Ji Xiao, He Jiawei, Zhang Lan, Huang Dingming
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
, No.14, 3rd section of Ren Min Nan Rd, Chengdu, 610041, Sichuan, China.
BMC Oral Health. 2025 Feb 13;25(1):236. doi: 10.1186/s12903-025-05442-3.
Due to the close relationship between maxillary posterior teeth and maxillary sinus floor (MSF), infection from teeth with endodontic disease may spread into maxillary sinus and cause the occurrence of maxillary sinusitis of endodontic origin (MSEO). Endodontic microsurgical intervention in infected teeth causing MSEO requires careful assessment and planning. This study evaluated the anatomical patterns of MSF using cone-beam computed tomography (CBCT), and further explored their influence on the endodontic microsurgery of MSEO.
A total of 333 CBCT scans were collected between August and December 2023. The classification of MSEO, the degree of mucosal thickening, and the shortest distance from the root apex to MSF were recorded. An improved classification of the anatomical relationships between the teeth and MSF was proposed based on CBCT images. Additionally, the angle at the nadir of MSF, and the divergence angle between the roots and maxillary sinus septa were recorded. Analysis of variance was used to analyze the differences among different groups. A significance level of P < 0.05 was employed.
The anatomical relationship between the root apex and MSF affected the endodontic microsurgery plan of MSEO. Maxillary sinus elevation is needed when MSF is below the line between the buccal and palatal roots, when the root apices contact or protrude into MSF, or when apical lesion is directly connected to the maxillary sinus mucosa. In addition, maxillary sinus mucosal thickening may be more severe when the root apex or apical lesion is close to the maxillary sinus.
The anatomical relationship between maxillary posterior teeth and MSF is an important factor in evaluating and designing endodontic microsurgery for MSEO.
由于上颌后牙与上颌窦底（MSF）关系密切，牙髓病牙齿的感染可能蔓延至上颌窦，导致牙髓源性上颌窦炎（MSEO）的发生。对引发MSEO的感染牙齿进行牙髓显微外科干预需要仔细评估和规划。本研究使用锥形束计算机断层扫描（CBCT）评估MSF的解剖形态，并进一步探讨其对MSEO牙髓显微外科手术的影响。
收集了2023年8月至12月期间的333例CBCT扫描图像。记录MSEO的分类、黏膜增厚程度以及根尖至MSF的最短距离。基于CBCT图像提出了一种改进的牙齿与MSF之间解剖关系的分类方法。此外，记录了MSF最低点的角度以及牙根与上颌窦隔之间的发散角。采用方差分析分析不同组之间的差异。采用P < 0.05的显著性水平。
根尖与MSF之间的解剖关系影响了MSEO的牙髓显微外科手术方案。当MSF位于颊侧和腭侧牙根之间的连线下方、根尖接触或突入MSF或根尖病变直接与上颌窦黏膜相连时，需要进行上颌窦提升。此外，当根尖或根尖病变靠近上颌窦时，上颌窦黏膜增厚可能更严重。
上颌后牙与MSF之间的解剖关系是评估和设计MSEO牙髓显微外科手术的重要因素。
