589例患者666个上颌窦底提升术前上颌窦解剖变异及病变的CBCT观测研究
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摘要
目的:探讨国人上颌窦底提升术前解剖形态学特点。方法:纳入行上颌窦底提升术的患者589人666个上颌窦。应用CBCT观测缺牙后上颌窦解剖形态及变异。结果:在666个上颌窦中,上颌窦分隔的发生率为30. 48%。上颌窦黏膜厚度≤2 mm占60. 36%。上颌窦外侧壁的厚度平均为(1. 38±0. 05) mm。上牙槽后动脉的检出率为66. 52%。上颌窦底骨质缺如的发生率为4. 35%。上颌窦宽度平均为(14. 20±0. 19) mm。上颌窦囊肿的检出率为11. 41%。结论:CBCT检查能够比较全面客观的反映上颌窦解剖形态的差异,为评估手术风险及术中操作提供参考依据。
Objective: To observe the anatomic variations and lesions of maxillary sinus by CBCT before sinus augmentation in Chinese patients with edentulous posterior maxilla. Methods: 589 participants with 666 sinuses were enrolled in this study. The anatomic variations and lesions of maxillary sinus were examined by CBCT prior to sinus augmentation surgery. Results: In all 666 sinuses,the prevalence of septa was 30. 48%,membrane thickness ≤2 mm was 60. 36%,the average thickness of the lateral wall was( 1. 38 ± 0. 05) mm,the prevalence of posterior superior alveolar artery in the sinus was 66. 52%,the average diameter of the artery was( 0. 98 ± 0. 03) mm,the discontinuity of the sinus floor was 4. 35%,the mean width of maxillary sinus was( 14. 20 ± 0. 19)mm,and the prevalence of cyst was 11. 41%. Conclusion: CBCT can reveal the sinus diversity and provide the information for the safe and effective sinus augmentation.
Objective: To observe the anatomic variations and lesions of maxillary sinus by CBCT before sinus augmentation in Chinese patients with edentulous posterior maxilla. Methods: 589 participants with 666 sinuses were enrolled in this study. The anatomic variations and lesions of maxillary sinus were examined by CBCT prior to sinus augmentation surgery. Results: In all 666 sinuses,the prevalence of septa was 30. 48%,membrane thickness ≤2 mm was 60. 36%,the average thickness of the lateral wall was( 1. 38 ± 0. 05) mm,the prevalence of posterior superior alveolar artery in the sinus was 66. 52%,the average diameter of the artery was( 0. 98 ± 0. 03) mm,the discontinuity of the sinus floor was 4. 35%,the mean width of maxillary sinus was( 14. 20 ± 0. 19)mm,and the prevalence of cyst was 11. 41%. Conclusion: CBCT can reveal the sinus diversity and provide the information for the safe and effective sinus augmentation.
引文
[1]Beaumont C,Zafiropoulos GG,Rohmann K,et al.Prevalence of maxillary sinus disease and abnormalities in patients scheduled for sinus lift procedures[J].J Periodontol,2005,76(3):461-467.
[2]Aimetti M,Romagnoli R,Ricci G,et al.Maxillary sinus elevation:the effect of macrolacerations and microlacerations of the sinus membrane as determined by endoscopy[J].Int J Periodontics Restorative Dent,2001,21(6):581-589.
[3]Tatum H.Maxillary and sinus implant reconstruction[J].Dent Clin North Am,1986,30:207-229.
[4]Boyne PJ,James RA.Grafting of the maxillary sinus floor with autogenous marrow and bone[J].J Oral Surg,1980,38(8):613-616.
[5]Summers RB.A new concept in maxillary implant surgery:The osteotome technique[J].Compendium,1994,15(2):152,154-156,162.
[6]牛一山,李志军.青年上颌窦窦底结构的影像解剖学研究[J].实用口腔医学杂志,2011,27(3):410-412.
