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[上颌窦下壁与上颌磨牙牙根的关系]

[Relationships between the inferior wall of maxillary sinus and the roots of the maxillary molars].

作者信息

Mekhtiev R S, Melnichenko Y M, Kabak S L, Savrasova N A, Zatochnaya V V

机构信息

Educational Establishment ««Belarusian State Medical University», Minsk, Republic of Belarus.

Medical center «LODE», Minsk, Republic of Belarus.

出版信息

Stomatologiia (Mosk). 2023;102(1):52-59. doi: 10.17116/stomat202310201152.

Abstract

OBJECTIVE

The aim of the study is to evaluate the position of the roots of the first and second upper molars relative to the bottom of the maxillary sinus (maxillary sinus) according to cone-beam computed tomography (CBCT).

MATERIAL AND METODS

The CBCT scans of 150 patients (69 men and 81 women) from the database of the X-ray department of the 11th City Clinical Hospital of Minsk who applied for dental care were studied. There are 4 variants of vertical relationships between the roots of the teeth and the lower wall of the maxillary sinus. At the contact of the molar roots and the bottom of the HPV, 3 variants of the horizontal relationship between the roots of the teeth and the bottom of the maxillary sinus in the frontal plane were identified.

RESULTS

The root apices of the maxillary molars can be located below the level of the MSF (type 0; 16.69%), contact with MSF (types 1-2; 72%) or protrude into the sinus cavity (type 3; 11.31%) at a distance of up to 6.49 mm. The roots of the second maxillary molar showed greater proximity to the MSF than the first molar roots and more often protruded into the maxillary sinus. The most common type of horizontal relationship between the molar roots and the MSF, in which the lowest point of the MSF was located centrally between buccal and palatal roots. It was found that the proximity between the roots and the MSF correlates with maxillary sinus vertical dimension. This parameter was significantly greater in type 3 when the roots protruded into the maxillary sinus than in type 0, when there was no contact between the MSF and the root apices of the molar teeth.

CONCLUSION

Significant individual variability in the anatomical relationships between the roots of the maxillary molars and the MSF indicates the need for the mandatory appointment of cone-beam computed tomography in preoperative planning for the extraction of these teeth and/or their endodontic treatment.

摘要

目的

本研究旨在根据锥形束计算机断层扫描(CBCT)评估上颌第一和第二磨牙牙根相对于上颌窦底部的位置。

材料与方法

研究了明斯克市第11城市临床医院放射科数据库中150例申请牙科治疗患者(69名男性和81名女性)的CBCT扫描图像。牙齿牙根与上颌窦下壁之间存在4种垂直关系变体。在磨牙牙根与上颌窦底部接触时,在额平面上确定了牙齿牙根与上颌窦底部之间3种水平关系变体。

结果

上颌磨牙牙根尖可位于上颌窦底平面以下(0型;16.69%)、与上颌窦底接触(1 - 2型;72%)或突入窦腔(3型;11.31%),突入距离可达6.49 mm。上颌第二磨牙牙根比第一磨牙牙根更靠近上颌窦底,且更常突入上颌窦。磨牙牙根与上颌窦底之间最常见的水平关系类型是上颌窦底最低点位于颊根和腭根之间的中央。研究发现,牙根与上颌窦底的接近程度与上颌窦垂直尺寸相关。当牙根突入上颌窦时的3型中该参数显著大于磨牙牙根尖与上颌窦底无接触时的0型。

结论

上颌磨牙牙根与上颌窦底之间解剖关系存在显著个体差异,这表明在这些牙齿拔除和/或根管治疗的术前规划中必须进行锥形束计算机断层扫描。

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