위턱굴의부피추정산출에대한연구

정화해,이덕구,서윤경,김창수,백두진 대한체질인류학회 2008 대한체질인류학회지 Vol.21 No.2

It is important that the surgeons expect difference in the volume of the maxillary sinus during endoscopic surgery because a variation in volume of the maxillary sinus is related to a variation in anatomical landmarks. Forty four Korean skulls (88 sinuses, 23 M/21F) were used in this study. Anatomical landmarks around the maxillary sinus were measured. The significant variables (r¤0.03, P⁄0.05) out of measured variables were pick out by use of SPSS-13.0 program. The regression equation models were developed by multiple regression analysis. The volume of maxillary sinus showed a high correlation with 19 variables included the width, height, depth of the maxillary sinus, depth on C-arm radiography, length of three borders of maxillary sinus, distance between the lowest point of orbit and the deepest point of maxillary sinus, distance between the deepest point of maxillary sinus and the porion, width of orbit, measured values from akanthion. The regression equation model for prediction of the volume of the maxillary sinus was volume=0.692×(the anteroposterior length of the maxillary sinus)+0.355×(the height of the maxillary sinus)-22.178. This study ascertained variables of a high correlation with volume of the maxillary sinus and would be useful to develop the regression model for prediction of volume of the maxillary sinus. 위턱굴 부피의 변화는 주변 해부학적 표지 구조물의 위치변화와 밀접한 관련이 있기 때문에 위턱굴 내 시경 수술시 위턱굴의 부피를 예측하여 주변 구조물의 위치를 미리 숙지하는 것이 필요하다. 고정된 한국인 시신 44구(남자 23구, 여자 21구, 평균나이 67.7세)의 머리뼈 88쪽을 대상으로 하여 위턱굴 주변 구조물들을 계측하여 위턱굴의 부피와의 상관관계를 구한 다음 의미있는 항목(r¤0.03, p⁄0.05)을 가려 부피추정 위턱굴의 부피는 위턱굴의 너비, 높이, 길이와 위턱굴 세 벽의 길이, 눈확아래지점과 위턱굴 가장 깊은점 사이의 거리, 위턱굴 가장 깊은점과 귀구멍점 사이의 거리, 눈확의 너비, 앞코가시점을 중심으로 계측한 변인들을 포함한 19항목들과 높은 상관관계를 보였다. 이러한 설명력이 높은 변인들을 독립변수로 하고 위턱굴의 부피를 종속변수 로 하여 다중회귀분석으로 추정식을 산출한 결과, 그 식은 부피=-22.178+0.692×(위턱굴실측 앞뒤길이)+0.355 ×(위턱굴 높이)이며 설명력(R2)은 0.759이었다. 본 연구에서는 위턱굴의 부피와 상관관계가 높은 주변 구조물들을 확인하여 내시경 수술시 위턱굴의 부피 예 측에 필요한 추정식을 제시한 것으로 생각된다.

The incidence and morphology of maxillary sinus septa in dentate and edentulous maxillae: a cadaveric study with a brief review of the literature

Kusum Rajendra Gandhi,Rajendra Namdeo Wabale,Abu Ubaida Siddiqui,Mujjebuddeen Samsudeen Farooqui 대한구강악안면외과학회 2015 대한구강악안면외과학회지 Vol.41 No.1

Objectives: The aim of this study is to determine the incidence, location, and orientation of maxillary sinus septa in formalin embalmed cadavers. Materials and Methods: The study was conducted on 210 cadaveric heads available in our department. After taking the mid-sagittal section the specimens were opened from the medial aspect and the sinus cavity was explored for the presence of maxillary sinus septa, their anatomical plane, location and dimensions. Results: The mean linear distance between maxillary sinus floor and its anatomical ostium was 26.76±5.21 mm and 26.91±4.96 mm on right and left side, respectively. A total of 59 maxillary sinus septa (28.1%) were observed in 210 maxillary specimens. Septae were most common, 33 septa (55.9%), in the middle region (between first and second molar tooth) of the sinus cavity. The maxillary sinus membrane (Schneiderian membrane) adhered tightly to the maxillary sinus and over the septae. Significantly more maxillary sinus septa were observed in edentulous maxillae in comparison to the dentate upper jaw. Conclusion: Knowledge of location of maxillary sinus ostium is mandatory for the rhinologist for drainage of secretions in maxillary sinusitis. The morphological details of maxillary sinus septa, particularly their location and anatomical planes, will guide dentists in performance of safe implant surgeries. The maxillary antrum septa of category I and II may complicate the procedure of inversion of bone plate and elevation of sinus membrane during maxillary augmentation surgeries. The category III septa observed in the sagittal plane were embedded by one of the branches of the infraorbital nerve in it, and if accidentally cut will lead to infraorbital nerve palsy in maxillary sinus surgeries.

