锥形束CT研究上颌磨牙根尖与上颌窦底壁的解剖关系

目的采用锥形束CT,观测上颌磨牙根尖与上颌窦底壁的解剖关系,并进行分类,为治疗方案的制定和操作风险评估提供解剖学依据。方法从宿迁口腔医院影像科数据库中筛选出60位成年人,120侧上颌磨牙区锥形束CT影像,对其进行重建,测量磨牙根尖与上颌窦底壁的距离,并按照Shahbazian M分类法进行分析。结果上颌第一磨牙远中颊侧根距离上颌窦底壁的距离最小。分类中出现最多的为Ⅰ型(41.67%),最易引起上颌窦炎的Ⅳ型约占总数的19.85%,且上颌第一磨牙的远颊侧根出现Ⅳ型最多(29.17%)。结论上颌磨牙根尖与上颌窦底壁的关系个体差异较大。因此临床上,涉及该区域的治疗,需个性化的制定治疗方案,增加治疗的成功率且减少医源性问题。

The anatomical relationship between the root apex of the maxillary molars and maxillary sinus floor in Cone-beam Computed Tomography images

Objective To measure and classify the anatomical relationship between the root apex of the maxillary molars and maxil-lary sinus floor with Cone-beam Computed Tomography, and to provide anatomical reference for clinical diagnosis and treatment as well as the assessment of operational risks. Methods CBCT images of 120 lateral maxillary molars in 60 healthy patients were selected from the database of the department of radiology of Suqian stomatological hospital. The distance between the maxillary sinus floor and root apex of the maxillary molars was measured with the 3-dimensional computed tomography images using CBCT. The relationship be-tween the maxillary sinus and the root apex of the maxillary molars was classified into 4 types by Shahbazian M method. Results The distance of buccal-distal root apex of first maxillary molar was the shortest. Among four types, the most common type was type Ⅰ(41. 67%), typeⅣ(19. 85%) was most likely to cause maxillary sinusitis, and typeⅣ(29. 17%) occurred most in the buccal-dis-tal apex of first molar. Conclusion The relationship between the maxillary sinus floor and root apex of the maxillary molars is individ-ually different. Therefore, to improve the success rate of treatment and reduce the medical problem, the therapeutic schedules should be designed individually.