目的:这项研究的目的是提出一种综合的上颌窦(MS)轮廓分类系统,该系统基于锥形束计算机断层扫描(CBCT)检查的解剖特征进行评估,并研究鼻窦轮廓与窦底抬高(SFE)之间的关系。
方法:分析了总共283例上颌骨后牙缺失并接受SFE的CBCT扫描。在每个牙齿位置对MS进行分类。对于颊腭评估,从A型到E的分类是窄锥度,锥度,卵形,正方形,不规则,分别。对于中远端评估,从类型1到类型4的分类是平的,斜坡,凹面,还有隔片,分别。评估的主要解剖参数是(1)残余骨高度(RBH),(2)窦宽度(SW),(3)上颌窦角(MSA),(4)颊倾角(BDA),(5)腭鼻隐窝(PNR),和(6)窦深度。
结果:经过详细计算,对11组MS等高线进行分类。RBH的差异,MSA,BDA,不同组之间的SW差异有统计学意义。窄锥度和斜率MS(A2)组RBH最高(8.66±0.77mm),最大BDA(79.9°±3.18°),最小MSA(19.8°±2.01°),最窄SW(6.30±1.23mm)。最低的RBH在方形和凹窦(D3)组(5.11±2.70mm)。卵形和凹窦(C3)组的BDA最小(50.64±8.73mm),MSA最大(74.11°±11.52°)。方形和扁平MS(D1)组的SW最宽(19.13±3.69mm)。在SW和MSA之间观察到显着的正相关(r=0.67),在SW和BDA之间观察到显着的负相关(r=-0.65)。PNR的患病率(平均角度:104.06°±16.83°,平均身高:14.72±11.78mm)为38%,在卵形和斜坡MS(C2)组中经常观察到。
结论:尽管在不同的牙齿部位有某些特征,相同的牙齿位置使用不同的分类系统进行不同的分类,指示MS的大的解剖变异。本文提出的分类系统允许基于单个牙齿部位的一般特征进行分类。旨在帮助外科医生改善术前评估。
OBJECTIVE: The aim of this study was to propose a comprehensive maxillary sinus (MS) contour classification system based on the evaluation of anatomical characteristics from cone beam computed tomography (CBCT) examination and investigate the relationship between sinus contours and sinus floor elevation (SFE).
METHODS: A total of 283 CBCT scans from patients who had single tooth loss in the posterior maxilla and underwent SFE were analyzed. The MS was classified at each tooth position. For buccal-palatal evaluation, the classification from Type A to E was narrow-taper, taper, ovoid, square, and irregular, respectively. For mesial-distal evaluation, the classification from Type 1 to 4 was flat, slope, concave, and septa, respectively. The major anatomical parameters evaluated were (1) residual bone height (RBH), (2) sinus width (SW), (3) maxillary sinus angle (MSA), (4) buccal dip angle (BDA), (5) palatonasal recess (PNR), and (6) sinus depth.
RESULTS: Eleven groups of MS contour were classified after detailed calculation. Differences in the RBH, MSA, BDA, and SW among different groups were statistically significant. The narrow-taper and slope MS (A2) group had the highest RBH (8.66 ± 0.77 mm), largest BDA (79.9° ± 3.18°), smallest MSA (19.8° ± 2.01°), and narrowest SW (6.30 ± 1.23 mm). The lowest RBH was in the square and concave sinus (D3) group (5.11 ± 2.70 mm). The ovoid and concave sinus (C3) group had the smallest BDA (50.64 ± 8.73 mm) and largest MSA (74.11° ± 11.52°). The square and flat MS (D1) group had the widest SW (19.13 ± 3.69 mm). A strongly significant positive correlation was observed between the SW and MSA (r = 0.67) and a strongly negative correlation between the SW and BDA (r = - 0.65). The prevalence of PNR (mean angle: 104.06° ± 16.83°, mean height: 14.72 ± 11.78 mm) was 38% and frequently observed in the ovoid and slope MS (C2) group.
CONCLUSIONS: Despite certain characteristics at different tooth sites, the same tooth position was categorized differently using different classification systems, indicating large anatomical variations in the MS. The classification system proposed herein allows for classification based on general characteristics at a single tooth site, aiming to help surgeons in improving presurgical evaluation.