Assessment of the relationship between the maxillary molars and adjacent structures using cone beam computed tomography

정연화,조봉혜 대한영상치의학회 2012 Imaging Science in Dentistry Vol.42 No.4

Purpose: This study investigated the relationship between the roots of the maxillary molars and the maxillary sinus using cone beam computed tomography (CBCT), and measured the distances between the roots of the maxillary molars and the sinus floor as well as the thickness of the bone between the root and the alveolar cortical plate. Materials and Methods: The study sample consisted of 83 patients with normally erupted bilateral maxillary first and second molars. A total of 332 maxillary molars were examined using CBCT images. The vertical relationship of each root with the maxillary sinus was classified into four types on CBCT cross-sectional images. The distance between the sinus floor and root and the bone thickness between the root and alveolar cortical plate were measured. Results: In the buccal roots of the maxillary molars, a root protruding into the sinus occurred most frequently. A root projecting laterally along the sinus cavity was most common in the palatal roots of the maxillary first molars. The mesiobuccal roots of the maxillary second molar were closest to the sinus. The mesiobuccal roots of the first molars were closest to the cortical plate. Conclusion: The relationship between the roots of the maxillary molars and the sinus differed between the buccal and palatal roots. A root protruding into the sinus occurred more frequent in the buccal roots of the maxillary molars. The mesiobuccal root of the maxillary second molar was closest to the maxillary sinus floor and farthest from the alveolar cortical plate. Purpose: This study investigated the relationship between the roots of the maxillary molars and the maxillary sinus using cone beam computed tomography (CBCT), and measured the distances between the roots of the maxillary molars and the sinus floor as well as the thickness of the bone between the root and the alveolar cortical plate. Materials and Methods: The study sample consisted of 83 patients with normally erupted bilateral maxillary first and second molars. A total of 332 maxillary molars were examined using CBCT images. The vertical relationship of each root with the maxillary sinus was classified into four types on CBCT cross-sectional images. The distance between the sinus floor and root and the bone thickness between the root and alveolar cortical plate were measured. Results: In the buccal roots of the maxillary molars, a root protruding into the sinus occurred most frequently. A root projecting laterally along the sinus cavity was most common in the palatal roots of the maxillary first molars. The mesiobuccal roots of the maxillary second molar were closest to the sinus. The mesiobuccal roots of the first molars were closest to the cortical plate. Conclusion: The relationship between the roots of the maxillary molars and the sinus differed between the buccal and palatal roots. A root protruding into the sinus occurred more frequent in the buccal roots of the maxillary molars. The mesiobuccal root of the maxillary second molar was closest to the maxillary sinus floor and farthest from the alveolar cortical plate.

측모두부방사선 사진을 이용한 아동 위턱뼈굴 성장의 누년적 고찰

박영석,백기석,장미숙,이승표 대한해부학회 2004 Anatomy & Cell Biology Vol.37 No.2

Investigation of flow characteristics in the maxillary sinus where polypoid changes develop

Chung, Seung-Kyu,Byun, Seongsu,Na, Yang Elsevier 2018 Computers in biology and medicine Vol.102 No.-

<P><B>Abstract</B></P> <P>Flow behavior in the maxillary sinus where polypoid changes develop was investigated using computational fluid dynamics. A nasal cavity model was constructed, after performing a virtual polypectomy based on computed tomography images of a patient, using a computer-aided design software to artificially remove polypoid changes inside the maxillary sinus. Local flow characteristics in the maxillary sinus were examined for one full respiration period.</P> <P>The results showed that the epithelial surfaces where polypoid changes occur are located in the lower part of the maxillary sinus which contains a protruding zone of the sinus and are characterized by stagnation of air during the entire respiration period. Due to the geometric characteristics, a very slow recirculating motion was found to occur in the bulging area for approximately half of the respiration period as a result of interaction with a larger-scale, counter-rotating vortex filling the middle of the maxillary sinus. With a much smaller velocity inside the maxillary sinus compared to that typically found in the airway passage through the middle meatus, both wall shear and pressure changes were found to be vanishingly small along the epithelial surface of the maxillary sinus where polypoid changes were found.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Virtual maxillary sinus polypectomy was performed to construct a numerical model. </LI> <LI> Flow characteristics inside the maxillary sinus were investigated. </LI> <LI> Regions where polypoid change developed in the maxillary sinus remain stagnant. </LI> <LI> Wall shear stress along the epithelial surface of the maxillary sinus is negligible. </LI> <LI> The role of wall pressure is negligible inside the maxillary sinus. </LI> </UL> </P>

