상악동 아래벽과 상악 대구치 치근사이 위치관계에 관한 방사선학적 연구

Abstract

In this study, radiographic evaluation was made using panoramic radiography and cross-sectional tomography of SCANORAR 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 using 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 topography 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 actual maxilla specimen were 2.83㎜, 4.5㎜, and 4.15㎜, respectively. In the crosssectional 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 crosssectional tomography. 3. In cross-sectional view, when the vertical relationship 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 molars, type Ⅱ(the 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 SCANORAR cross-sectional topography 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 topography 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.