Brañas Gisela V, Grisolia Brenda G, Iuliano Romina G, Gualtieri Ariel, Lenarduzzi Ariel, Renou Sandra J, Rodríguez Pablo A
Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Endodoncia, Hospital Odontológico Universitario.
Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Biofísica y Bioestadística, Hospital Odontológico Universitario.
Acta Odontol Latinoam. 2018 Dec;31(3):164-169.
The aim of this study was to evaluate thickening of the Schneiderian membrane and to determine its association with periapical pathologies, using computerized cone beam tomography. An observational, analytical, cross-sectional retrospective study was conducted. A total 179 maxillary sinuses were evaluated using CBCT. The presence of sinus membrane thickening and its association with unhealthy teeth was analyzed. Results are shown as percentages with 95% confidence intervals (95%CI); Chi square test was used with a significance level of 5%.Sinus membrane thickening was detected in 70 cases (39%; 95%CI=32% to 46%) and no sinus membrane thickening was observed in 109 (61%; 95%CI = 54% to 68%) (p<0.05). The 70 cases showing sinus membrane thickening included 46 of odontogenic origin (66%; 95%CI = 54% to 76%) and 24 (34%; 95%CI = 24% to 46%) of non odontogenic origin (p<0.05). The frequency of odontogenic causes followed a heterogeneous distribution (p<0.05): penetrating caries, failing endodontic therapy, root remnants, deep restorations, implants, periodontal pathology. The main cause was caries (46%; 95%CI=32% to 60%) followed by failing endodontic therapy (26%, 95% CI=16% to 40%). The frequency distribution of involved teeth was uneven (p<0.05), with tooth 16 (33%; 95%CI=21% to 47%) being the most frequently involved, followed by tooth 26 (30%; 95%CI=19% to 45%).The high incidence of sinus pathology of odontogenic origin shows the need for interdisciplinary work involving dentists and ear-nose-throat specialists. Caries, inadequate restorations, periodontal lesions, implants, and the presence of root remnants are the main causes of Schneiderian membrane thickening. The use of CBCT for diagnosis and treatment planning allows detecting maxillary sinus membrane thickening and determining its association with an odontogenic etiology.
本研究的目的是使用计算机化锥形束断层扫描评估施奈德膜增厚情况，并确定其与根尖周病变的关联。进行了一项观察性、分析性、横断面回顾性研究。使用CBCT对总共179个上颌窦进行了评估。分析了窦膜增厚的存在情况及其与不健康牙齿的关联。结果以百分比及95%置信区间（95%CI）表示；采用卡方检验，显著性水平为5%。在70例（39%；95%CI = 32%至46%）中检测到窦膜增厚，109例（61%；95%CI = 54%至68%）未观察到窦膜增厚（p<0.05）。显示窦膜增厚的70例中，46例（66%；95%CI = 54%至76%）起源于牙源性，24例（34%；95%CI = 24%至46%）起源于非牙源性（p<0.05）。牙源性病因的频率呈异质性分布（p<0.05）：穿通性龋、根管治疗失败、牙根残留、深修复体、种植体、牙周病变。主要原因是龋齿（46%；95%CI = 32%至60%），其次是根管治疗失败（26%，95%CI = 16%至40%）。受累牙齿的频率分布不均衡（p<0.05），其中16号牙（33%；95%CI = 21%至47%）受累最为频繁，其次是26号牙（30%；95%CI = 19%至45%）。牙源性窦病变的高发生率表明需要牙科医生和耳鼻喉科专家开展跨学科工作。龋齿、修复不当、牙周病变、种植体以及牙根残留的存在是施奈德膜增厚的主要原因。使用CBCT进行诊断和治疗计划有助于检测上颌窦膜增厚并确定其与牙源性病因的关联。