A Novel Approach to Treat Dental Implant-related Maxillary Sinusitis via Intentional Oroantral Fistula: Case Series

Jae-Hyeong Park(박재형),Jin-Wook Kim(김진욱),Hyun-Woo Yoon(윤현우),Sung-Tak Lee(이성탁) 대한치과의사협회 2024 대한치과의사협회지 Vol.62 No.5

상악동저 거상술과 임플란트 식립 후 상악동저 변화에 대한 연구

조상호,김옥수,Cho, Sang-Ho,Kim, Ok-Su 대한치주과학회 2006 Journal of Periodontal & Implant Science Vol.36 No.2

Loss of maxillary molar teeth leads to rapid loss of crestal bone and inferior expansion of the maxillary sinus floor (secondary pneumatization). Rehabilitation of the site with osseointegrated dental implants often represents a clinical challenge because of the insufficient bone volume resulted from this phenomenon. Boyne & James proposed the classic procedure for maxillary sinus floor elevation entails preparation of a trap door including the Schneiderian membrane in the lateral sinus wall. Summers proposed another non-invasive method using a set of osteotome and the osteotome sinus floor elevation (OSFE) was proposed for implant sites with at least 5-6mm of bone between the alveolar crest and the maxillary sinus floor. The change of grafted material in maxillary sinus is important for implant survival and the evaluation of graft height after maxillary sinus floor elevation is composed of histologic evaluation and radiomorphometric evaluation. The aim of the present study was radiographically evaluate the graft height change after maxillary sinus floor elevation and the influence of the graft material type in height change and the bone remodeling of grafts in sinus. A total of 59 patients (28 in lateral approach and 31 in crestal approach) who underwent maxillary sinus floor elevation composed of lateral approach and crestal approach were radiographically followed for up to about 48 months. Change in sinusgraft height were calculated with respect to implant length (IL) and grafted sinus height(BL). It was evaluated the change of the graft height according to time, the influence of the approach technique (staged approach and simultaneous approach) in lateral approach to change of the graft height, and the influence of the type of graft materials to change of the graft height. Patients were divided into three class based on the height of the grafted sinus floor relative to the implant apex and evaluated the proportion change of that class (Class I, in which the grafted sinus floor was above the implant apex; Class II, in which the implant apex was level with the grafted sinus floor; and Class III, in which the grafted sinus floor was below the implant apex). And it was evaluated th bone remodeling in sinus during 12 months using SGRl(by $Br\ddot{a}gger$ et al). The result was like that; Sinus graft height decreased significantly in both lateral approach and crestal approach in first 12 months (p<O,01). Significant difference was not observed between staged approach and simultaneous approach in graft height change according to time in lateral approach, However, staged approach had more height loss to simultaneous approach in all observed time. In lateral approach, there was significant difference in BL/IL change according to the type of graft material (p<0.05). Autogenous bone had maximum height loss and $MBCP^{TM}$ had minimum height loss. Class III and Class II was increased by time in both lateral and crestal approach and Class I was decreased by time. SGRI was increased statistically significantly from baseline to 3 months and 3 months(p<0.05) to 12 months(p<O.01) in both approach. From above mentioned results, we concluded that progressive sinus graft height reduction occurs in both maxillary sinus floor elevation approaches and then stability of sinus graft height is achieved, In case of autogenous bone or $ICB^{(R)}$ single use, more reduction of sinusgraft height was appeared. Therefore we speculated that the mixture of graft materials is preferable as a reduction of graft materials. Increasing of the SGRI as time goes by explains the stability of implant, but additional histologic or computed tomographic study will be needed for accurate conclusion. From the radiographic evaluation, we come to know that placement of dental implant with sinus floor elevation is an effective procedure in atrophic maxillary reconstruction.

