Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지

Morphological Analysis of the Sinus Lateral Wall using Computed Tomography

전산화단층촬영법을 이용한 상악동 측벽의 형태학적 분석

  • Kim, Yong-Gun (Department of Periodontics, Chung-Ang University Hospital)
  • 김용건 (중앙대학교병원 치과센터 치주과)
  • Received : 2011.07.22
  • Accepted : 2011.09.25
  • Published : 2011.09.30
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Abstract

The purpose of thise study was to measure the thickness of the sinus lateral wall using computed tomography (CT), and to find the most suitable vertical position for lateral window opening prior to sinus elevation. Thirty patients requiring sinus elevation had CT images taken with Philips Brilliance iCT. The thickness of the sinus lateral wall was measured according to its vertical position against the sinus inferior border, and its mean was calculated through three repeated measurements. When measured 2 mm above the sinus inferior border (SIB+2), the thickness of the sinus lateral wall was observed to be more than 2 mm. When measured 3 mm above the sinus inferior border (SIB +3), the sinus lateral wall was less than 2 mm in thickness. It is recommended that the lateral wall window be made 3 mm above the sinus inferior border when performing sinus elevation using the lateral approach.

이번 연구는 전산화단층촬영법 (computed tomography)을 이용하여 상악동 측벽의 두께를 측정하고, 상악동 거상술을 위한 측벽창 (lateral wall window)형성 시 가장 적절한 수직적 위치를 평가하고자 한다. 상악동 거상술이 필요한 30명 환자의 전산화단층촬영 방사선영상을 대상으로 분석하였다. 상악동 측벽의 두께는 상악동 하연을 기준으로 수직적 위치에 따라 분류하고, 3회 반복 측정하여 평균을 구하였다. 상악동 측벽의 두께는 상악동 하연 (sinus inferior border, SIB)을 기준으로 상방 2 mm (SIB + 2) 까지는 2 mm 이상으로 관찰되었고, 상악동의 하연을 기준으로 3 mm 상방 (SIB + 3)에서는 2 mm 미만으로 나타났다. 이번 연구에서 근거하여 측방 접근법을 이용한 상악동 거상술에서 측벽창의 위치는 상악골의 하연을 기준으로 약 3 mm 상방에서 형성하는 것이 적절할 것으로 사료된다.

