上颌磨牙牙周状况与上颌窦黏膜增厚的相关性研究  

Correlation between periodontal status of maxillary molars and maxillary sinus mucosal thickening

作　　者：宋雨姣 孙晓军 SONG Yujiao;SUN Xiaojun(School and Hospital of Stomatology,Shanxi Medical University,Taiyuan 030001,China;Department of Stomatology,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学口腔医学院·口腔医院,山西太原030001 [2]山西医科大学第一医院口腔内科,山西太原030001

出　　处：《口腔疾病防治》2025年第5期368-376,共9页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：山西省自然科学研究面上项目(202203021221253)。

摘　　要：目的探讨上颌磨牙的牙周炎症对上颌窦黏膜增厚的影响,为牙源性上颌窦炎的防治提供参考。方法本研究已通过医院医学伦理委员会批准。回顾性分析246例牙周炎患者的双侧上颌窦锥形束CT(cone beam CT,CBCT)影像资料,根据纳入排除标准,最后纳入共331侧上颌窦影像,将牙周炎症程度最重的磨牙纳入统计,其中第一磨牙270颗,第二磨牙61颗。通过患者的CBCT影像,测量上颌磨牙的牙周指标[最小剩余牙槽骨高度(minimum residual alveolar bone height,minRABH)、牙槽骨吸收程度、根分叉病变、垂直骨下袋],分析以上牙周指标与上颌窦黏膜增厚(上颌窦最大黏膜厚度≤2 mm时为正常,>2 mm为黏膜增厚)的相关性。结果331颗上颌磨牙对应的上颌窦中,264个上颌窦黏膜增厚,平均(5.9±5.1)mm,占比79.8%。上颌窦黏膜增厚与牙周指标包括minRABH、牙槽骨吸收程度、根分叉病变、垂直骨下袋均显著相关(P<0.05),也与牙周炎患牙牙位显著相关(P<0.05)。进一步的二元logistic回归分析结果显示,minRABH在所有指标中对于上颌窦黏膜增厚的影响最显著,minRABH<4 mm组上颌窦黏膜增厚的可能性为minRABH≥10 mm组的5.6倍,minRABH 4~10 mm组上颌窦黏膜增厚的可能性为minRABH≥10 mm组的2.2倍,上颌第二磨牙牙周炎致上颌窦黏膜增厚的可能性为第一磨牙2.8倍,minRABH和牙周炎患牙牙位对上颌窦黏膜增厚的影响与其他因素相比更显著(P<0.05)。结论牙周炎症时上颌磨牙minRABH小于4 mm或牙位为上颌第二磨牙时,上颌窦黏膜增厚的可能性更大,提示完善的牙周治疗是预防牙源性上颌窦炎的重要因素。Objective To investigate the effect of periodontal inflammation of maxillary molars on the mucosal thickening of the maxillary sinus and to provide references for the prevention and treatment of odontogenic maxillary sinusitis.Methods This study was approved by the hospital’s Medical Ethics committee.A retrospective analysis was conducted on the cone beam CT(CBCT)images of the maxillary sinuses of 246 patients with periodontitis.Based on the inclusion and exclusion criteria,a total of 331 maxillary sinus images were finally included.The molars with the most severe periodontal inflammation were selected for statistical analysis,including 270 first molars and 61 second molars.CBCT images of these patients were collected.Periodontal indices of maxillary molars[minimum remaining alveolar bone height(minRABH),degree of alveolar bone absorption,furcation involvement,and vertical bone loss]were measured.The correlation between these periodontal indices and maxillary sinus mucosal thickening(defined as normal when the maximum thickness of the maxillary sinus mucosa≤2 mm and thickening when>2 mm)was analyzed.Results Among the 331 maxillary molars and their corresponding maxillary sinuses,264 cases showed thickening of the maxillary sinus mucosa,with an average thickness of(5.9±5.1)mm,accounting for 79.8%.The thickening of the maxillary sinus mucosa was significantly correlated with periodontal indices,including minRABH,degree of alveolar bone absorption,furcation involvement,and vertical bone loss(P<0.05),as well as with tooth position(P<0.05).Further binary logistic regression analysis revealed that the possibility of maxillary sinus mucosal thickening in the minRABH<4 mm group was 5.6 times that of the group with minRABH≥10 mm.The possibility of maxillary sinus mucosal thickening in the group with minRABH of 4-10 mm was 2.2 times that of the group with minRABH≥10 mm.The possibility of maxillary sinus mucosal thickening caused by periodontitis in the second maxillary molar was 2.8 times that of the first maxilla

关 键 词：牙周炎 上颌窦黏膜增厚 最小剩余骨高度 牙槽骨吸收 根分叉病变 垂直骨下袋 牙位 锥形束CT 

分 类 号：R78[医药卫生—口腔医学]