国际口腔医学杂志

国际口腔医学杂志 ›› 2023, Vol. 50 ›› Issue (3): 302-307.doi: 10.7518/gjkq.2023027

• 论著 • 上一篇    下一篇

上颌窦黏膜增厚的锥形束CT影像分析

杨雨楠1(),刘鹏1,王虎2(),游梦2   

  1. 1.口腔疾病与生物医学重庆市重点实验室;重庆市高校市级口腔生物医学工程重点实验室;重庆医科大学附属口腔医院放射科 重庆 401147
    2.口腔疾病研究国家重点实验室;国家口腔疾病临床医学研究中心;四川大学华西口腔医院放射科 成都 610041
  • 收稿日期:2022-11-20 修回日期:2023-02-11 出版日期:2023-05-01 发布日期:2023-05-16
  • 通讯作者: 王虎
  • 作者简介:杨雨楠，医师，硕士，Email：yangyn@hospital.cqmu.edu.cn

Evaluation of maxillary sinusitis with cone beam computed tomography

Yang Yunan1(),Liu Peng1,Wang Hu2(),You Meng2   

  1. 1.Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences & Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education & Dept. of Radiology, Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China
    2.State Key Laboratory of Oral Disea-ses & National Clinical Research Center for Oral Diseases & Dept. of Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2022-11-20 Revised:2023-02-11 Online:2023-05-01 Published:2023-05-16
  • Contact: Hu Wang

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摘要：

目的 运用锥形束CT（CBCT）研究牙源性因素对上颌窦黏膜增厚的影响，同时，通过对上颌窦黏膜增厚的随访，研究口腔治疗的作用。 方法 回顾性分析2017年8—12月四川大学华西口腔医院就诊的患者，通过CBCT图像筛选出上颌窦最大黏膜厚度>2 mm的患者，评估上颌窦底及上颌窦黏膜增厚与患牙的关系，同时，记录患牙及其治疗的情况，观察随访前后上颌窦黏膜增厚的变化。 结果 黏膜厚度与炎症距窦底的距离呈极弱负相关（P<0.05，r=-0.154），而根尖距窦底的距离与黏膜厚度无直接相关性（P>0.05）。在治疗组中，窦底破坏组的黏膜厚度变化较窦底连续组大，黏膜厚度变化与根尖距窦底的距离呈弱负相关（P<0.01，r=-0.382），黏膜厚度变化与炎症距窦底的距离呈中等程度负相关（P<0.001，r=-0.524）。 结论 上颌窦炎的严重程度可能更大程度上取决于根尖周炎症边缘距窦底的远近而与单纯的根尖位置没有明显的关系。但从治疗效果来讲，炎症病变离上颌窦越近，上颌窦底越易被破坏，上颌窦炎受牙源性因素影响越大，口腔治疗的效果也越好。

关键词: 上颌窦, 黏膜增厚, 牙源性上颌窦炎, 锥形束CT

Abstract:

Objective The present study aimed to analyze the influence of odontogenic factors on maxillary sinus mucosal thickening using cone beam computed tomography (CBCT). Simultaneously, this study evaluated the effect of dental treatment on maxillary sinus mucosal thickening through the follow-up. Methods This study retrospectively reviewed patients with mucosal thickness thickened more than 2 mm in the maxillary sinus selected by CBCT in West China Hospital of Stomatology, Sichuan University from August 2017 to December 2017. Herein, the relationship between the floor of the maxillary sinus and the affected teeth was evaluated while the affected teeth and relevant dental treatment were recorded, and the changes in maxillary sinus mucosal thickening were observed. Results A very weak negative correlation was found between the mucosal thickness and the distance from the inflammation to the sinus floor (P<0.05, r=-0.154), whereas the distance from the root apex to the sinus floor had no direct correlation with the mucosal thickness (P>0.05). In the treatment group, the change of mucosal thickness in the sinus floor destruction group was larger than that in the continuous sinus floor group. In addition, the change in mucosal thickness was weakly negatively correlated with the distance from the root apex to the sinus floor (P<0.01, r=-0.382), meanwhile the change in mucosal thickness was moderately negatively correlated with the distance from inflammation to sinus floor (P<0.001, r=-0.524). Conclusion The severity of maxillary sinusitis may be more dependent on the distance of the periapical inflammatory margin from the sinus floor rather than the simple apical position. On the contrary, the closer the inflammation is to the maxillary sinus, the larger destruction of the maxillary sinus floor. Furthermore, the greater the influence of odontogenic factors on maxillary sinusitis, the better the effect of the oral treatment.

Key words: maxillary sinus, mucosal thickening, odontogenic maxillary sinusitis, cone beam computed tomography

中图分类号: 

  • R 781.34

图 1

在CBCT矢状位及冠状位测量上颌窦最大黏膜厚度A：随访前矢状位；B：随访前冠状位；C：随访后矢状位；D：随访后冠状位。"

图 2

测量矢状位和冠状位的最短距离A：矢状位测量根尖病变与上颌窦底的最短距离；B：冠状位测量根尖病变与上颌窦底的最短距离；C：矢状位测量根尖与上颌窦底的最短距离；D：冠状位测量根尖与上颌窦底的最短距离。"

表 1

不同组病例基本资料"

分组例数年龄/岁男/女
无患牙16021.70±10.3475/85
有患牙未治疗13744.07±14.1273/64
有患牙且治疗9342.33±12.0448/45

图3

黏膜厚度与炎症距上颌窦底距离的相关性"

图4

不同组的黏膜厚度变化差异**：P<0.01。"

表 2

治疗组与未治疗组中窦底连续性对黏膜厚度变化的影响"

分组窦底连续组黏膜厚度变化/mm窦底破坏组黏膜厚度变化/mmP值
治疗组0.75±4.525.06±6.22<0.001
未治疗组0.27±2.761.80±2.93>0.05

图5

黏膜厚度变化与根尖距上颌窦底距离的相关性"

图6

黏膜厚度变化与炎症距上颌窦底距离的相关性"

《咬合重建病例集——短面型病例》出版发行"

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