上颌窦外侧壁骨内吻合血管的CBCT观察  

Detection of intraosseous anastomosis vessel in lateral wall of maxillary sinus using cone beam computerized tomography

作　　者：刘薇丽[1] 张颖奇 李镭[3] 随丽娜[1] 

机构地区：[1]郑州人民医院口腔科,郑州450000 [2]中国石油天然气中心医院口腔科,河北廊坊065000 [3]武汉大学口腔医院种植科,武汉430079

出　　处：《郑州大学学报（医学版）》2017年第2期170-173,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省医学科技攻关计划项目201403237

摘　　要：目的:通过锥体束CT(CBCT)来分析评估上颌窦外侧壁骨内吻合血管情况,为上颌窦外侧开窗提升术提供指导。方法:共纳入无上颌窦疾病的患者238例(476个上颌窦),其中108例存在上颌后牙缺失。通过CBCT影像学资料分析评估上颌窦外侧壁骨内吻合血管的直径、血管下缘到牙槽嵴顶的距离、血管内壁到上颌窦内侧壁的距离、上颌窦底到牙槽嵴顶的距离,并且比较后牙留存和后牙缺失情况下该血管的位置变化。结果:上颌窦中骨内吻合血管的检出率为39.08%(186/476)。血管直径为(1.33±0.56)mm,男性血管直径大于女性,50~岁和60岁以上年龄组血管直径大于其他年龄组(P<0.05)。血管下缘到牙槽嵴顶的距离为(13.01±1.60)mm,女性小于男性,后牙缺失组小于后牙留存组(P<0.05),但各年龄组间差异无统计学意义(P>0.05)。血管内壁到上颌窦内侧壁的距离男性大于女性(P<0.05),但各年龄组间差异无统计学意义(P>0.05)。结论:应用CBCT可以有效发现上颌窦外侧壁骨内吻合血管的存在。建议行上颌窦手术之前应进行CBCT检查以避免术中损伤骨内吻合血管。Aim： To detect the intraosseous anastomosis vessels in the lateral wall of the maxillary sinus using cone beam computerized tomography（ CBCT） scans,so as to guide the sinus floor grafting procedures in implant surgery. Methods： A total of 476 examined sinuses from 238 patients were included in present study. Among the 238 patients,108 patients had molars loss. The intraosseous anastomosis vessel was detected by CBCT. Distance from the lower border of the artery to the alveolar crest,distance from the artery to the medial sinus wall,bone height below the sinus floor to the ridge crest and diameter of the artery were measured. The change of the artery position was analyzed between patients with molars loss and those without. Results： The total prevalence of intraosseous anastomosis vessel was 39. 08%（ 186 /476） of all sinuses. Mean diameter of intraosseous anastomosis vessel was（ 1. 33 ± 0. 56） mm. The mean diameter of the male group was significantly greater than female group. The mean diameter in the age groups（ 50 to 60 years and over 60 years） were significantly greater than other groups（ P〈0. 05）. The mean distance from the lower border of the artery to the alveolar crest,which was the most important distance,was（ 13. 01 ± 1. 60） mm. It was significantly shorter in the female group and teeth lost group（ P〈0. 05）,but not in different age groups（ P〈0. 05）. The distance from the artery to the medial sinus wall was significantly greater in the male group（ P〈0. 05）,but not different in various age groups（ P〈0. 05）. Conclusion： CBCT scan is a valuable tool in evaluating presence of intraosseous anastomosis vessel. To avoid any potential vascular damage,CBCT scan is necessary before maxillary sinus surgery.

关 键 词：骨内吻合血管 种植手术 上颌窦 CBCT 

分 类 号：R783.5[医药卫生—口腔医学]