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上颌骨解剖变异和副结构与种植手术的关系:使用锥形束 CT 对 212 例病例进行的观察性回顾性研究。

Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography.

机构信息

Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain.

Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040, Madrid, Spain.

出版信息

Int J Implant Dent. 2022 Nov 28;8(1):59. doi: 10.1186/s40729-022-00459-7.

Abstract

PURPOSE

This study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity.

METHODS

212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes. P < 0.05 was considered statistically significant.

RESULTS

PSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males.

CONCLUSIONS

The use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery.

摘要

目的

本研究使用锥形束 CT(CBCT)分析上颌几种解剖/附属结构的发生率,以及每种类型内的变异情况,评估准确诊断如何最大程度地降低口腔种植手术过程中术中并发症的风险。

方法

分析了 212 例上颌 CBCT 扫描,这些扫描是为了手术计划目的在 18 个月内捕获的。评估了后上牙槽动脉(PSAA)、上颌窦间隔(MSS)和窦内分支(CS)的发生率,以及每个解剖结构在水平和垂直平面上的直径和位置。P 值<0.05 被认为具有统计学意义。

结果

99.1%的病例观察到 PSAAs,其中 intrasinus 型最常见;15.6%的样本中观察到 MSS,主要位于后区且呈矢状位;50%的患者观察到 CS 分支,主要与切牙有关,且男性更为常见。

结论

使用 CBCT 显著增加了明确识别这些解剖结构的可能性。患者之间的差异强调了对个体进行详尽的影像学研究的重要性,以预防手术过程中如 Schneiderian 膜穿孔、神经血管损伤或出血等并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2984/9705638/d30ed0ec4ad9/40729_2022_459_Fig1_HTML.jpg

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