Konik Işınlı Bilgisayarlı Tomografi Kullanarak Sinüs Tabanı Kortikasyonunun Sınıflaması, Prevalansı ve Antral Patoloji ile İlişkisinin Tayini
Öz
Amaç: Maksiller posterior bölgede maksiller sinüsün pnömatizasyonu, yaşın artmasıyla birlikte alveolar kemiğin rezorpsiyona olan
eğilimi ve yetersiz kemik yoğunluğu dental implant uygulamalarında çeşitli zorluklara neden olmaktadır. Atrofik maksillada sinüs
duvarı kaldırılması işlemiyle birlikte eş zamanlı olarak implant uygulanıp uygulanamayacağı; kemiğin kalitesine, rezidüel kemik yüksekliğine ve primer stabilite gibi faktörlere bağlıdır. Bu çalışmanın amacı, antral patoloji varlığı ile sinüs tabanı kortikasyonu arasındaki ilişkiyi ve sinus taban kortikasyonunun tiplerine göre sıklığını konik ışınlı bilgisayarlı tomografi görüntüleri üzerinde araştırmadır.
Materyal ve Metot: Çalışma grubu, yaş ortalaması 48,63 olan 64 erkek ve 86 kadın olmak üzere toplam 150 kişiden oluşmaktadır. Sağ ve sol maksiller sinüsü içeren 300 adet KIBT görüntüsü incelenmiştir. Antral patoloji ve sinüs taban kortikasyonuistatistiksel ki-kare analiz yöntemi kullanılarak karşılaştırılmıştır.
Bulgular: Sinüs tabanı kortikasyonu sınıflamasına göre, maksiller sinüslerden 158’inde Tip 1, 60’ında Tip 2, 22’sindeTip 3, 60’ında ise Tip 4 kortikasyon saptanmış, antral patoloji varlığı ile kortikasyon varlığı arasında istatistiksel olarak anlamlı bir ilişki izlenmiştir (p<0,05).
Sonuç: Sinüs tabanı kortikasyonu derecesine dayanan bu sınıflandırma klinik olarak sinüs ogmentasyon prosedürlerinin (SOP) (lateral pencere tekniği veya transkrestal teknik) gerekli olup olmadığına karar vermek ve sinüs tabanı yükseltilmesi işlemiyle eş zamanlı implant yerleştirmesinin uygunluğunu saptama konusunda hekime yardımcı olacağı için değerlidir.
Anahtar Kelimeler
Maksiller sinüs konik ışınlı bilgisayarlı tomografi patoloji
Kaynakça
- 1. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of thesuccess of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol 2008;35:216–240.
- 2. Kaneko T, Masuda I, Horie N, Shimoyama T. New bone formation in nongrafted sinus lifting with space-maintaining management: A novel technique using a titanium bone fixation device. J Oral MaxillofacSurg 2012;70: e217–24.
- 3. Üngör C, Atasoy KT, Çizmeci-Şenel F. Migration of dental implants into maxillary sinus during the healing period due to wrong indication: report of two cases. J Dent Fac Atatürk Uni 2014;24(1);93–97.
- 4. Erkan M, Somdaş M. Rinosinüzit Komplikasyonları. Van Tıp Dergisi, 2000, 7:75–79.
- 5. Sümbüllü MA. Maksiller Sinüs Enflamatuar Hastalıklarında Volumetrik Dental Tomografinin Tanı Değeri ve Bulguların Waters Pozisyonunda Çekilen Paranasal Sinüs Radyogramı ile Karşılaştırılması. Sağlık Bilimleri Enstitüsü, Oral Diagnoz ve Radyoloji Anabilim Dalı. Doktora Tezi, Erzurum: Atatürk Üniversitesi, 2010.
- 6. Mehra P, Murad H. Maxillary sinus disease of odontogenic origin. Otolaryngol Clin North Am 2004;37:347–364.
- 7. Som PM, Curtin HD. Head and Neck Imaging, 4th ed. St Louis, Mosby, 2003:193–260.
- 8. Libersa C, Laude M, Libersa JC. The pneumatization of the nasal fossae during growth. AnatClin 1981;2:265–273.
- 9. Ludlow JB, Ivanovic M. Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:106–114.
