中国实用口腔科杂志

中国实用口腔科杂志

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基于锥形束CT分析罹患重度牙周炎磨牙对应上颌窦黏膜厚度特点的初步研究

blank">张波a，blank">曹洁a，blank">胡文杰a，blank">甄敏a，blank">杨刚a，blank">徐涛a，b   

  1. 北京大学口腔医学院·口腔医院a牙周科，b急诊科；口腔疾病国家临床研究中心；口腔数字化医疗技术和材料国家工程实验室；口腔数字医学北京市重点实验室，北京  100081
  • 出版日期:2018-11-15 发布日期:2018-12-12
  • 基金资助:

    北京市科学技术委员会首都临床特色应用研究基金（Z161100000516042）；首都卫生发展科研专项基金（2011-4025-04）

  • Online:2018-11-15 Published:2018-12-12

摘要：

目的　运用锥形束CT（cone-beam computed tomography，CBCT）分析罹患重度牙周炎磨牙对应上颌窦黏膜厚度特点及患牙拔除同期行位点保存术后6个月黏膜厚度的变化。方法　选取2016年2月至2017年11月于北京大学口腔医院牙周科就诊的因罹患重度牙周炎而需拔除上颌磨牙患者8例，设其为试验组；选取同期于北京大学口腔医院牙周科就诊的上颌磨牙牙槽骨轻度吸收患者8例，设其为对照组。应用CBCT测量两组磨牙对应上颌窦黏膜最大厚度（maximum membrane thickness，maxMT）及磨牙最小剩余牙槽骨高度（minimum residual ridge height，minRRH）。试验组患牙拔除同期行位点保存术后6个月，测量拔除患牙对应的上颌窦黏膜maxMT。结果　试验组上颌窦黏膜maxMT为（4.06 ± 1.80）mm，黏膜增厚的上颌窦比例为87.5%，磨牙minRRH为（1.09 ± 0.68）mm；对照组上颌窦黏膜maxMT为（1.42 ± 0.38）mm，无上颌窦黏膜增厚，磨牙minRRH为（8.50 ± 1.72）mm，两组间测量指标比较，差异均有统计学意义（P < 0.05）。试验组患牙拔除清创同期行位点保存术后6个月上颌窦黏膜maxMT为（1.55 ± 0.63）mm，黏膜增厚的上颌窦比例降到12.5%，拔牙前后测量值比较，差异有统计学意义（P < 0.05）。结论　上颌磨牙区重度牙周炎患牙对应上颌窦黏膜易发生黏膜增厚，患牙拔除同期行位点保存术后6个月上颌窦增厚的黏膜大多恢复至正常。

关键词: 重度牙周炎, 上颌窦, 黏膜增厚

Abstract:

Objective　To investigate the characteristics of the thickness of maxillary sinus membrane corresponding to molars with severe periodontitis，and observe the thickness changes of maxillary sinus membrane at six months after tooth extraction and alveolar ridge preservation by measurements of cone-beam computed tomography（CBCT） images. Methods　Totally 8 patients with a total of 8 maxillary molars with severe periodontitis intending to receive alveolar ridge preservation and implant placement were recruited in Peking University School and Hospital of Stomatology from February 2016 to November 2017，and another 8 CBCT images of maxillary molars with mild periodontitis were included in the control group. The maximum membrane thickness（maxMT）of the maxillary sinus，and the minimum residual ridge height（minRRH）were measured by CBCT. In the experimental group，the maxMT corresponding to the affected tooth was measured 6 months after the tooth extraction and alveolar ridge preservation. Results　The maxMT of the maxillary sinus in the experimental group was（4.06 ± 1.80）mm，87.5% of the maxillary sinus membranes were found thickening compared to normal thickness，and the minRRH of the molar was（1.09 ± 0.68）mm. The maxMT of the maxillary sinus and the minRRH of the molar in the control group was（1.42 ± 0.38）mm and （8.50 ± 1.72）mm respectively，and there was no mucosal thickening. There were statistically significant differences between two groups. In the experimental group，the maxMT of the maxillary sinus was changed from（4.06 ± 1.80）mm to（1.55 ± 0.63）mm in six months after alveolar ridge preservation，the proportion of mucosal thickening was decreased to 12.5%，and the difference was statistically significant（P < 0.05）. Conclusion　Maxillary sinus mucosa tends to be thickened in molars with severe periodontitis. The thickness of the maxillary sinus mucosa is likely to return to normal at 6 months after tooth extraction and alvedar ridge preservation.

Key words: severe periodontitis, maxillary sinus, mucosal thickening