与上颌窦底提升术相关的腭鼻隐窝的CBCT研究  

CBCT study of palatonasal recess associated with maxillary sinus augmentation

作　　者：常蓓 蒋瑞芳 徐本雨 CHANG Bei;JIANG Rui-fang;XU Ben-yu(Department of Stomatology,The PLA Rocket Force Characteristic Medical Center,Beijing 100088,China;Department of Implantology,The PLA General Hospital,Beijing 100143,China;Department of Stomatology,People's Hospital of Chengwu County,Shandong 274200,China)

机构地区：[1]中国人民解放军火箭军特色医学中心口腔科,100088 [2]中国人民解放军总医院第一医学中心口腔科,100853 [3]山东省成武县人民医院口腔科,274200

出　　处：《口腔颌面修复学杂志》2024年第5期342-349,共8页Chinese Journal of Prosthodontics

摘　　要：目的:腭鼻隐窝(palatonasal recess,PNR)是上颌窦内侧壁的凹陷性结构,熟悉腭鼻隐窝的解剖特点有利于评估上颌窦底提升术的难度,降低黏膜穿孔的风险。本研究通过锥形束CT(CBCT)分析了PNR的解剖特点,为上颌窦底提升手术提供参考。方法:选取于解放军总医院第一医学中心口腔科就诊的189例上颌后牙缺失患者(223个缺牙位点)的CBCT影像资料,测量缺失牙位的PNR的检出率、PNR的角度以及PNR与牙槽嵴顶、上颌窦侧壁的距离,并进一步统计PNR角度<90°且距离牙槽嵴顶<15 mm的风险位点的发生率。结果:共有176位(93.12%)患者观察到PNR,总计PNR位点为202个(90.58%)。PNR角度为(123.81±25.15)°,从第一前磨牙到第二磨牙位点角度逐渐增大。PNR与牙槽嵴顶距离是(12.89±2.85)mm,第二前磨牙处与牙槽嵴顶的距离最远,第二磨牙处最近。PNR与上颌窦外侧壁的距离是(16.93±4.57)mm,第一磨牙处的PNR距离上颌窦外侧壁最远。PNR风险位点在第一前磨牙处发生率最高。结论:PNR是上颌窦内壁的常见解剖结构,在上颌窦底提升术前应通过CBCT仔细了解PNR的解剖特点,降低上颌窦黏膜穿孔的发生率。Objective:The palatonasal recess(PNR)is a concave structure in the medial wall of the maxillary sinus.Anatomical features of the palatonasal recess could determine the difficulty of the maxillary sinus augmentation,which is one of the important factors affecting the difficulty of operation and mucosa perforation during maxillary sinus augmentation.In this study,the anatomical features of PNR were investigated by cone beam CT(CBCT)to provide reference for maxillary sinus augmentation.Methods:CBCT images of 189 patients with maxillary posterior tooth loss were selected from the Department of Dentistry,the First Medical Center of PLA General Hospital.The detection rate of PNR,the angle of PNR and the distance between PNR and alveolar ridge crest well as the lateral wall of maxillary sinus were measured,and the rate of risk sites with the angle of PNR<90°and the distance from the alveolar ridge crest<15 mm was calculated.Results:PNR was observed in 176 patients(93.12%),with 202 PNR(90.58%)sites in total.The average PNR angle was(123.81±25.15)°,and the angle increased gradually from the first premolar to the second molar.The average distance between PNR and alveolar ridge crest was(12.89±2.85)mm,and the distance between PNR and alveolar ridge crest was farthest at the second premolar site and closest at the second molar site.The average distance between PNR and the lateral wall of maxillary sinus was(16.93±4.57)mm,and PNR at the first molar site was farthest from the lateral wall of maxillary sinus.The highest rate of PNR risk sites was found in the first premolar.Conclusion:PNR is a common anatomical structure in the medial wall of the maxillary sinus,and the anatomical features of PNR should be examined by CBCT before maxillary sinus augmentation,in order to reduce the incidence of sinus mucosa perforation of the maxillary sinus.

关 键 词：锥形束CT 腭鼻隐窝 上颌窦底提升术 

分 类 号：R782.051[医药卫生—口腔医学]