Radiographic evaluations of the various lesions of maxillary sinus, inferior wall of sinus and surrounding structures using reformatted computed tomography / 대한구강악안면방사선학회지

PURPOSE: To evaluate the degree of accuracy of DentaScan reformatted images of the maxillary sinus and periapical, periodontal lesions and to clarify the usefulness of the reconstructed 3-dimensional images to the dental clinical aspects. MATERIALS AND METHODS: 33 sides of maxillae of the hemi-sectioned Korean heads were used in this study. Periapical radiographs, computed tomography and DentaScan reformatted cross-sectional images were taken for the radiographic evaluation of the peiapical and peiodontal lesions of the maxillary teeth and inferior wall of maxillary sinus. RESULTS: Compared the degree of accuracy and findings of dental and periapical pathoses on the intraoral radiographs and DentaScan reformatted images with the cross-sectioned specimens, the DentaScan reformatted cross-sectional images were more accurate and more effective than the intraoral radiography with a viewpoint of the detection of dental and periapical pathoses. CONCLUSION: Comparing the lesions of specimens with intraoral radiographies and DentaScan reformatted images, the dental and periodontal pathoses and topographical structures were more clearly observed in the DentaScan reformatted images, providing the possibility of more applications of reformatted images to clinical dentistry.

Morphometries of the Maxillary Sinus in Koreans / 체질인류학회지

The anatomical description and the relationship between the root apex and the inferior wall of sinus are critical in diagnoses and surgeries of the sinus pathoses, and in dental implantation. So, identification of the proximity between the root apex and the inferior wall of sinus and the clarification of cortical thickness of inferior wall of sinus are indicated the topography of spreading dental infection into the maxillary sinus. Therefore, anatomical knowledge of the topography between the root apex and the inferior wall maxillary sinus are important in the diagnosis and treatment planning of the dental implantation, endodontic procedures, and orthodontic treatment. The purposes of this study were 1) to clarify the morphological and clinical characteristics of the maxillary sinus, especially the inferior wall of sinus in Korean, 2) to identify the relationship between the inferior wall of maxillary sinus and the roots of maxillary teeth, and 3) to evaluate the degree of accuracy of DentaScan reformatted images of the maxillary sinus. 33 sides of maxillae of the hemi -sectioned Korean heads were used in this study. All specimens were taken periapical radiographs, computed tomography and DentaScan reformatted cross -sectional images were taken for the radiographic evaluation of the maxillary teeth and inferior wall of maxillary sinus. From the CT images, 3 -dimentional reconstructive images of maxillary sinuses were made using the V -works TM 3.0 program. All specimens were decalcificated and then were sectioned coronally. On the sectioned specimen, 21 metric items were measured using the image analyzing system. The results were as follows: 1. In 6 categories of maxillary sinus according to their lateral aspects and shapes of the inferior walls, flat (54.5%) and round (21.2%) inferior wall of maxillary sinus were prominent. In 58.4%, the anterior limit of maxillary sinus was located in the 1st premolar area and the posterior limit was in the 3rd molar and maxillary tuberosity area (93.9%). The lowest level of the maxillary sinus was in the 1st molar and 2nd molar area. 2. From the 3 -dimentional reconstructive images of maxillary sinus, the maximum anteroposterior length of sinus was 39.3 +/-4.2 mm, the maximum height was 37.1 +/-5.6 mm, and the maximum width was 32.6 +/-6.5 mm. And the average volume of sinus was 15.1 +/-6.2 ml. All measurements were larger in male than female. Taken all together, this study demonstrated various anatomical characteristics and relationships between the maxillary sinus and their surrounding structures. Recognition of these findings may have an impact on the clinical management of patients.

