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目的为上颌牙种植术等临床口腔外科提供解剖学基础。方法选取新鲜上颌骨标本10例20侧、成人全牙上颌骨标本18例36侧和20名全牙志愿者,分别暴露出上颌窦粘膜、上颌窦与上颌后牙牙根和CT连续扫描后进行三维重建。观察上颌窦的形态及其下壁的骨性和粘膜结构,用游标卡尺和CT三维重建工作站分别测量上颌后牙牙根至上颌窦下壁的距离。结果上颌窦呈三边形或四边形的锥体形腔隙,其下壁常有凸起的骨隔和粘膜隔。上颌磨牙的近中颊根至上颌窦的距离均较舌根、远中颊根近,由近及远依次为近中颊根、舌根和远中颊根。在标本及影像上的第1前磨牙、第2前磨牙、第1磨牙、第2磨牙、第3磨牙牙根至上颌窦下壁的距离分别为(9.30±2.64)mm和(9.50±2.72)mm、(4.50±1.98)mm和(4.60±1.95)mm、(2.02±0.91)mm和(2.18±0.96)mm、(2.06±1.04)mm和(2.26±1.20)mm、(3.74±1.73)mm和(3.82±1.84)mm。结论(1)上颌后牙至上颌窦的距离以第1磨牙最近,由近及远依次为第1磨牙、第2磨牙、第3磨牙、第2前磨牙和第1前磨牙。(2)对选择适宜长度的牙种植体,避免牙种植体误入上颌窦等具有重要意义。
Objective To provide anatomical basis for clinical oral surgery such as maxillary dental implant. Methods Twenty newborns in 10 cases of maxillary bone and 18 cases of maxillary alveolar bone in 20 adult patients were enrolled in this study. The maxillary sinus mucosa, maxillary sinus and maxillary posterior teeth were scanned consecutively for three-dimensional reconstruction. The shape of the maxillary sinus and the bony and mucosal structure of its inferior wall were observed. The distance between the root of the maxillary posterior teeth and the inferior wall of the maxillary sinus was measured with a vernier caliper and a CT three-dimensional reconstruction workstation respectively. Results The maxillary sinus was triangular or quadrilateral pyramidal lacunar, the lower wall often protruding bones and mucosal septum. The maxillary molar near the mesiobuccal root to the maxillary sinus distance than the tongue base, far from the buccal root, near and far in order from the mesiobuccal root, base of the tongue and far in the buccal root. The distance from the root of the first premolar, the second premolar, the first molars, the second molars and the third molars to the inferior wall of the maxillary sinus in specimens and images were (9.30 ± 2.64) mm and (9.50 ± 2.72) mm , (4.50 ± 1.98) mm and (4.60 ± 1.95) mm, (2.02 ± 0.91) mm and (2.18 ± 0.96) mm, (2.06 ± 1.04) mm and (2.26 ± 1.20) mm and (3.82 ± 1.84) mm. Conclusions (1) The distance between the maxillary posterior teeth and the maxillary sinus closest to the first molar is the first molar, the second molar, the third molar, the second premolar and the first premolar, respectively. (2) It is of great significance to choose the appropriate length of dental implants, to avoid the dental implants into the maxillary sinus and so on.