Posteriyor Maksillanın Kemik Morfolojisi ve Maksiller Sinüsün Seyri: İmplant Tedavisi için Üç Boyutlu Analiz

Amaç: Bu çalışmanın amacı, maksiller premolar ve molar dişleri destekleyen alveoler kemiğin morfolojik özelliklerini ve maksiller sinüs ile dişler arasındaki ilişkiyi koni ışınlı bilgisayarlı tomografi (KIBT) kullanarak değerlendirmektir.Gereç ve Yöntemler: 100 hastanın KIBT taramalarında, 652 arka dişi çevreleyen hem trabeküler kemik hem de kortikal kemik kalınlığı ölçüldü ve dişler ile maksiller sinüs arasındaki ilişki sınıflandırıldı. Ayrıca, dişlerin alveol kreti ile arasındaki açı ölçüldü.Bulgular: İncelenen dişlerin % 25'i maksiller sinüsün alt duvarı ile temas halinde, %12'si sinüsün içinde, % 63'ü ise maksiller sinüsten uzaktaydı. Maksiller sinüs tabanına en yakın kök 1.3 mm mesafe ile ikinci molar dişlerin meziyobukkal kökleriydi. En ince kemik konfigürasyonuna sahip dişler maksiller birinci premolardı. Taraflar ve cinsiyet arasında ölçümler açısından anlamlı fark yoktu (p>005). Bukkal kemik kalınlığı ve maksiller sinüs tabanına olan uzaklık, azı dişlerinde negatif korelasyon gösterdi (p˂0.001 ve 0.003).Sonuç: Olası komplikasyonları önlemek için, maksiller posterior bölgeye yapılacak implant işlemlerinden önce, posterior maksilla ve maksiller sinüsün üç boyutlu analizine ihtiyaç vardır.

Anahtar Kelimeler:

Kemik kalınlığı, KIBT, maksiller molarlar, maksiller premolar

ASSESSMENT OF BONE MORPHOLOGY AND STATUS OF MAXILLARY SINUS IN THE POSTERIOR MAXILLA: THREE-DIMENSIONAL ANALYSIS FOR IMPLANT THERAPY

Objective: The purpose of this study was to assess morphologic features of alveolar bone supporting maxillary premolars and molars and to determine the relationship between maxillary sinus and teeth using cone beam computed tomography (CBCT).Material and Methods: In CBCT scans of 100 patients, the thickness of both trabecular bone and cortical plates surrounding 652 posterior teeth were measured and the relationship between teeth and maxillary sinus was classified. Also, the angle between the teeth and the alveolar crest was measured.Results: Of the teeth examined, 25 % were in contact with the inferior wall of maxillary sinus, 12% had penetrated the sinus and 63 % were far away from maxillary sinus. The closest root to the maxillary sinus floor was mesiobuccally root of second molar teeth with 1.3 mm distance. The teeth which had thinnest bone configuration were maxillary first premolars. There were no significant differences for measurements between sides and gender (p>005). Buccal bone thickness and distance to the maxillary sinus floor showed a negative correlation in molars (p˂0.001 and 0.003).Conclusion: In order to prevent possible complications, a three-dimensional analysis of the posterior maxilla and maxillary sinus is required before implant procedures to be performed on the maxillary posterior region.

Keywords:

Bone thickness, CBCT, maxillary molars, maxillary premolars,

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