Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
Applied Oral Sciences, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Sai Ying Pun, Hong Kong, SAR, China.
Clin Oral Investig. 2019 May;23(5):2253-2263. doi: 10.1007/s00784-018-2650-4. Epub 2018 Oct 4.
The aim was to assess the anatomical relationship of anterior maxillary teeth to the nasal floor in patients referred for apical surgery.
Cone beam computed tomographic images (CBCT) of 83 patients were analysed retrospectively to quantify the distances between the root apices of maxillary anterior teeth (canine to canine) to the nasal floor or maxillary sinus (whichever was closer). Secondary outcome variables were the distances of the periapical lesion to the nasal floor, distances of the apices to the labial and palatal bone plates as well as to the neighbouring teeth.
A total of 93 teeth (39 central, 35 lateral incisors and 19 canines) were analysed. The mean shortest distances of the apices to the nasal floor (or maxillary sinus) were 8.54 mm for central incisors, 9.49 mm for lateral incisors and 5.39 mm for the canines. The canines exhibited a significantly shorter distance to the nasal floor/maxillary sinus. In the presence of an osteolysis, the distance to the nasal floor was significantly shorter compared to the teeth without lesions. The lateral and central incisors showed significant proximity to each other at the level of the future surgical resection (3 mm from the apex).
A close proximity between apices and adjacent anatomical structures such as nasal floor, maxillary sinus or adjacent roots could be shown in some cases.
CBCT could be a valuable adjunctive imaging tool prior to apical surgery in the anterior maxilla to assess the risk for and decrease the incidence of damage to neighbouring anatomical structures such as the nasal floor, maxillary sinus or adjacent roots.
评估上颌前牙根尖手术患者的上颌前牙（尖牙至尖牙）与鼻底或上颌窦（以更近者为准）之间的解剖关系。
回顾性分析 83 例患者的锥形束 CT 图像（CBCT），以量化上颌前牙（尖牙至尖牙）根尖与鼻底或上颌窦（以更近者为准）之间的距离。次要结局变量为根尖病变与鼻底的距离、根尖与唇侧和腭骨板的距离以及与邻牙的距离。
共分析了 93 颗牙（39 颗中切牙、35 颗侧切牙和 19 颗尖牙）。根尖至鼻底（或上颌窦）的最短平均距离为中切牙 8.54mm、侧切牙 9.49mm 和尖牙 5.39mm。尖牙到鼻底/上颌窦的距离明显较短。在存在骨质溶解的情况下，与无病变的牙齿相比，距离鼻底的距离明显缩短。侧切牙和中切牙在未来手术切除水平上（根尖 3mm 处）显示出明显的接近度。
在某些情况下，可以显示根尖与相邻解剖结构（如鼻底、上颌窦或相邻牙根）之间的接近程度。
CBCT 可在前上颌根尖手术前作为一种有价值的辅助成像工具，以评估对相邻解剖结构（如鼻底、上颌窦或相邻牙根）造成损伤的风险，并降低其发生率。