Topography of the Inferior Wall of the Maxillary Sinus in Koreans / 체질인류학회지

The anatomical description and the relationship between the root apex and the inferior wall of sinus are critical in diagnoses and surgeries of the sinus pathoses, and in dental implantation. So, identification of the proximity between the root apex and the inferior wall of sinus and the clarification of cortical thickness of inferior wall of sinus are indicated the topography of spreading dental infection into the maxillary sinus. Therefore, anatomical knowledge of the topography between the root apex and the inferior wall maxillary sinus are important in the diagnosis and treatment planning of the dental implantation, endodontic procedures, and orthodontic treatment. The purposes of this study were to clarify the morphological and clinical characteristics of the maxillary sinus, especially the inferior wall of sinus in Korean, and to identify the relationship between the inferior wall of maxillary sinus and the roots of maxillary teeth. 24 sides of maxillae of the hemi -sectioned Korean heads were used in this study. All specimens were taken DentaScan reformatted cross -sectional images were taken for the radiographic evaluation of the maxillary teeth and inferior wall of maxillary sinus. All specimens were decalcificated and thenp were sectioned coronally. On the sectioned specimen, 21 metric items were measured using the image analyzing system. The results were as follows: 1. The distance between the each root apex and the inferior wall of maxillary sinus were measured. In the 2nd molar area the distance from the root apex to the inferior wall of sinus was the shortest and the longest in the 1st premolar area. 2. The thickness of the cortical plate of the inferior wall of maxillary sinus was thinnest in the 1st premolar area, whereas, the thickest in the 2nd premolar area. 3. The vertical relationship between the inferior wall and the roots of the maxillary molars was classified into 5 types. Type I (the inferior wall of sinus was located above the level connecting the buccal and lingual root apices) was predominant (54.5% in the 1st molar area, 52.4% in the 2nd molar area). 4. The horizontal relationship between the inferior wall of sinus and root apex were classified into 3 types. Type 2 (the alveolar recess of the inferior wall of sinus was located between the buccal and lingual roots) was predominant (80% in the 1st and 2nd molar area). Taken all together, this study demonstrated various anatomical characteristics and relationships between the maxillary sinus and their surrounding structures. Recognition of these findings may have an impact on the clinical management of patients.

A Raiologic Study of the Relationship of the Maxillary Sinus Floor and Apex of the Maxillary Molar / 대한구강악안면방사선학회지

In this study, radiographic evaluation was made using panoramic radiography and cross-sectional tomography of SCANORA in male and female adults in their 20 s on the relationship between the maxillary sinus floor and the apex of the maxillary molar, to test the accuracy and effectiveness of the cross-sectional tomography, and to use this information in the assessment of preop, and postop, root canal treatment, apical surgery, extraction and implantology. Forty-one adults with an average age of 24.4 years were studied panoramic radiography and cross-sectional tomography. In panoramic view and cross-sectional view, the position of the apices of maxillary molars were classified as separated, contacted, or protruded type; the general shape of the maxillary sinus floor was evaluated horizontally and vertically from cross-sectional tomography. The accuracy of each radiography was tested using maxilla from 5 fresh cadavers from the Anatomy Lab at Yonsei University Dental College, and panoramic view and cross-sectional tomography were taken in the same condition as with the patients. The results were as follows ; 1. Panoramic view and cross-sectional view were taken in the maxilla specimen, and the actual distance between the maxillary sinus floor and the tooth apices were measured in the specimen; the median values of the distance from the tooth apices to the maxillary sinus floor in the panoramic view, cross-sectional view and in the acrual maxilla specimen were 2.83mm, 4.51mm, and 4.15mm, respectively. In the cross-sectional view, the measured distance was close to the actual distance but in the panoramic view, the measured distance was far from the actual distance. 2. When the results of the panoramic view and cross-sectional view were compared, 40.5% of the results agreed with each other in the two radiographic methods and buccal roots of the 2nd molar were the closest to the maxillary sinus floor in the cross-sectional tomography. 3. In cross-sectional view, when the vertical relatioship of the maxillary sinus floor and maxillary roots was assessed, in 1st molars, type II (the sinus floor that extends down to the buccolingual furcation area) was predominant, while in 2nd molars, type I (the sinus floor located above the level connecting the buccal and lingual apices) was predominant. In the horizontal relationship, in 1st olars, type II (ths lowest floor of the maxillary sinus located in between the buccal and lingual roots) was predominant; in 2nd molars, type I (the lowest floor of the maxillary sinus located on the buccal side of the buccal roots) and type II appeared in similar frequency. In conclusion, the SCANORA cross-sectional tomography was more effective than the frequently used panoramic view, in that the relationship of the maxillary molars and maxillary sinus floor can be evaluated more accurately and the buccolingual cross-sectional view can also be observed. And maxillary sinus floor that was close to maxillary 2nd molar had tendency to be located on buccal side than that close to 1st molar. Therefore, cross-sectional tomography is an effective and accurate method to evaluate the position of the teeth in relation to the sinus floor preoperative and can be easily used to diagnose localized periapical lesions. Also the image quality obtained was quite satisfactory.