Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Ratchathewi District, 6, Yothi Road, Bangkok, Thailand.
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Ratchathewi District, No. 6, Yothi Road, Bangkok, 10400, Thailand.
Odontology. 2024 Jan;112(1):287-298. doi: 10.1007/s10266-023-00833-w. Epub 2023 Jul 5.
The study aimed to (a) investigate the amount and characteristics of the surrounding bone of protruded molar roots into the maxillary sinus using cone-beam computed tomography (CBCT) and (b) assess the correlation between the amount of bone with panoramic high-risk signs. Radiographs of 408 roots protruding beyond the sinus floor were evaluated. Axial CBCT images were used to investigate then classify eight characteristics of surrounding bone: no bone; bone < half the root girth in the proximal or buccal-palatal aspect; bone covering half the root girth in the proximal or buccal-palatal aspect; bone > half the root girth in the proximal or buccal-palatal aspect; and, complete bone. These were then grouped into four degrees of bone support: no bone; bone ≤ half the root girth; bone > half the root girth; and, complete bone. Panoramic signs were subclassified as: projection of root; interruption of the sinus floor; darkening of the root; upward curving of the sinus floor; absence of periodontal ligament space; and, absence of the lamina dura. Correlation between the degree of bone and the panoramic signs was evaluated using the Chi-square or Fisher's exact tests. Positive and negative predictive values, sensitivity, specificity, accuracy, and receiver operating characteristic analysis were calculated. Complete bone support was the most common. 'Projection of root' had a high negative predictive value and sensitivity. 'Absence of the periodontal ligament space and lamina dura' had a high positive predictive value, specificity, accuracy, and area under the curve. These two signs were significantly correlated with the degree of bone support.
本研究旨在（a）使用锥形束 CT（CBCT）研究上颌窦内突出磨牙根周围的骨量和特征，（b）评估骨量与全景高危征象之间的相关性。评估了 408 个超出窦底的牙根。使用轴向 CBCT 图像研究并分类周围骨的 8 种特征：无骨；根近远中或颊腭侧骨<根周长的一半；根近远中或颊腭侧骨覆盖根周长的一半；根近远中或颊腭侧骨>根周长的一半；以及完整骨。然后将其分为四个骨支持程度：无骨；骨≤根周长的一半；骨>根周长的一半；以及完整骨。全景征象被细分为：根突；窦底中断；根变暗；窦底向上弯曲；牙周膜间隙缺失；以及无硬骨板。使用卡方检验或 Fisher 确切检验评估骨量与全景征象之间的相关性。计算阳性和阴性预测值、敏感性、特异性、准确性和接收者操作特征分析。完整的骨支持是最常见的。“根突”具有高阴性预测值和敏感性。“牙周膜间隙和硬骨板缺失”具有高阳性预测值、特异性、准确性和曲线下面积。这两个征象与骨支持程度显著相关。
