应用CBCT回顾分析牙源性上颌窦病变

［摘要］ 目的 通过回顾CBCT资料评估牙源性上颌窦炎的影像学表现及最易引起牙源性上颌窦炎的牙位。方法 将500例CBCT资料分为正常上颌窦、牙源性上颌窦病变、非牙源性上颌窦病变和无法判断来源的上颌窦病变，并进行统计学分析。结果 牙源性上颌窦炎的影像学表现是发生龋病、不良修复体的上颌后牙或对应牙位有未愈合的拔牙创，无论其是否伴有根尖周病变，该病变牙相应上颌窦底黏膜会呈局部隆突性增厚影像。牙源性上颌窦炎发病率占常人的12.4%，占上颌窦病变病人的48.6%。上颌第一磨牙最易引起牙源性上颌窦炎。发生上颌窦炎，即黏膜增厚>2 mm的病例中，黏膜平均增厚(6.11±4.43) mm。结论 牙源性因素占上颌窦炎发病因素的一半;上颌第一磨牙最易引起牙源性上颌窦炎;CBCT能清晰反映上颌窦的解剖解构及上颌窦炎所引起的变化。

The evaluation of maxillary sinusitis using cone beam computed tomography

Objective: To describe the radiographic features of odontogenic maxillary sinusitis using cone beam computed tomography (CBCT) scans and to determine whether any tooth was more frequently associated with this disease. Methods: 500 CBCT scans were classified as normal sinus, maxillary sinusitis of an odontogenic origin, maxillary sinusitis of a non-odontogenic origin and maxillary sinusitis of an undetermined origin. Result: Sinusitis of odontogenic origin was recognized if it met the following criteria: carious tooth, tooth with defective restoration, or extraction site with or without radiographically periapical lesion and mucosal thickening limited to the area of the tooth or extraction site in question. 124 maxillary sinusitis with possible odongenic origin were detected, which accounted for 48.6% of all the maxillary sinusitis. Maxillary first molar was most likely to be frequently associated with odontogenic sinusitis. In sinuses in which the thickening was more than 2mm, the mean mucosal thickening was 6.11±4.43mm Conclusion: Among patients with maxillary sinusitis, nearly half of the cases appear to be associated with odontogenic pathology. Maxillary first molar is the most likely to cause odontogenic maxillary sinusitis. The use of CBCT scans can provide the accurate anatomic structure of maxillary sinus and the changes in it.