Department of Periodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan.
Department of Periodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan; Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan.
Biomed J. 2019 Oct;42(5):328-334. doi: 10.1016/j.bj.2019.03.001. Epub 2019 Nov 7.
Cone-beam computed tomography (CBCT) presurgical assessment on the maxillary sinus can reduce the possibility of Schneiderian membrane perforation. This study examined Schneiderian membrane thickness (SMT) and its relationship with neighboring hard tissues for patients with and without membrane thickening. For patients with sinus infections, we evaluated dimensional changes of the SMT post-extraction relative to pre-extraction SMT and residual bone height (RBH).
CBCT images from 93 patients needing single-tooth implant reconstruction without (n = 83) and with (n = 14) odontogenic infected maxillary sinuses were assessed. SMT, RBH, and lateral wall thickness (LWT) were measured. Causes of extraction, RBH in the infection site, and retrospective post-extraction record of SMT were recorded for the thickened SMT group.
Mean SMT for normal SMT group was 1.13 ± 0.43 mm, RBH was 6.26 ± 2.38 mm; upper and lower LWT was 1.85 ± 0.95 mm, and 3.07 ± 2.26 mm, respectively. RBH and LWT had no significant relationships with SMT. For thickened SMT group, mean values for SMT and RBH prior to extraction were 4.53 ± 2.46 mm and 1.97 ± 1.43 mm, respectively. Pre-extraction SMT had a moderately negative correlation with pre-extraction RBH. SMT resolution in thickened SMT group was observed by 2.80 ± 1.37 months post-extraction; post-extraction SMT was not significantly different from normal SMT group (p = .187).
Within the limitation of the sample size, thickened SMT induced by odontogenic infection subsides about 3 months following tooth extraction, and further sinus lifting implant surgery may be considered.
锥形束 CT(CBCT)对上颌窦的术前评估可降低施氏膜穿孔的可能性。本研究检测了有和无施氏膜增厚的患者的施氏膜厚度(SMT)及其与邻近硬组织的关系。对于患有窦感染的患者,我们评估了相对于术前 SMT 和剩余骨高度(RBH)的术后 SMT 尺寸变化。
评估了 93 例需要单牙种植重建的患者的 CBCT 图像,其中无(n=83)和有(n=14)牙源性感染上颌窦。测量 SMT、RBH 和侧壁厚度(LWT)。对于增厚 SMT 组,记录了 SMT 增厚的原因、感染部位的 RBH 以及回顾性的术后 SMT 记录。
正常 SMT 组的平均 SMT 为 1.13±0.43mm,RBH 为 6.26±2.38mm;上壁和下壁 LWT 分别为 1.85±0.95mm 和 3.07±2.26mm。RBH 和 LWT 与 SMT 无显著关系。对于增厚 SMT 组,术前 SMT 和 RBH 的平均值分别为 4.53±2.46mm 和 1.97±1.43mm。术前 SMT 与术前 RBH 呈中度负相关。增厚 SMT 组在术后 2.80±1.37 个月观察到 SMT 分辨率;术后 SMT 与正常 SMT 组无显著差异(p=0.187)。
在样本量的限制内,牙源性感染引起的增厚 SMT 在拔牙后约 3 个月消退,可考虑进一步行鼻窦提升植入手术。