Yondon Namuunzul, Erdenechuluun Urangua, Ulziisaikhan Khatanzaya, Munkhtur Nominzaya, Batbayar Enkh-Orchlon, Rashsuren Oyuntugs, Jargaltsogt Delgertsetseg
Dentistry, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar, MNG.
Oral and Maxillofacial Surgery, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar, MNG.
Cureus. 2025 May 21;17(5):e84560. doi: 10.7759/cureus.84560. eCollection 2025 May.
The relationship between the maxillary posterior teeth and the level of the maxillary sinus varies across different populations and can significantly impact the success of endodontic, prosthodontic, orthodontic, and surgical treatments. This study aimed to evaluate the alveolar bone anatomy of maxillary posterior teeth and the vertical relationship to the maxillary sinus in Mongolian adults using cone-beam computed tomography (CBCT) images.
The study was designed as a retrospective study. We selected 30 CBCT images and examined a total of 202 maxillary posterior teeth using these CBCT images. We measured the alveolar bone thickness at six different distances (L1-L6) by millimeter scale, and the vertical relationship between the maxillary sinus and the maxillary molars was classified into five categories according to Kwak's classification. Statistical analyses were done using IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York).
The average distances measured were 1.66±1.10 mm at L1, 2.13±1.00 mm at L2, 3.03±2.21 mm at L3, 6.04±3.50 mm at L4, 2.41±3.54 mm at L5, and 0.74±2.09 mm at L6, with statistical significance (p<0.001). According to Kwak's classification, the most commonly observed types are Type I (82.1%) at the maxillary first premolars, Type III (63.3%) at the maxillary second premolars, Type II (43.3%) at the maxillary first molars, and Type I (43.3%) at the maxillary second molars (p<0.001).
The horizontal distances between the buccal and palatal roots to the alveolar plate were shorter in molars than in premolars due to root numbers, indicating a narrower bone structure that may limit implant stability. Additionally, the vertical distance between the root apex and the maxillary sinus was shortest in second molars, increasing the risk of sinus perforation during implant placement.
上颌后牙与上颌窦水平之间的关系因不同人群而异,并且会显著影响牙髓治疗、修复治疗、正畸治疗及外科治疗的成功率。本研究旨在使用锥形束计算机断层扫描(CBCT)图像评估蒙古族成年人上颌后牙的牙槽骨解剖结构以及与上颌窦的垂直关系。
本研究设计为一项回顾性研究。我们选取了30张CBCT图像,并使用这些CBCT图像检查了总共202颗上颌后牙。我们用毫米尺度测量了六个不同距离(L1-L6)处的牙槽骨厚度,并且根据Kwak分类法将上颌窦与上颌磨牙之间的垂直关系分为五类。使用IBM SPSS Statistics for Windows 27版(2020年发布;IBM公司,纽约州阿蒙克)进行统计分析。
测量的平均距离在L1处为1.66±1.10毫米,L2处为2.13±1.00毫米,L3处为3.03±2.2毫米,L4处为6.04±3.50毫米,L5处为2.41±3.54毫米,L6处为0.74±2.09毫米,具有统计学意义(p<0.001)。根据Kwak分类法,最常观察到的类型在上颌第一前磨牙为I型(82.1%),上颌第二前磨牙为III型(63.3%),上颌第一磨牙为II型(43.3%),上颌第二磨牙为I型(43.3%)(p<0.001)。
由于牙根数量的原因,磨牙颊侧和腭侧牙根至牙槽骨板的水平距离比前磨牙短,这表明骨结构较窄,可能会限制种植体稳定性。此外,第二磨牙根尖与上颌窦之间的垂直距离最短,增加了种植体植入过程中发生窦腔穿孔的风险。