A CBCT Study About The Relationship Between The Thickening Of Schneiderian Membrane And Oral Conditions Of Maxillary Posterior Area

Objective:Using cone beam computed tomography(CBCT)imaging system to evaluate the thickening of patients’ maxillary sinus floor lining epithelium,which is called schneiderian membrane(SM),as well as analyze the correlation between SM thickening and intra oral conditions of maxillary posterior area.This experiment can provide some references for clinical diagnosis and treatment of maxillary sinus inflammation caused by oral diseases.Content:According to the CBCT images of the samples record the anatomical relationship between maxillary premolar and molar teeth and maxillary sinus floor,the degree of alveolar bone loss,the incidence of root canal treatment and periapical lesions,as well as implant,impacted and missing teeth.At the same time record the thickness of SM and their grades to analyze above factors’ relationship with SM thickening.And analyze the epidemiological characteristics of SM thickening..Methods:1.Data collection: 500 patients were randomly selected from those whose CBCT images were taken in the CT room of the international clinic center of Tianjin Nankai university stomatology hospital from June 2018 to March 2019.Unilateral CBCT image of each patient was taken as one sample to obtain a total of 1,000 CBCT image samples.Inclusion criteria: the patient is over 18 years old;non-operative patients.Exclusion criteria: Patient with osteoarthropathy or bone asymmetry;low quality scattered or no enough bone edges to visualize or altered CBCT images;CBCT images of patients with deciduous or substitute teeth;CBCT images of small field or temporomandibular joint;CBCT images of SM thickening caused by chronic obstructive,acute and chronic inflammation and tumor.2.CBCT image evaluation: the CBCT images were evaluated from the sagittal,coronal and axial positions respectively.3.Data recording of gender,age,thickness and grade of SM,anatomical relationship between the root of the maxillary posterior teeth and the maxillary sinus floor,maxillary posterior alveolar bone loss,root canal treatment and periapical lesions of the maxillary posterior teeth,implant and impacted teeth,and so on.4.Statistical analysis: according to the experimental data,analyze the thickening of the schneiderian membrane and the correlation between the SM thickness and the patient’s age,gender,anatomical relationship between the root of the maxillary posterior teeth and the maxillary sinus floor,alveolar bone loss,endodontic status of the maxillary posterior teeth as well as implant and impacted teeth.Results:According to the statistical analysis of the experimental data,619(61.9%)of the1000 samples had thickened schneiderian membrane(>2mm).In 64.2% of the samples without root contact or enter the maxillary sinus,the thickening of the schneiderian membrane occurred.In the cases which had one or more root contact or enter the maxillary sinus,the incidence was 66.2% and 59.3%,respectively.In the case of alveolar bone loss,the incidence of schneiderian membrane thickening was significantly higher(p<0.05).The incidence of schneiderian membrane thickening in the samples with and without periapical lesions was 77.3% and 57.5%,respectively.And there was a positive correlation between the number of periapical lesions and the incidence of schneiderian membrane thickening(p<0.05).In addition,thickening of the maxillary sinus mucosa was significantly correlated with age,sex and missing teeth(p<0.05).Conclusion:Periapical disease,root canal therapy,periodontal disease and the anatomical relationship between maxillary teeth and maxillary sinus floor may contribute to the thickening of schneiderian membrane.Oral conditions and their roles as the risk factors for maxillary sinus infection should be fully taken into account by oral specialists,otolaryngology and general practitioners to properly plan the treatment of maxillary sinus lesions.