A Cone Beam CT Analysis Of Maxillary Sinus To Alveolar Process Pneumatization In Different Age Groups

Background:This physiological process which maxillary sinus develops from the mucosal lining of paranasal sinuses into the maxillary recess and extends to the adjacent anatomical structures(orbital floor,alveolar process,maxillary tubercle,zygomatic bone,medial nasal wall,etc.)is called maxillary sinus pneumatization.It has been reported in the literature that the extension of the maxillary sinus to the alveolar process is the most common,and our preliminary work has shown that there is a high correlation between the amount of pneumatization of the maxillary sinus to the alveolar process and the maxillary sinus volume.Therefore,maxillary sinus floor-the maxillary sinus to the alveolar process can be used to evaluate the overall pneumatization degree of the maxillary sinus.In the field of oral cavity,when Extensive maxillary sinus pneumatization(extensive outspread of maxillary sinus to alveolar process)causes the root of maxillary posterior teeth to contact directly with the mucosa of the sinus floor or even penetrate into the sinus cavity,it will have many effects on the diagnosis,treatment and prognosis of multidisciplinary.Congenital and acquired environmental factors affect the pneumatization degree of maxillary sinus,but the mechanism and exact influencing factors of Extensive maxillary sinus pneumatization have not been clarified.Objective:The amount of maxillary sinus to alveolar process pneumatization(PA)in different age groups was measured by cone beam CT(CBCT)to analyze the relationship between PA and age,and explore the related mechanism of maxillary sinus pneumatization preliminarily.In addition,According to the degree of maxillary sinus to alveolar process pneumatization,the included maxillary sinuses were divided into two groups: Normal pneumatization and Extensive pneumatization,to analyze the difference of the Diameter of the ostium(OD)and the Accessory maxillary ostium(AMO)between the two groups,and to explore the influencing factors of maxillary sinus pneumatization.Data and Methods:A total of 293 patients with CBCT imaging were randomly selected from the Affiliated Stomatological Hospital of Nanchang University from January to October2020.They were divided into group I(18-34 years old,young),group II(35-59 years old,middle aged),and group III(≥60 years old,old)according to age.The distance between the lowest maxillary sinus floor and nasal floor in the central area of maxillary posterior teeth was measured and recorded as PA.At the same time,according to the position relationship between the maxillary posterior teeth and the maxillary sinus floor,the pneumatization of the maxillary sinus toward the alveolar process was divided into type I Normal pneumatization and type II Extensive pneumatization.The distribution of pneumatization degree in different age groups was analyzed.In addition,OD and probability of AMO were measured and observed between Normal maxillary sinus pneumatization group and Extensive maxillary sinus pneumatization group.SPSS23.0 software was used for statistical processing of data.RESULTS:The PA of group I was(3.75±3.77)mm,group II was(2.30±4.48)mm,and group III was(2.09±4.70)mm.There was significant difference between Group I and Group II and III(P < 0.05),but no statistical difference between Group II and Group III(P > 0.05).The proportion of Extensive pneumatization in group I was the highest,66.44%.OD was(1.93±0.50)mm in Normal pneumatization group and(1.87±0.49)mm in Extensive pneumatization group,and there was no significant difference between the two groups(P > 0.05).The incidence probability of AMO between the two groups was 4.27% and 18.26%,respectively,and the difference was statistically significant(P < 0.05).Conclusion:1.The occurrence of Extensive maxillary sinus pneumatization is a slow and adaptive physiological process;quantitative and qualitative analysis show that young people are more likely to develop Extensive maxillary sinus pneumatization than middle-aged and old people.is speculated that the elongation of the middle face and the decrease of bite force in the modern youth population promote over-extension of sinus cavity.2.There is no correlation between the size of maxillary sinus ostium and the pneumatization degree of the maxillary sinus.The existence of AMO may have a certain influence on maxillary sinus pneumatization by affecting the ventilation and drainage in the sinus cavity.