- 10. Shahbazian M, Jacobs R. Diagnostic value of 2D and 3D imaging in odontogenic maxillary sinusitis: a review of literature. J Oral Rehabil 2012;39:294–300.
- 11. Carter L, Farman AG, Geist J, Scarfe WC, Angelopoulos C, Nair MK, et al. American Academy of Oral and Maxillofacial Radiology Executive Opinion Statement on Performing and Interpreting Diagnostic Cone Beam Computed Tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:561–562.
- 12. Carmeli G, Artzi Z, Kozlovsky A, Segev Y, Landsberg R. Antral computerized tomography pre-operative evaluation: relationship between mucosal thickening and maxillary sinüs function. Clin Oral ImplRes 2011;22:78–82.
- 13. Rege IC, Sousa TO, Leles CR, Mendonca EF. Occurence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health 2012;10;12:30. doi:10 1186/1472–6831–12–30.
- 14. Nedir R, Bischof M, Vazquez L, Nurdin N, Szmukler Moncler S, Bernard JP. Osteotome sinus floor elevation technique without grafting material:3 year results of a prospective pilot study. Clin Oral Implants Res 2009;20:701–707.
- 15. Choucroun G, Mourlaas J, Affendi NHK, Froum SJ, Cho SC. Sinus floor cortication: classification and prevelance. Clin Implant Dent Relat Res 2017;19(1):69–73.
- 16. Yan X, Zhang X, Chi W, Ai H, Wu L. Comparing the influence of crestal cortical bone and sinus floor cortical bone in posterior maxilla bi-cortical dental implantation: a three-dimensional finite element analysis. Acta Odontol Scand 2015;73:312–320.
- 17. Cha JY, Mah J, Sinclair P. Incidental findings in the maxillofacial area with 3-dimensional cone-beam imaging. Am J Orthod Dentofacial Orthop 2007;132:7–14.
- 18. Costes AR, Correa L, Arita ES. Evaluation of a maxillary sinus floor augmentation in the presence of a large antral pseudocyst. J Craniofac Surg 2012;23(6): e535–537.
- 19. Wen SC, Lin YH, Yang YC, Wang HL. The influence of sinus membrane thickness upon membrane perforation during transcrestal sinus lift procedure. Clin Oral Implants Res 2015;26(10):1158–1164.
- 20. Vallo J, Suominen-Taipale L, Huumonen S, Soikkonen K, Norblad A. Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: results from the Health 2000 Health Examination Survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109(3): e80–7.
- 21. Soikkonen K, Ainamo A. Radiographic maxillary sinus findings in the elderly. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80(4):487–91.
Assessment of Classification, Prevalance and Comparison with Antral Pathology of Sinus Floor Cortication by Using Cone Beam Computed Tomography
Öz
Aim: Pneumatization of maxillary sinus at maxillary posterior region, alveolar bone tendency to resorption together with increasing
of age and insufficient bone density cause various difficulties in dental implant placement. Whether implant will be put or not
simultaneously together with sinus lifting process at atrophic maxillary depends on the factors as the quality of the bone, the residual bone height and the primer stability. The aim of this study is to assess the relation between sinus floor cortication and antral pathology and to assess the frequency of sinus floor cortication types on cone beam computed tomography images.
Material and Method: The study group consists of a total of 150 persons, 64 males and 86 females, that an average age is 48.63 years. CBCT images that consist of right and left maxillary sinuses have been examined. Antral pathologies and sinus floor cortications were compared with statistical chi-square analysis method.
Results: According to the sinus floor cortication classification, it was stated that among maxillary sinuses Type 1was present in 158
sinuses, Type 2 was present in 60 sinuses, Type 3 was present in 22 sinuses and Type 4 was present in 60 sinuses. There was
statistically significant relation between antral pathology and sinus floor cortication (p<0.05).
Conclusion: This classification that is based on the degree of the sinus floor cortication is valuable in order to evaluate whether
SAP (lateral window technique or transcrestal approach) is clinically necessary or not and to help clinician in the suitability
statement of implant placement and sinus lifting process, simultaneously.
Anahtar Kelimeler
Kaynakça
- 1. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of thesuccess of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol 2008;35:216–240.