[7]van den Bergh JP,ten Bruggenkate CM,Disch FJ,et al.Anatomical aspects of sinus floor elevations[J].Clin Oral Implants Res,2000,11(3):256-265.
[8]Mozzo P,Procacci C,Tacconi A,et al.A new volumetric CT machine for dental imaging based on the cone-beam technique:Preliminary results[J].Eur Radiol,1998,8(9):1558-1564.
[9]Lana JP,Carneiro PM,Machado Vde C,et al.Anatomic variations and lesions of the maxillary sinus detected in cone beam computed tomography for dental implants[J].Clin O-ral Implants Res,2012,23(12):1398-1403.
[10]Underwood AS.An inquiry into the anatomy and pathology of the maxillary sinus[J].J Anat Physiol,1910,44(Pt4):354-369.
[11]González-Santana H,Pe1arrocha-Diago M,Guarinos-CarbóJ,et al.A study of the septa in the maxillary sinuses and the subantral alveolar processes in 30 patients[J].J Oral Implantol,2007,33(6):340-343.
[12]Khojastehpour L,Dehbozorgi M,Tabrizi R,et al.Evaluating the anatomical location of the posterior superior alveolar artery in cone beam computed tomography images[J].Int JOral Maxillofac Surg,2016,45(3):354-358.
[13]Zijderveld SA,van den Bergh JP,Schulten EA,et al.Anatomical and surgical findings and complications in 100 consecutive maxillary sinus floor elevation procedures[J].J O-ral Maxillofac Surg,2008,66(7):1426-1438.
[14]Schwartz-Arad D,Herzberg R,Dolev E.The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival[J].J Periodontol,2004,75(4):511-516.
[15]Ulm CW,Solar P,Krennmair G,et al.Incidence and suggested surgical management of septa in sinus-lift procedures[J].Int J Oral Maxillofac Implants,1995,10(4):462-465.
[16]Wen SC,Lin YH,Yang YC,et al.The influence of sinus membrane thickness upon membrane perforation during transcrestal sinus lift procedure[J].Clin Oral Implants Res,2015,26(10):1158-1164.
[17]杜良智,冯海楠,常晓峰,等.超声骨刀在上颌窦底外提升术中的临床应用观察[J].实用口腔医学杂志,2014,30(5):689-692.
[18]Avila G,Wang HL,Galindo-Moreno P,et al.The influence of the bucco-palatal distance on sinus augmentation outcomes[J].J Periodontol,2010,81(7):1041-1050.
[19]Chan HL,Suarez F,Monje A,et al.Evaluation of maxillary sinus width on cone-beam computed tomography for sinus augmentation and new sinus classification based on sinus width[J].Clin Oral Implants Res,2014,25(6):647-652.
[20]Kara IM,Kücük D,Polat S.Experience of maxillary sinus floor augmentation in the presence of antral pseudocysts[J].J Oral Maxillofac Surg,2010,68(7):1646-1650.
[21]Meer S,Altini M.Cysts and pseudocysts of the maxillary antrum revisited[J].SADJ,2006,61(1):10-13.
[22]Gardner DG.Pseudocysts and retention cysts of the maxillary sinus[J].Oral Surg Oral Med Oral Pathol,1984,58(5):561-567.
[23]Lin Y,Hu X,Metzmacher AR,et al.Maxillary sinus augmentation following removal of a maxillary sinus pseudocyst after a shortened healing period[J].J Oral Maxillofac Surg,2010,68(11):2856-2860.
[2]Aimetti M,Romagnoli R,Ricci G,et al.Maxillary sinus elevation:the effect of macrolacerations and microlacerations of the sinus membrane as determined by endoscopy[J].Int J Periodontics Restorative Dent,2001,21(6):581-589.
[3]Tatum H.Maxillary and sinus implant reconstruction[J].Dent Clin North Am,1986,30:207-229.
