Dept. of Endodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao 266001, China.
Medical College of Dalian University, Dalian 116622, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2024 Oct 1;42(5):644-651. doi: 10.7518/hxkq.2024.2024164.
This study aimed to evaluate the thickening of sinus membrane, which is also named Schneiderian membrane (SM), in patients and its relationship with periapical lesions (PAL) in the posterior maxillary region to provide reference for the prevention and treatment of odontogenic maxillary sinusitis.
A retrospective analysis was conducted on 554 cone beam computed tomography (CBCT) imaging data of maxillary sinuses from 301 patients who met the inclusion criteria to determine the correlation between PAL and SM thickening in the posterior maxillary region. Cases of pathological SM were recorded and classified on the basis of the degree and type of SM thickening. The correlation between SM thickening and the diameter of PAL, the relationship between the upper edge of PAL and the maxillary sinus floor, and its relationship with whether affected teeth with PAL undergo root canal treatment were evaluated.
The detection rate of SM thickening in patients with PAL was significantly higher than in those without PAL, so PAL was correlated with SM thickening. Analysis on the correlation between PAL detection indicators and SM thickening degree showed that SM thickening degree was positively correlated with PAL diameter (cone beam computed tomography-periapical index) and not correlated with the three spread effects between the upper edge of PAL and the maxillary sinus floor, as well as whether the teeth with PAL undergo root canal treatment. The correlation analysis between PAL detection indicators and SM thickening types showed that whether the teeth with PAL undergo root canal treatment was not correlated with SM thickening types, and the diameter of PAL, the three spread effects between the upper edge of PAL, and the maxillary sinus floor were not correlated with SM thickening types.
The PAL of posterior maxillary teeth is closely related to SM thickening, and the diameter of PAL is positively correlated with the degree of SM thickening. Patients with PAL who have undergone root canal treatment often exhibit SM polyp thickening. In addition, the relationship between the upper edge of PAL and the maxillary sinus floor does not affect the possibility of SM development.
本研究旨在评估上颌窦黏膜增厚（也称为 Schneiderian 膜，SM），并探讨其与上颌窦后区根尖周病变（PAL）的关系，为预防和治疗牙源性上颌窦炎提供参考。
对 301 例符合纳入标准的上颌窦锥形束 CT（CBCT）影像学资料进行回顾性分析，以确定上颌窦后区 PAL 与 SM 增厚的相关性。记录病理性 SM 病例，并根据 SM 增厚的程度和类型进行分类。评估 SM 增厚与 PAL 直径、PAL 上缘与上颌窦底的关系及其与是否对伴有 PAL 的患牙进行根管治疗的关系。
PAL 患者 SM 增厚的检出率明显高于无 PAL 患者，因此 PAL 与 SM 增厚相关。对 PAL 检出指标与 SM 增厚程度的相关性分析显示，SM 增厚程度与 PAL 直径（CBCT-根尖指数）呈正相关，与 PAL 上缘与上颌窦底的三个扩展效应及是否对伴有 PAL 的患牙进行根管治疗无关。PAL 检出指标与 SM 增厚类型的相关性分析显示，是否对伴有 PAL 的患牙进行根管治疗与 SM 增厚类型无关，PAL 直径、PAL 上缘与上颌窦底的三个扩展效应与 SM 增厚类型也无关。
上颌窦后区牙的 PAL 与 SM 增厚密切相关，PAL 直径与 SM 增厚程度呈正相关。接受根管治疗的 PAL 患者常表现为 SM 息肉样增厚。此外，PAL 上缘与上颌窦底的关系不影响 SM 发生的可能性。
