右上颌窦囊肿误诊为根尖周脓肿1例

上颌窦囊肿为上颌窦常见疾病,虽然生长缓慢,但发展到一定程度后也会出现临床症状。现报道右上颌窦囊肿被误诊为根尖周脓肿1例,并分析其X线片表现和诊断要点。     

上颌窦提升同期种植体植入术的临床应用

目的：研究上颌窦提升术不植入自体骨或人工骨并同期植入种植体的可行性。方法：上颌窦外侧壁开窗，剥离上颌窦粘膜，种植体植入，突入上颌窦底粘膜下之种植体周围充盈血液，4～6个月后修复。结果：6例7颗种植体骨结合良好，无上颌窦炎症发生一结论：上颌窦提升术不植入自体骨或人工骨并同期植入种植体，方法简单，结果肯定，值得推广应用。     

上颌后牙缺失病人上颌窦CBCT影像学特征分析

目的:针对上颌后牙缺失病人的CBCT资料,分析上颌窦内异常影像的发生率,为病人行种植术前的评估提供参考。方法:选择2011-01—03因上颌后牙缺失需行种植修复病人的CBCT资料76例,共152个上颌窦。由两名研究人员对影像资料进行观察分析,影像诊断结果分为5类:①未见异常影像;②窦底黏膜增厚;③上颌窦囊肿;④上颌窦炎;⑤上颌窦分隔。同时测量所有窦底黏膜增厚病例的平均厚度以及缺牙区窦嵴距,使用SPSS 16.0软件进行统计分析。结果:152例上颌窦中未见异常影像者65例(42.76%),黏膜增厚者36例(23.68%),上颌窦囊肿23例(15.13%),上颌窦炎17例(11.18%),上颌窦分隔11例(7.24%)。窦底黏膜增厚厚度为(3.65±1.65)mm,缺牙区窦嵴距为(7.05±2.99)mm。结论:上颌窦异常影像诊断发生率最高者为窦底黏膜增厚,其次为上颌窦囊肿;不同上颌窦影像诊断类型间窦嵴距的差异无统计学意义(P>0.05);不同性别及不同缺牙情况下诊断类型的发生率间差异无统计学意义(P>0.05)。     

闭合式上颌窦挤压提升同期人工牙种植修复45例分析

目的：观察使用Summers骨凿或骨挤压器经牙槽嵴顶闭合式抬高上颌窦底、同期植入种植体的临床效果。方法：对41例45侧后牙缺失患者行上颌窦闭合式提升，必要时植自体骨或人工骨，同时植入种植体。结果：45侧上颌窦剩余牙槽骨平均高度为6．8mm(5～9mm)，用骨凿平均提升上颌窦底高度3．5mm(2～6mm)。2侧上颌窦黏膜被钻穿孔，放弃牙种植。其余43侧上颌窦共植入63颗种植体，长度10～15mm。Ⅱ期手术时，5颗种植体松动拔除。追踪12～48个月，修复后1颗种植牙松动拔除，1颗进行性骨吸收，总成功率达88．9％。所有病例均无上颌窦并发症：结论：上颌窦内提升技术较开窗式上颌窦提升创伤小，操作步骤简单，对有适量剩余牙槽骨的上颌窦区种植可以考虑使用；但由于存在窦底黏膜穿孔风险，技术要求高，同时必须有专用的器械，应慎重使用。在严格控制适应证、掌握种植外科技巧的情况下，开展上颌窦内提升技术是可行的，可以取得较高的成功率。     

关节镜直视下取出误入上颌窦的牙或牙根

目的：介绍一种微创取出进入上颌窦内牙或牙根的方法。方法：2004年3月～2005年2月期间．3例患者在外院拔除上颌磨牙或牙根时，牙或牙根意外进入上颌窦，其中男l例，女2例；平均年龄36．5岁(28-40岁)；l例为左侧上颌第三磨牙，另外2例为上颌第一磨牙牙根。术前全景片证实上颌窦内有高密度异物。经上颌窦前壁开窗．在关节镜直视下取出进入上颌窦的牙或牙根。结果：关节镜直视下成功取出3例误入上颌窦的牙或牙根，术后创口均一期愈合，无任何并发症发生。结论：关节镜直视下取出误入上颌窦的牙或牙根是可行的，具有创伤小、视野清楚、操作时间短等优点；但须具有经过关节镜专门培训的人员方可进行。     

基于螺旋CT影像的计算机辅助重建及测量上颌窦的实验研究

目的：建立一种基于螺旋CT影像的计算机辅助重建及测量上颌窦的方法,为上颌窦辅助诊断、手术治疗提供参考。方法：利用64排螺旋CT对60例正常成人（男30例,女30例）颌骨进行薄层容积扫描,将DICOM数据输入计算机辅助软件Simplant,重建上颌窦,测量相关数据并进行统计学分析。结果：上颌窦前后径均值为（35.12±3.47）mm,上下径均值为（39.58±2.96）mm,左右径均值为（32.14±2.50）mm,上颌窦容积均值为（15187.16±596.12）mm3。左右侧上颌窦径线值和容积无显著差异。男女性上颌窦径线值和容积无显著性差异。结论：利用该方法获得的上颌窦重建影像和测量数据可以为上颌窦影像诊断和手术治疗提供参考。     

上颌窦霉菌病误诊为上颌窦癌2例

上颌窦霉菌病表现的颌面部肿块与恶性肿瘤的肿块甚是相似,临床上容易误诊,为此,特将我科收治的2例典型病例报告如下,以供同仁参考。1　临床资料例1:男,39岁。因左侧面部肿胀伴鼻根部疼痛,左眼流泪半年余,曾在外地医院行抗炎治疗2月无效,后转来我院。外院CT提示左上颌窦内?..     

