Syverson Abby, Li Chenshuang, Zheng Zhong, Proskurnin Evgenii, Chung Chun-Hsi, Zou Min
Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th St, Philadelphia, PA, 19104, USA.
David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
Clin Oral Investig. 2022 Jul;26(7):5045-5060. doi: 10.1007/s00784-022-04476-z. Epub 2022 Mar 31.
The location of the maxillary sinus significantly affects the orthodontic treatment, particularly when temporary anchorage devices (TADs) are taking place. The current study aims to evaluate the maxillary sinus size and location in a skeletal class II population.
The pre-orthodontic treatment CBCT images of the skeletal class II population were selected. The sinus's volumetric size, height, width, and depth were measured and compared among different skeletal vertical patterns and between genders. In addition, the height and width of the alveolar bone surrounding the maxillary sinus floor were quantified in the same manner.
Patients who displayed a high-angle skeletal pattern had significantly greater maxillary sinus dimensions, shorter vertical distance between the maxillary sinus floor and the alveolar bone crest, and thinner alveolar bone surrounding the maxillary sinus. Meanwhile, the maxillary sinus dimension measurements were positively correlated with the SN-MP angle in both genders but only correlated with ANB angle in females. On the other hand, the vertical distance between the maxillary sinus floor and the alveolar bone crest was negatively correlated with the SN-MP angle in males but the ANB angle in females.
In the skeletal class II population, the high-angle patients faced a higher risk of maxillary sinus perforations by TADs. In addition, gender-related variations were noticed warranting clinical attention, as males have a higher potential for maxillary sinus penetration from TAD placement than females.
Maxillary posterior alveolar TADs are often prescribed to achieve the distalization of maxillary posterior teeth in class II patients. The current study provided more insight into the "safe zone" for TAD placement related to the maxillary sinus.
上颌窦的位置对正畸治疗有显著影响,尤其是在使用临时支抗装置(TADs)时。本研究旨在评估骨性II类人群的上颌窦大小和位置。
选取骨性II类人群正畸治疗前的CBCT图像。测量并比较不同骨性垂直类型以及不同性别之间窦腔的容积大小、高度、宽度和深度。此外,以相同方式对围绕上颌窦底的牙槽骨高度和宽度进行量化。
呈现高角骨性类型的患者上颌窦尺寸显著更大,上颌窦底与牙槽嵴之间的垂直距离更短,且围绕上颌窦的牙槽骨更薄。同时,上颌窦尺寸测量值在两性中均与SN-MP角呈正相关,但仅在女性中与ANB角相关。另一方面,上颌窦底与牙槽嵴之间的垂直距离在男性中与SN-MP角呈负相关,而在女性中与ANB角呈负相关。
在骨性II类人群中,高角患者使用TADs时发生上颌窦穿孔的风险更高。此外,注意到了与性别相关的差异,值得临床关注,因为男性因放置TADs导致上颌窦穿透的可能性高于女性。
上颌后牙区TADs常用于实现II类患者上颌后牙的远中移动。本研究为与上颌窦相关的TADs放置“安全区”提供了更多见解。