- 2. Kaneko T, Masuda I, Horie N, Shimoyama T. New bone formation in nongrafted sinus lifting with space-maintaining management: A novel technique using a titanium bone fixation device. J Oral MaxillofacSurg 2012;70: e217–24.
- 3. Üngör C, Atasoy KT, Çizmeci-Şenel F. Migration of dental implants into maxillary sinus during the healing period due to wrong indication: report of two cases. J Dent Fac Atatürk Uni 2014;24(1);93–97.
- 4. Erkan M, Somdaş M. Rinosinüzit Komplikasyonları. Van Tıp Dergisi, 2000, 7:75–79.
- 5. Sümbüllü MA. Maksiller Sinüs Enflamatuar Hastalıklarında Volumetrik Dental Tomografinin Tanı Değeri ve Bulguların Waters Pozisyonunda Çekilen Paranasal Sinüs Radyogramı ile Karşılaştırılması. Sağlık Bilimleri Enstitüsü, Oral Diagnoz ve Radyoloji Anabilim Dalı. Doktora Tezi, Erzurum: Atatürk Üniversitesi, 2010.
- 6. Mehra P, Murad H. Maxillary sinus disease of odontogenic origin. Otolaryngol Clin North Am 2004;37:347–364.
- 7. Som PM, Curtin HD. Head and Neck Imaging, 4th ed. St Louis, Mosby, 2003:193–260.
- 8. Libersa C, Laude M, Libersa JC. The pneumatization of the nasal fossae during growth. AnatClin 1981;2:265–273.
- 9. Ludlow JB, Ivanovic M. Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:106–114.
- 10. Shahbazian M, Jacobs R. Diagnostic value of 2D and 3D imaging in odontogenic maxillary sinusitis: a review of literature. J Oral Rehabil 2012;39:294–300.
- 11. Carter L, Farman AG, Geist J, Scarfe WC, Angelopoulos C, Nair MK, et al. American Academy of Oral and Maxillofacial Radiology Executive Opinion Statement on Performing and Interpreting Diagnostic Cone Beam Computed Tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:561–562.
- 12. Carmeli G, Artzi Z, Kozlovsky A, Segev Y, Landsberg R. Antral computerized tomography pre-operative evaluation: relationship between mucosal thickening and maxillary sinüs function. Clin Oral ImplRes 2011;22:78–82.
- 13. Rege IC, Sousa TO, Leles CR, Mendonca EF. Occurence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health 2012;10;12:30. doi:10 1186/1472–6831–12–30.
- 14. Nedir R, Bischof M, Vazquez L, Nurdin N, Szmukler Moncler S, Bernard JP. Osteotome sinus floor elevation technique without grafting material:3 year results of a prospective pilot study. Clin Oral Implants Res 2009;20:701–707.
- 15. Choucroun G, Mourlaas J, Affendi NHK, Froum SJ, Cho SC. Sinus floor cortication: classification and prevelance. Clin Implant Dent Relat Res 2017;19(1):69–73.
- 16. Yan X, Zhang X, Chi W, Ai H, Wu L. Comparing the influence of crestal cortical bone and sinus floor cortical bone in posterior maxilla bi-cortical dental implantation: a three-dimensional finite element analysis. Acta Odontol Scand 2015;73:312–320.
- 17. Cha JY, Mah J, Sinclair P. Incidental findings in the maxillofacial area with 3-dimensional cone-beam imaging. Am J Orthod Dentofacial Orthop 2007;132:7–14.
- 18. Costes AR, Correa L, Arita ES. Evaluation of a maxillary sinus floor augmentation in the presence of a large antral pseudocyst. J Craniofac Surg 2012;23(6): e535–537.
- 19. Wen SC, Lin YH, Yang YC, Wang HL. The influence of sinus membrane thickness upon membrane perforation during transcrestal sinus lift procedure. Clin Oral Implants Res 2015;26(10):1158–1164.
- 20. Vallo J, Suominen-Taipale L, Huumonen S, Soikkonen K, Norblad A. Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: results from the Health 2000 Health Examination Survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109(3): e80–7.
- 21. Soikkonen K, Ainamo A. Radiographic maxillary sinus findings in the elderly. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80(4):487–91.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2017 |
| Yayımlandığı Sayı | Yıl 2017 Yıl: 2017 Sayı: 3 |