Cone Beam Computed Tomography For Maxillary Posterior And Maxillary Sinus Lesions

Objective:CBCT retrospective analysis of maxillary posterior apical lesions,periodontal bone loss and anatomical location of apical or apical lesions on maxillary sinus lesions,by CBCT apical index,periodontal bone loss,anatomical location Determination of the type of indicators to determine the incidence of maxillary sinus mucosal thickening,while studying the distribution of the position of the periapical lesions,to explore the relationship between the maxillary posterior and maxillary sinus lesions,in order to clinically determine the odontogenic maxillary sinusitis A reference is made for the occurrence.Method:1.Research objectA retrospective analysis of CBCT images of The People’s Hospital of Liaoning Province patients in the dental department from October 2016 to June 1818 was conducted.224 maxillary sinus and 896 maxillary posterior teeth were included in 132patients,including 80 females and males 52.For example,the age ranged from 18 to83 years old,with an average of 44.17±14.76 years.2.Inclusion criteria(1)CBCT image is clear,less artifacts;(2)patients are over 18 years old;(3)medical records are complete;(4)at least one maxillary sinus is intact and shows all maxillary first and second premolars,maxillary first and second molars(measuring tooth position);(5)measurement of tooth position without root canal treatment.3.Exclusion criteria(1)history of sinusitis;(2)maxillary bone disease;(3)trauma;(4)maxillary implant;(5)presence of crown restoration and can not clearly show the measurement of dental enamel bone boundary and alveolar bone dome;(6)maxillary third molar;(7)maxillary sinus effusion,complete turbidity and submucosal cysts.4.Experimental methods and measurement items(1)Record the patient’s gender and age(2)Maxillary sinus mucosa thickness:reconstruct the coronal and sagittal images of the maxillary sinus and measure the thickness of the maxillary sinus mucosa.The thickness of the maxillary sinus mucosa Y is classified as follows:Grade 1(normal mucosal thickening):Y≤2 mmGrade 2(moderate mucosal thickening):2<Y≤10 mmGrade 3(severe mucosal thickening):Y>10 mm(3)CBCT-periapical index(CBCT-PAI):reconstruction of axial,coronal,sagittal images,combined with medical records to measure the maximum diameter of all maxillary posterior apical to transmissive areas.According to the apical peripheral image transmission diameter X,the CBCT-PAI score is expressed as follows:1 point value:the apical periodontal bone is basically normal2 points:0.5mm≤X≤1mm3 points:1mm<X≤2mm4 points:2mm<X≤4mm5 points:4mm<X≤8mm6 points:X>8mm(4)Periodontal bone loss(PBL)degree:measure all upper and lower posterior buccal,lingual,mesial,and distal ABC-CEJ(set to d1),apical-CEJ(set to The distance of d2),the degree of periodontal bone loss on each face=(d1-2/d2-2)×100%.The amount of unilateral bone loss is the sum of the number of bone loss per posterior teeth divided by four.Periodontal bone loss is classified as follows:Normal-mild periodontal bone loss,less than 25%Moderate periodontal bone loss,25%to 50%severe periodontal bone loss,greater than 50%(5)The anatomical positional relationship between the apical or apical lesion and the maxillary sinus wall:Type I apical or apical lesion into the maxillary sinusType II,contact between the twoType III There is a distance between the two5.Statistical analysisStatistical analysis was performed on the experimental results using the SPSS22.0 version software package.Performχ~2 test,Spearman correlation analysis and linear trend chi-square test.Result:1.There was no significant difference between gender and maxillary sinus mucosa thickening(P>0.05).2.There was a low correlation between different age groups and maxillary sinus mucosal thickening.Spearman correlation analysis was P<0.05,and the difference was statistically significant.There was a linear correlation between different age groups and maxillary sinus mucosal thickening,and the linear trend test was P<0.05.3.There was a low correlation between maxillary sinus mucosal thickening and CBCT-PAI score.Spearman correlation analysis was P<0.001,and the difference was statistically significant.There was a linear correlation between maxillary sinus mucosal thickening and CBCT-PAI score,and linear trend test P<0.001.The pathological teeth with maxillary sinus mucosa thickening>2 mm and periapical lesions were most commonly the first molar(37.2%)and the second molar(27.9%).4.There was a low correlation between maxillary sinus mucosal thickening and periodontal bone loss.Spearman correlation analysis was P<0.001,and the difference was statistically significant.There was a linear correlation between maxillary sinus mucosal thickening and degree of periodontal bone loss,and a linear trend test P<0.001.5.In patients with moderate or severe periodontal bone loss and associated with periapical lesions,the prevalence of maxillary sinus mucosal thickening>2 mm increased.6.There was no correlation between the number of teeth in the type I positional relationship and the maxillary sinus mucosa thickening.Spearman correlation analysis was P>0.05,and the difference was not statistically significant.The number of teeth in the type I positional relationship was related to the wireless trend of maxillary sinus mucosal thickening,and the linear trend test was P>0.05.Conclusion:1.Periapical lesions and periodontal bone loss in the maxillary posterior teeth are closely related to maxillary sinus lesions.2.Maxillary sinus mucosal thickening increases with age.3.Maxillary sinus mucosal thickening increased with the increase of CBCT-PAI score.4.Maxillary sinus mucosal thickening increases with the increase of periodontal bone loss.