Keywords

References

  1. Misch CE. Maxillary sinus augmentation for endosteal implants: organized alternative treatment plans. Int J Oral Implantol 1987;4:49-58
  2. Jemt T, Lekholm U. Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption. Int J Oral Maxillofac Implants. 1995;10:303-11.
  3. Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium. 1994;15:152, 154-6, 158
  4. Jensen OT, Shulman LB, Block MS et al. Report of the Sinus Consensus Conference of 1996. Int J Oral Maxillofac Implants. 1998;13 Suppl:11-45.
  5. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613-6.
  6. Tatum OH. Maxillary and sinus implant reconstructions. Dent Clin North Am 1986;30:207-29.
  7. Betts KIT, Miloro M. Modification of the sinus lift procedure for septa in the maxillary antrum. J Oral Maxillofac Surg 1994;52:332-3. https://doi.org/10.1016/0278-2391(94)90313-1
  8. Block M, Kent JN. Sinus augmentation for dental implants. The use of autogenous bone. J Oral Maxillofac Surg 1997;55:1281-6. https://doi.org/10.1016/S0278-2391(97)90185-3
  9. Nevins M. The sinus-elevation surgical procedure to support implant prostheses. Dent Econ 1995;85:88-9.
  10. Wheeler SL, Holmes RE, Calhoun CJ. Six-year clinical and histologic study of sinus-lift grafts. Int J Oral Maxillofac Implants 1996;11:26-34.
  11. Jensen J, Sindet-Pederson S, Oliver AJ. Varying treatment strategies for reconstruction of maxillary atrophy with implants: Results in 98 patients. J Oral Maxillofac Surg 1994;52:210-216. https://doi.org/10.1016/0278-2391(94)90283-6
  12. David M, Momtaheni, Kenneth Schweitzer, technique for stabilization of autogeneous cancellous bone grafts in sinus lift procedures. Oral Surg Oral Med Oral Pathol 1994;78:14-6. https://doi.org/10.1016/0030-4220(94)90110-4
  13. Kim soo Guan, Surgery of the Sinus Bone Graft, Sinus Bone Graft, Seoul, Daehan Publishing Co. 2004;67-8.
  14. Froum SJ, Tarnow DP, Wallace SS, et al: Sinus floor elevation using anorganic bovine bone matrix (Osteograf/N) with and without autogenous bone: A clinical, histologic, radiographic, and histomorphometric analysis-Part 2 of an ongoing prospective study. Int J Periodontics Restorative Dent1998; 18:528-43.
  15. Szabo G, Huys L, Coulthard P, et al. A prospective multicenter randomized clinical trial of autogenous bone versus beta-tricalcium phosphate graft alone for bilateral sinus elevation: histologic and histomorphometric evaluation. Int J Oral Maxillofac Implants. 2005 May-Jun;20(3):371-81.
  16. Karabuda C, Ozdemir O, Tosun T, et al: Histological and clinical evaluation of 3 different grafting materials for sinus lifting procedure based on 8 cases. J Periodontol 2001;72:1436-42. https://doi.org/10.1902/jop.2001.72.10.1436
  17. Wallace SS, Froum SJ: Effect of maxillary sinus augmentation on the survival of endosseous dental implants. A systematic review. Ann Periodontol 2003;8:328-43 https://doi.org/10.1902/annals.2003.8.1.328
  18. Olson JW, Dent CD, Morris HF, et al: Long-term assessment (5 to 71 months) of endosseous dental implants placed in theaugmented maxillary sinus. Ann Periodontol 2000;5:152-6 https://doi.org/10.1902/annals.2000.5.1.152
  19. Chanavaz M: Sinus grafting related to implantology: Statistical analysis of 15 years of surgical experience. J Oral Implantol 1996;22:119-30
  20. Valentini P, Abensur DJ: Maxillary sinus grafting with anorganic bovine bone: A clinical report of long-term results. Int J Oral Maxillofac Implants 2003;18:556-60
  21. Wallace SS: Maxillary sinus augmentation: Evidence- based decision making with a biological surgical approach. Compendium 2006;27:662-8
  22. George A, mandelaris. Alternative applications of guided surgerys: precise outlning of the lateral window in antral sinus bone grafting. J oral maxillofac surg 2009(suppl 3);67:23-30
  23. Lekholom U, Zarb GA. patient selection and preparations. In: Branemark PI, Zarb GA. &Albreksson T. Tissue-integrated prostheses. Osseointegration in clinical dentistry. 1st ed Chicago: Quintessence Publishing Co Inc; 1985:199-220
  24. Bosse LP, Taylor TD. Problems associated with implant rehabilitation of the edentulous maxilla. Dent Clin North Am. 1998;42:117-27.
  25. Fugazzotto PA, Vlassis J. Long-term success of sinus augmentation using various surgical approaches and grafting materials. Int J Oral Maxillofac Implants. 1998 ;13:52-8.
  26. Smiler DG, Johnson PW, Lozada JL, Misch C, Rosenlicht JL, Tatum OH Jr, Wagner JR. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36:151-86
  27. Krennmair G, Ulm GW, Lugmayr H, Solar P. The incidence, location, and height of maxillary sinus septa in the edentulous and dentate maxilla. J Oral Maxillofacial Surg. 1999;57:667-671. https://doi.org/10.1016/S0278-2391(99)90427-5
  28. Lugmayr H, Krennmair G, Holzer H. The morphology and incidence of maxillary sinus septa. Rofo. 1996;165:452-454. https://doi.org/10.1055/s-2007-1015788
  29. Krennmair G, Ulm C, Lugmayr H. Maxillary sinus septa: incidence, morphology and clinical implications. J Craniomaxillofac Surg. 1997;25:261-265. https://doi.org/10.1016/S1010-5182(97)80063-7