Comparison of panoramic radiography and cone-beam computed tomography for assessing radiographic signs indicating root protrusion into the maxillary sinus

Jung, Yun-Hoa,Cho, Bong-Hae,Hwang, Jae Joon Korean Academy of Oral and Maxillofacial Radiology 2020 Imaging Science in Dentistry Vol.50 No.4

Purpose: This study investigated correlations between findings on panoramic radiographs and cone-beam computed tomography (CBCT) to assess the relationship between the maxillary sinus floor and the roots of maxillary posterior teeth. In addition, radiographic signs indicating actual root protrusion into the maxillary sinus were evaluated on panoramic radiographs. Materials and Methods: Paired panoramic radiographs and CBCT images from 305 subjects were analyzed. This analysis classified 2,440 maxillary premolars and molars according to their relationship with the maxillary sinus floor on panoramic radiographs and CBCT images. In addition, interruption of the sinus floor was examined on panoramic radiographs. Results: Root protrusion into the maxillary sinus occurred most frequently in the mesiobuccal roots of the second molars. The classification according to panoramic radiographs and CBCT images was the same in more than 90% of cases when there was no contact between the root apex and the sinus floor. When the panoramic radiograph showed root protrusion into the sinus, the CBCT images showed the same classification in 67.5% of second molars, 48.8% of first molars, and 53.3% of second premolars. There was a statistically significant relationship between interruption of the sinus floor on panoramic radiographs and root protrusion into the sinus on CBCT images. Conclusion: The presence of root protrusion into the sinus on panoramic radiographs demonstrated a moderate ability to predict root protrusion into the maxillary sinus. Interruption of the maxillary sinus floor could be considered an indicator of actual root protrusion into the maxillary sinus.

Does Nasal Septal Deviation and Concha Bullosa Have Effect on Maxillary Sinus Volume and Maxillary Sinusitis?: A Retrospective Study

이주연,박상만,차승환,문진실,김명순 대한영상의학회 2020 대한영상의학회지 Vol.81 No.6

Purpose This study aimed to determine whether nasal septal deviation and concha bullosa affect the maxillary sinus volume, and whether this effect is associated with the prevalence of chronic sinusitis. Materials and Methods This study retrospectively reviewed 209 paranasal sinus CT (PNS CT) images of patients with sinonasal symptoms from January 2017 to December 2018. The maxillary sinus volume was measured twice by a radiologist, and statistical analysis was performed using SAS 9.4. Results Intersex comparison of the maxillary sinus volume (on left and right sides) revealed that the volume was significantly larger on both the sides (p < 0.0001) in men compared with that in women. Concha bullosa was found to occur mainly in the concave cavity of the septal deviation (p < 0.0001). No significant association was found between nasal septal deviation and maxillary sinusitis (p = 0.8756) as well as between concha bullosa and maxillary sinusitis prevalence (p = 0.3401) or maxillary sinus volume (both: p = 0.6289, Rt.: p = 0.9522, Lt.: p = 0.9201). Conclusion Although nasal septal deviation and the location of concha bullosa may affect each other, maxillary sinus volume and maxillary sinusitis were neither associated with nasal septal deviation nor concha bullosa.

Assessment of the relationship between the maxillary molars and adjacent structures using cone beam computed tomography

Jung, Yun-Hoa,Cho, Bong-Hae Korean Academy of Oral and Maxillofacial Radiology 2012 Imaging Science in Dentistry Vol.42 No.4

Purpose: This study investigated the relationship between the roots of the maxillary molars and the maxillary sinus using cone beam computed tomography (CBCT), and measured the distances between the roots of the maxillary molars and the sinus floor as well as the thickness of the bone between the root and the alveolar cortical plate. Materials and Methods: The study sample consisted of 83 patients with normally erupted bilateral maxillary first and second molars. A total of 332 maxillary molars were examined using CBCT images. The vertical relationship of each root with the maxillary sinus was classified into four types on CBCT cross-sectional images. The distance between the sinus floor and root and the bone thickness between the root and alveolar cortical plate were measured. Results: In the buccal roots of the maxillary molars, a root protruding into the sinus occurred most frequently. A root projecting laterally along the sinus cavity was most common in the palatal roots of the maxillary first molars. The mesiobuccal roots of the maxillary second molar were closest to the sinus. The mesiobuccal roots of the first molars were closest to the cortical plate. Conclusion: The relationship between the roots of the maxillary molars and the sinus differed between the buccal and palatal roots. A root protruding into the sinus occurred more frequent in the buccal roots of the maxillary molars. The mesiobuccal root of the maxillary second molar was closest to the maxillary sinus floor and farthest from the alveolar cortical plate.