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经外侧入路行上颌窦底提升的解剖学分析:锥形束 CT 研究。

Anatomical analyses for maxillary sinus floor augmentation with a lateral approach: A cone beam computed tomography study.

机构信息

Department of Oral Implantology, Osaka Dental University, Osaka, Japan.

ARDEC Academy, Rimini, Italy; DentalPro Academy, Milan, Italy.

出版信息

Ann Anat. 2019 Nov;226:29-34. doi: 10.1016/j.aanat.2019.07.003. Epub 2019 Jul 19.

Abstract

BACKGROUND

Various anatomical references and structures should be analyzed prior approaching a surgery in the maxillary sinus. The objective of the present study was to evaluate the anatomical structures and references involved in sinus floor elevation with a lateral approach.

MATERIALS AND METHODS

Seventy-five patients planned for sinus floor elevation were included in the study. Eighty-eight maxillary sinuses were evaluated using cone beam computed tomographies (CBCTs). The nasal floor was used as main reference (X) and sinus mucosa width, bone crest height, palatal-nasal recess angle (PNR), sinus width at the level of the nasal floor, distance from the nasal floor to the base of the sinus (X-F), position of the posterior superior alveolar artery (PSAA height) and diameter (PSAA diameter), lateral bone wall width at 3mm (LW 3mm) and 9mm (LW 9mm) from the base of the sinus (F), patency of the ostium (OP), and presence and position of septa have been evaluated.

RESULTS

The mean dimensions and standard deviations were the following: mucosa thickness was 2.0±1.4mm, bone crest height 2.8±1.4mm, distance X-F 8.3±1.9mm, PNR angle 135.5±23.1, sinus width 12.6±4.2mm, X-F 8.3±1.9mm, PSAA height 14.4±2.9mm, PSAA diameter 1.1±0.4mm, LW 3mm 1.5±1.2, LW 9mm 1.3±0.6mm, OP 1.9±0.4mm. Septa were present in 19.3% of the sinuses evaluated and were located mostly in the molar region.

CONCLUSIONS

In conclusion, the analysis of the CBCT before sinus floor elevation allows the identification of anatomical structures and references that might be used for the planning of the surgical approach, aiming to improve the outcome of the treatment and to avoid possible complications.

摘要

背景

在进行上颌窦内手术之前,需要对各种解剖参考结构进行分析。本研究的目的是评估经外侧入路行上颌窦底提升术涉及的解剖结构和参考结构。

材料和方法

本研究共纳入 75 例拟行上颌窦底提升术的患者。对 88 例上颌窦进行锥形束 CT(CBCT)检查。以鼻底作为主要参考点(X),评估窦黏膜宽度、牙槽嵴顶高度、腭-鼻隐窝角(PNR)、鼻底水平窦宽度、鼻底至窦底距离(X-F)、上颌后动脉(PSAA)高度和直径(PSAA 直径)、距窦底 3mm(LW 3mm)和 9mm(LW 9mm)处的外侧骨壁宽度(F)、窦口通畅性(OP)以及有无中隔及其位置。

结果

平均尺寸和标准差如下:黏膜厚度为 2.0±1.4mm,牙槽嵴顶高度为 2.8±1.4mm,X-F 距离为 8.3±1.9mm,PNR 角为 135.5±23.1°,窦宽度为 12.6±4.2mm,X-F 距离为 8.3±1.9mm,PSAA 高度为 14.4±2.9mm,PSAA 直径为 1.1±0.4mm,LW 3mm 为 1.5±1.2mm,LW 9mm 为 1.3±0.6mm,OP 为 1.9±0.4mm。评估的窦腔中有 19.3%存在中隔,且多位于磨牙区。

结论

综上所述,在上颌窦底提升术前对 CBCT 进行分析,可以识别出可能用于手术入路规划的解剖结构和参考结构,以提高治疗效果,避免可能发生的并发症。

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