Zadsirjan Saeede, Sheikhi Mahnaz, Dakhilalian Ali, Feli Mojgan
Dept. of Endodontics, Dental School, Shahid Beheshti University of Medical Science, Tehran, Iran.
Torabinejad Dental Research Center, Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
J Dent (Shiraz). 2021 Dec;22(4):273-280. doi: 10.30476/DENTJODS.2021.87286.1254.
Odontogenic infections such as periapical lesions (PLs) can cause changes in the adjacent tissues. Infection of the maxillary posterior teeth can be easily transmitted to the maxillary sinus and cause changes in the maxillary sinus mucosa. Cone-beam computed tomography (CBCT) has high accuracy and sensitivity for detection of odontogenic lesions and is efficient for maxillary sinus assessment.
This study aimed to assess the maxillary sinuses for abnormalities such as mucosal thickening, polyps, and periostitis, and evaluate the periapical status of maxillary posterior teeth considering the presence of PLs, their size and distance from the sinus floor by evaluating CBCT images.
This retrospective, cross-sectional study evaluated the CBCT scans of 143 patients, depicting the posterior maxilla with at least one premolar or molar tooth present in this region. Sinus abnormalities (mucosal thickening, sinus polyps, and periostitis) and presence/ absence of PLs, its size, and its distance from the sinus floor were all assessed on CBCT scans. Data were analyzed using the Chi-square test in SPSS version 21 (a= 0.05).
PLs were observed in 31.2% of the cases. In presence of PLs, mucosal thickening was noted in 56.8%, sinus polyps in 29.6% and periostitis in 1.3% of the maxillary sinuses. All teeth with a CBCT periapical index (CBCTPAI) score of 5 were associated with sinus abnormalities; there was neither correlation between the sizes of lesions, nor their distance from the sinus floor with sinus abnormalities (> 0.05).
PLs in the posterior maxilla have a direct correlation with the maxillary sinus abnormalities. However, the size or distance of PLs from the sinus floor had no significant effect on the frequency of sinus abnormalities.
牙源性感染，如根尖周病变（PLs），可导致相邻组织发生变化。上颌后牙的感染很容易传播至上颌窦，并引起上颌窦黏膜的变化。锥形束计算机断层扫描（CBCT）在检测牙源性病变方面具有很高的准确性和敏感性，并且在上颌窦评估中效率很高。
本研究旨在通过评估CBCT图像，对上颌窦进行评估，以检测诸如黏膜增厚、息肉和骨膜炎等异常情况，并考虑PLs的存在、其大小以及与窦底的距离，评估上颌后牙的根尖周状况。
本回顾性横断面研究评估了143例患者的CBCT扫描图像，这些图像描绘了上颌后部区域至少有一颗前磨牙或磨牙的情况。在CBCT扫描图像上评估窦异常（黏膜增厚、鼻窦息肉和骨膜炎）以及PLs的存在与否、其大小及其与窦底的距离。使用SPSS 21版软件中的卡方检验对数据进行分析（α = 0.05）。
在31.2%的病例中观察到PLs。在存在PLs的情况下，56.8%的上颌窦出现黏膜增厚，29.6%出现鼻窦息肉，1.3%出现骨膜炎。所有CBCT根尖指数（CBCTPAI）评分为5的牙齿均与鼻窦异常有关；病变大小及其与窦底的距离与鼻窦异常之间均无相关性（>0.05）。
上颌后部的PLs与上颌窦异常直接相关。然而，PLs的大小或其与窦底的距离对鼻窦异常的发生率没有显著影响。