上颌磨牙缺失患者上颌窦的CBCT影像学特点

目的 :观察上颌磨牙缺失患者上颌窦生理及病理CBCT影像学表现,并分析各类异常的发生率,为种植术前评估提供参考。方法:选择复旦大学附属中山医院口腔科及静安区牙病防治所,2014-01-01—2015-05-01期间,收治的上颌磨牙缺失患者CBCT影像学资料202例,共404侧上颌窦。由2名研究人员对资料进行研究分析,观察项目分为3类:正常上颌窦、上颌窦炎、上颌窦囊肿。测量3种类型病例缺牙区窦嵴距、上颌窦的宽度、外侧骨壁厚度、外侧骨壁血管位置与直径,采用SPSS17.0软件进行统计分析。结果:404侧上颌窦中,正常上颌窦185侧(45.80%);上颌窦炎118侧(29.20%);上颌窦囊肿101侧(25.00%)。结论:上颌窦异常影像诊断发生率最高者为上颌窦炎,其次为上颌窦囊肿;不同上颌窦影像诊断类型间窦嵴距、上颌窦的宽度、外侧骨壁厚度、外侧骨壁血管位置与直径差异均无统计学意义(P>0.05)。     

应用颌面专用CT显示上颌窦与上颌后牙区关系

目的：探讨应用颌面专用CT（QR—DVT 9000 NEWTOM）成像技术，显示上颌窦与上颌后牙区关系的意义。方法：对上颌牙齿拔除、种植牙、肿瘤等需要显示上颌窦与上颌后牙区关系的患者，进行颌面专用CT扫描和重建成像。结果：颌面专用CT成像技术能够分别以水平位、矢状位、冠状位、曲面以及3D影像，清楚地显示出上颌窦与上颌后牙区的解剖关系等信息。结论：应用颌面专用CT显示上颌窦与上颌后牙区的关系具有重要的临床意义，更能有效地指导临床手术。     

上颌窦提升术在重度萎缩上颌骨牙种植中的应用

目的：寻找上颌后牙区骨量不足，种植体易穿上颌窦的解决方法。方法：4例5侧上颌窦行上颌窦底提升、植骨、同期或延期种植体植入要，术后当天1、3、6、12月检查上颌窦与种植体界面结合情况。结果：种植体无松动或脱落，X线显示上颌窦无液平面，种植体周围无阴影。结论：上颌窦提升术可有效解决上颌后部牙缺失后骨量不足，种植易失败的难题。     

Intercepted orthopedic treatment of skeletal maxillary protrusion deformity

Maxillary protrusion deformity may be divided into three types: functional, skeletal and their combination. The diagnosis of which should be differentiated carefully. The treatment of skeletal maxillary protrusion is very difficult. It must be diagnosed in the growing stage of children and treated with intercepted orthopedic appliance in time. In order to bring the mandible into harmony with maxilla, the growth of maxilla should be inhibited while the mandible is stimulated. In this article an efficient orthopedic appliance using orthopedic force to inhibit the growth of maxilla was introduced. The factors which influenced the orthopedic effect were introduced by cases report. The use of the roentgenography cephalometric in diagnosing the maxillary protrusion deformity was discussed.     

上颌骨骨折合并泪道损伤的早期处理及意义

目的:探讨上颌骨骨折合并泪道损伤的处理方法,以及早期处理的重要性。方法:回顾分析27例上颌骨骨折合并泪道损伤的临床资料,按外伤后治疗时间早晚分为2组:伤后10d以内组和10d以后组。泪道损伤患者根据不同的损伤情况给予局部抗生素点眼,冲洗泪道和泪道置管、泪小管吻合术、激光泪道成形术等相应手术治疗,以患者溢泪消失、泪道冲洗通畅为治愈指标。采用χ2检验分析2组间的疗效差异。结果:10d以内组16例经治疗,15例泪道通畅;10d以后组11例经治疗,5例泪道通畅。2组间差异有显著性(P<0.05)。结论:上颌骨骨折合并泪道损伤应引起口腔颌面外科医生的足够重视,早期诊断、早期治疗可获得良好的治疗效果。     

根尖周炎引起的牙源性上颌窦炎的治疗

目的:探讨根管治疗/根管再治疗治疗根尖周炎引起的牙源性上颌窦炎的可行性.方法:临床确诊的根尖周炎引起的牙源性上颌窦炎病例5例,根管治疗/根管再治疗3个月、6个月和12个月复查CBCT.结果:根管治疗/根管再治疗后5例临床病例临床症状消失,3个月和6个月CBCT显示5例临床病例根尖周、上颌窦底和上颌窦内变化不明显,12个...     

