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目的:应用螺旋CT图像结合Simplant软件对低位上颌窦缺牙患者缺牙区上颌窦底不同部位牙槽骨宽度及高度进行测量,探讨患者性别、年龄、缺牙时间及拔牙原因等对牙槽骨宽度与高度的影响。方法:选择43例上颌后牙缺失、全景片示缺牙区牙槽嵴顶距上颌窦底距离为4～6mm的患者CT图像为对象,利用Simplant软件进行重建,测量缺牙区上颌窦底不同部位处牙槽骨的宽度及高度,采用SPSS16.0软件包对数据进行t检验、方差分析和秩和检验。结果:①缺牙区牙槽嵴顶至上颌窦底距离为4.03～6.00mm,平均为(5.26±0.58)mm;②在上颌窦底上方不同水平,除上颌第二磨牙在3.75mm水平处,窦底内侧壁宽度与外侧壁宽度均存在显著差异(P<0.01);③随年龄增长及缺牙时间延长,缺牙区剩余牙槽骨高度及上颌窦底宽度显著减小(P<0.01),而对于距窦底1.25mm以上的上颌窦底侧壁宽度则无显著影响(P>0.05);④因牙周炎拔除患牙者,其剩余牙槽骨高度明显小于因冠折或无法修复的残根(冠)而拔除者(P<0.01)。结论:患者年龄、缺牙时间及拔牙原因对剩余牙槽骨量具有重要影响,而对于上颌窦底上方不同水平上颌窦底侧壁宽度则影响较小。上颌磨牙区上颌窦底内侧壁宽度总体大于外侧壁宽度,植入种植体可考虑该解剖特点,并根据患者年龄、缺牙时间及拔牙原因,适当改变种植体植入位置和方向,使一部分低位上颌窦缺牙患者能够避免行复杂的上颌窦提升术。
OBJECTIVE: To measure the width and height of alveolar bone in different parts of the maxillary sinus with or without maxillary sinus in patients with low maxillary sinus edema using spiral CT and Simplant software to investigate the effect of alveolar bone The impact of width and height. Methods: Forty-three patients with maxillary posterior teeth missing and panoramic films showing CT images of patients with 4 to 6 mm distance from the top of alveolar ridge in maxillary sinus were selected for reconstruction. Simplant software was used to measure the maxillary sinus floor The width and height of the alveolar bone at the site were analyzed by t test, ANOVA and rank sum test using SPSS16.0 software package. Results: ① The distance between alveolar crest and maxillary sinus floor was 4.03 ~ 6.00mm (average 5.26 ± 0.58) mm in edentulous area; ② At the level of 3.75mm above maxillary sinus, The width of the medial wall of the sinus floor and the width of the lateral wall were significantly different (P <0.01). With the increase of age and the time of missing teeth, the remaining alveolar bone height and the width of the maxillary sinus floor were significantly decreased (P <0.01) , While there was no significant difference (P> 0.05) in the width of the side wall of the maxillary sinus 1.25 mm above the sinus floor. The height of the remaining alveolar bone was significantly smaller than that of the patients with periodontitis Of the remnant (crown) and unplugged (P <0.01). Conclusion: The age of patients, the number of missing teeth and the cause of tooth extraction have an important influence on the residual alveolar bone mass, but have little effect on the width of the maxillary sinus wall at different levels above the maxillary sinus floor. The width of the medial wall of the maxillary sinus in the maxillary molar area is larger than the width of the lateral wall. Implants can be considered for this anatomical feature. Depending on the age of the patient, the time of missing teeth and the cause of tooth extraction, the position and orientation of the implants should be appropriately changed so that some lower digits Patients with maxillary sinus can avoid complex maxillary sinus surgery.