分析 294 例(143 例女性,151 例男性;年龄 18-78 岁)588 例上颌窦 CBCT 图像。确定上颌窦与牙齿的解剖关系并进行分类。记录这些牙齿的根管充填和根尖病变情况。将窦黏膜增厚分为 1 级(正常)(<2mm)、2 级(中度)(2-10mm)和 3 级(重度)(>10mm)。测量所有上颌前磨牙/磨牙的牙槽骨丧失情况。

结果

在 172 例(58.5%)患者的一侧或两侧上颌窦中发现超过 2mm 的黏膜增厚(2 级和 3 级)。有根尖病变的上颌窦和无根尖病变的上颌窦黏膜增厚(>2mm)的发生率分别为 42.1%和 53.6%(p<0.05)。牙周牙槽骨丧失患者的黏膜增厚发生率增加(p<0.05)。黏膜增厚与年龄、性别和缺牙之间存在显著相关性(p<0.05)。

结论

多种因素,包括根尖感染、根管治疗以及上颌牙齿与窦腔的密切关系,可能对上颌窦黏膜增厚的发生有前导作用。牙周状况及其作为触发上颌窦感染的危险因素,不仅应被牙科专业人员,也应被医疗专业人员考虑,以便为上颌窦病变的治疗方案提供依据。

临床意义

上颌窦受多种牙源性疾病的显著影响,包括牙周骨丧失、根尖病变和缺牙,这可能导致上颌窦黏膜增厚。

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