颞下间隙恶性肿瘤15例报告

目的　总结颞下间隙恶性肿瘤的临床特点。方法　对我院经治的 15例 (其中 10例接受手术治疗 )患者的诊治情况作回顾性研究。结果　颞下间隙恶性肿瘤多见于青壮年 ,多数可在耳屏前乙状切迹处、上颌结节外侧、咽侧壁出现隆起或包块 ,三叉神经第二、三支的感觉异常 ,张口受限及中线偏移。结论　由于颞下间隙恶性肿瘤临床症状的复杂性和不典型性 ,在上述临床症状持续存在或不断加重时应高度重视 ,及时进行CT检查或穿刺涂片细胞学检查 ,以利早期诊断和治疗。?     

Clinics and therapy of the osteomyelitis of the lower jaw

During the last three decades the clinical picture of osteomyelitis has considerably changed. Acute cases have become rarer than in the past. The outbreak of the disease to be observed in recent times is primarily of a subacute chronic stage. These non-characteristic symptoms make diagnosis more difficult. Acute cases of osteomyelitis are treated with antibiotics; chronic cases should surgically be approached as early as possible. Surgical methods used are above all decortication as well as transplantation of autogenous spongiosa.     

Solitary median maxillary central incisor: a report of 2 cases

A single median maxillary central incisor (SMMCI) is a rare dental anomaly that may occur alone or be associated with growth deficiency or other systemic abnormalities. The best known association is with holoprosencephaly (HPE). HPE is a complex brain malformation that affects both the forebrain and the face. Early diagnosis of SMMCI is important, since it may be a sign of other severe congenital or developmental abnormalities. Therefore, systematic follow-up and close monitoring of the growth and development of SMMCI patients is crucial. The purpose of this paper was to report the cases of 2 children, each with a single median maxillary central incisor, and describe important symptoms of this syndrome that have not yet been reported.     

A review of maxillary sinus cholesterol granuloma

Cholesterol granuloma in sites other than the ear may present to many different specialties. Diagnosis is rarely suspected pre-operatively, and depends on the finding of a characteristic histological picture. It is generally considered that malaeration with haemorrhage into a cavity which is normally aerated is the primary event in the development of this condition. Nine cases of cholesterol granuloma affecting the maxillary sinus are described, together with the radiological appearances in some cases. The main differential diagnosis in these cases were mucoceles of the maxillary antrum, cysts arising within the sinus, or cysts of dental origin, and in those cases showing expansion or erosion of the maxillary sinus, malignant disease. The results of treatment are discussed.     

内窥镜在牙拔除术断根误入上颌窦诊治中的研究

目的研究断根误入上颌窦后利用牙槽窝通路,使用内窥镜诊断及取断根的方法。方法对在拔牙过程中怀疑牙根断入上颌窦的13例病例,使用内窥镜进行诊断,对于明确断根完全进入上颌窦的病例行经牙槽窝直视下取出断根,同时行牙龈黏膜减张严密缝合。对于断根未进入上颌窦的行保守治疗。结果 13例患者中有7例为完全进入上颌窦,采用内窥镜从牙槽窝进入,均成功取出断根。13例病例术后1月黏膜愈合良好,均未出现口腔上颌窦瘘。术后3月除1例患者失访,其余牙槽窝愈合良好。结论利用内窥镜扩大视野可准确判断牙根是否完全进入上颌窦。采用经牙槽窝扩大内窥镜取根法可以在直视下取出进入上颌窦的断根,创伤小,术后恢复良好,是一种微创、快捷的方法。     

Clinicopathologic features of dentigerous cysts in the maxillary sinus

Dentigerous cyst (DC) in the maxillary sinus is extremely rare. This study evaluated the clinical features, etiologic factors, imaging, treatment, and signs and symptoms of this type of DC. Clinical symptoms, radiographic findings, surgical methods, and histopathologic findings of 4 patients with DCs in the maxillary sinus were evaluated. In addition, we reviewed the literature reports of DCs in the maxillary sinus over the past 40 years. Our 4 patients with DC in the maxillary sinus showed the following results: (1) all the patients were males at first 3 decades of age, (2) swelling and/or yellow-green pus discharges from pharyngeal cavity were common symptoms, (3) the involved teeth in the DC were the maxillary third molar teeth and supernumerary teeth, and (4) Caldwell-Luc approach was performed in these 4 patients. The patients with DC in the maxillary sinus should be evaluated thoroughly by extraoral and intraoral examinations, proper diagnostic imaging procedures, and pathologic examination to avoid misdiagnosis of maxillary sinusitis. The standard treatment for DC in the maxillary sinus is often removed by Caldwell-Luc approach. Furthermore, marsupialization or functional endoscopic sinus surgery may be performed because of the size, location of the cysts, or the age of the patients.