Rümeysa ŞENDİŞÇİ, Bilay STEVANOVIC SANCAR, Ali EKİNCİ, Sevcihan GÜNEN YILMAZ

Maksiller Sinüs Patolojilerinin Odontojenik Faktörlerle İlişkisinin Konik Işınlı Bilgisayarlı Tomografi ile Değerlendirilmesi

Amaç: Bu çalışmanın amacı maksiller sinüs patolojilerine sebep olabilen odontojen faktörlerin belirlenmesi ve bu amaçla konik ışınlı bilgisayarlı tomografinin kullanılabilirliğinin değerlendirilmesidir. Materyal ve metod: Çalışmamızda 200 hastaya ait Akdeniz Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Radyolojisi Anabilim Dalı’ na başvuran bireylerden çeşitli nedenlerle alınmış konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleri, maksiler sinüs patoloji varlığı ve odontojenik faktörler arasındaki ilişkiyi belirlemek amacıyla retrospektif olarak tarandı. Maksiller sinüs patolojileri; mukozal kalınlaşma, mukus retansiyon kisti, sinüzit, polip ve antrolit olarak belirlendi. Sinüs mukozası kalınlığının 2 mm ve üzerinde olduğu olgular patolojik olarak kabul edildi. Odontojen faktörler; kronik apikal lezyon, marjinal kemik kaybı, oro-antral fistül, restoratif uygulamalar, kanal tedavisi, implant, gömülü diş ve rezidüel kök olarak belirlendi. Verilerin analizinde SPSS kullanıldı ve p< .05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Maksiller sinüs patolojisi prevalansı toplam 200 hastanın 192'sinde %96 oranında gözlendi. Her iki maksiller sinüsde en sık maksiller sinüs patolojisi mukozal kalınlaşma idi. En nadir görülen maksiller sinüs patolojisi antrolit idi. Sağ maksiller sinüs patolojisi cinsiyete göre farklılık gösterirken (p= 0,02), sol maksiller sinüs patolojisi ile cinsiyet arasında ilişki yoktu (p=0,1). 182 hastada (%91) odontojenik faktörler mevcuttu. Hem odontojenik faktörlerin hem de maksiller sinüs patolojilerin gözlendiği 175 hasta (%87,5) tespit edildi. Mukozal kalınlaşma ile kronik periapikal periodontitis arasında istatistiksel olarak anlamlı korelasyon vardı (p=0,004). Sinüzit ve oroantral ilişki arasında istatistiksel olarak anlamlı korelasyon tespit edilmiştir (p=0,0001). Antrolit ile rezidüel kök arasında istatistiksel olarak anlamlı korelasyon tespit edilmiştir (p=0,04). Sonuç: Periodontal hastalıklar, kronik apikal periodontitis, restoratif işlemler, maksiller sinüs bölgesine yakın rezidüel kökler maksiller sinüs patolojileriyle ilişkilidir. Düşük radyasyon dozu ve yüksek uzaysal çözünürlülüğü ile KIBT, maksiller sinüzit patolojilerinde odontojen etyolojisinin belirlenmesine yardımcı olabilmektedir.

Anahtar Kelimeler:

Konik ışınlı bilgisayarlı tomografi, maksiller sinüs, patoloji, odontojenik faktörler

Evaluation of the Relationship between Maxillary Sinus Pathologies and Odontogenic Factors by Cone Beam Computed Tomography

Aim: The aim of this study is to determine the odontogenic factors that can cause maxillary sinus pathologies and to evaluate the usability of cone beam computed tomography for this purpose. Material and methods: In our study, cone beam computed tomography (CBCT) images of 200 patients who applied to the Department of Oral and Maxillofacial Radiology of Akdeniz University Faculty of Dentistry for various reasons were retrospectively scanned to determine the relationship between the presence of maxillary sinus pathology and odontogenic factors. Maxillary sinus pathologies; mucosal thickening, mucus retention cyst, sinusitis, polyp and anthrolite. Cases with a sinus mucosa thickness of 2 mm or more were considered pathological. Odontogenic factors; chronic apical lesion, marginal bone loss, oro-antral fistula, restorative applications, root canal treatment, implant, impacted tooth and residual root. SPSS was used in the analysis of the data and p< .05 was considered statistically significant. Results: The prevalence of maxillary sinus pathology was 96% in 192 of 200 patients. The most common maxillary sinus pathology in both maxillary sinuses was mucosal thickening. The most rare maxillary sinus pathology was antrolite. While right maxillary sinus pathology differed according to gender (p= 0.02), there was no relationship between left maxillary sinus pathology and gender (p=0.1). Odontogenic factors were present in 182 patients (91%). There were 175 patients (87.5%) with both odontogenic factors and maxillary sinus pathologies. There was a statistically significant correlation between mucosal thickening and chronic periapical periodontitis (p=0.004). A statistically significant correlation was found between sinusitis and oroantral relationship (p=0.0001). A statistically significant correlation was found between anthrolite and residual root (p=0.04). Conclusion: Periodontal diseases, chronic apical periodontitis, restorative procedures, residual roots close to the maxillary sinus region are associated with maxillary sinus pathologies. With its low radiation dose and high spatial resolution, CBCT can help determine the odontogenic etiology in maxillary sinusitis pathologies.

Keywords:

Cone-beam computed tomography maxillary sinus, , pathology, odontogenic factors,

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