[4]Boyne PJ,James RA.Grafting of the maxillary sinus floor with autogenous marrow and bone[J].J Oral Surg,1980,38(8):613-616.
[5]Summers RB.A new concept in maxillary implant surgery:The osteotome technique[J].Compendium,1994,15(2):152,154-156,162.
[6]牛一山,李志军.青年上颌窦窦底结构的影像解剖学研究[J].实用口腔医学杂志,2011,27(3):410-412.
[7]van den Bergh JP,ten Bruggenkate CM,Disch FJ,et al.Anatomical aspects of sinus floor elevations[J].Clin Oral Implants Res,2000,11(3):256-265.
[8]Mozzo P,Procacci C,Tacconi A,et al.A new volumetric CT machine for dental imaging based on the cone-beam technique:Preliminary results[J].Eur Radiol,1998,8(9):1558-1564.
[9]Lana JP,Carneiro PM,Machado Vde C,et al.Anatomic variations and lesions of the maxillary sinus detected in cone beam computed tomography for dental implants[J].Clin O-ral Implants Res,2012,23(12):1398-1403.
[10]Underwood AS.An inquiry into the anatomy and pathology of the maxillary sinus[J].J Anat Physiol,1910,44(Pt4):354-369.
[11]González-Santana H,Pe1arrocha-Diago M,Guarinos-CarbóJ,et al.A study of the septa in the maxillary sinuses and the subantral alveolar processes in 30 patients[J].J Oral Implantol,2007,33(6):340-343.
[12]Khojastehpour L,Dehbozorgi M,Tabrizi R,et al.Evaluating the anatomical location of the posterior superior alveolar artery in cone beam computed tomography images[J].Int JOral Maxillofac Surg,2016,45(3):354-358.
[13]Zijderveld SA,van den Bergh JP,Schulten EA,et al.Anatomical and surgical findings and complications in 100 consecutive maxillary sinus floor elevation procedures[J].J O-ral Maxillofac Surg,2008,66(7):1426-1438.
[14]Schwartz-Arad D,Herzberg R,Dolev E.The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival[J].J Periodontol,2004,75(4):511-516.
[15]Ulm CW,Solar P,Krennmair G,et al.Incidence and suggested surgical management of septa in sinus-lift procedures[J].Int J Oral Maxillofac Implants,1995,10(4):462-465.
[16]Wen SC,Lin YH,Yang YC,et al.The influence of sinus membrane thickness upon membrane perforation during transcrestal sinus lift procedure[J].Clin Oral Implants Res,2015,26(10):1158-1164.
[17]杜良智,冯海楠,常晓峰,等.超声骨刀在上颌窦底外提升术中的临床应用观察[J].实用口腔医学杂志,2014,30(5):689-692.
[18]Avila G,Wang HL,Galindo-Moreno P,et al.The influence of the bucco-palatal distance on sinus augmentation outcomes[J].J Periodontol,2010,81(7):1041-1050.
[19]Chan HL,Suarez F,Monje A,et al.Evaluation of maxillary sinus width on cone-beam computed tomography for sinus augmentation and new sinus classification based on sinus width[J].Clin Oral Implants Res,2014,25(6):647-652.
[20]Kara IM,Kücük D,Polat S.Experience of maxillary sinus floor augmentation in the presence of antral pseudocysts[J].J Oral Maxillofac Surg,2010,68(7):1646-1650.
[21]Meer S,Altini M.Cysts and pseudocysts of the maxillary antrum revisited[J].SADJ,2006,61(1):10-13.
[22]Gardner DG.Pseudocysts and retention cysts of the maxillary sinus[J].Oral Surg Oral Med Oral Pathol,1984,58(5):561-567.
[23]Lin Y,Hu X,Metzmacher AR,et al.Maxillary sinus augmentation following removal of a maxillary sinus pseudocyst after a shortened healing period[J].J Oral Maxillofac Surg,2010,68(11):2856-2860.