Clinical application of oro-maxillaofacial cone-beam CT to evaluate the changes of maxillary sinus mucosa in nonoperative treatment of chronic periodontitis

doi:10.3877/cma.j.issn.1674-1366.2019.04.008

Abstract

Abstract:

Objective

The present study used oro-maxillaofacial cone-beam computed tomography (CBCT) to analyze the effect of nonoperative periodontal treatment on morphological changes of the schneiderian membrane of maxillary sinus, in the chronic periodontitis patients.

Methods

The clinical data of 30 cases of chronic periodontitis, with mucosal thickening maxillary sinusitis suspected in the department of stomatology of the central hospital of Baoan district in Shenzhen from January 2018 to October 2018, were retrospectively analyzed. All patients underwent oro-maxillaofacial CBCT scanning at 6 months after the first periodontal non-surgical treatment. The changes of the maxillary sinus mucosa were measured by CBCT software, and the clinical indexes [probing depth (PD) , clinical attachment loss (CAL) , plaque index (PLI) , sulcus bleeding index (SBI) ] thickness and length of maxillary sinus mucosa before and after treatment were also analyzed. Pearson correlation coefficient was used to analyze the correlation between clinical indicators and mucosal thickness. The paired t test was used to compare the thickness and length of the left and right mucous membrane as well as the examination indexes before and after treatment.

Results

Among 30 patients, the dimension of the mucosal thickening was positively correlated with PD and CAL values, and the correlation was statistically significant (P<0.05) . Totally 58 maxillary sinus showed mucosal thickening. There were 20 mild thickening cases, and the dimension of mucosal thickening 6 months after treatment [ (1.1±0.6) mm] was significantly lower than that before treatment [ (2.5±0.7) mm] (t = 2.983, P = 0.015) . There were 30 moderate thickening cases and the dimension of mucosal thickening 6 months after treatment [ (2.3±0.6) mm] was significantly lower than that before treatment [ (5.8±0.5) mm] (t = 3.987, P<0.001) . There were 8 severe thickening cases and the dimension of mucosal thickening 6 months after treatment [ (4.2 ± 0.4) mm] was also significantly lower than that before treatment [ (11.2±1.8) mm] (t = 3.951, P<0.001) . The periodontal indexes of patients with mild, moderate and severe mucosal thickening in maxillary sinus showed statistically significant difference after treatment compared with those before treatment (P<0.05) .

Conclusions

Nonoperative periodontal treatment has a positive therapeutic significance for improving the schneiderian membrane thickening of maxillary sinus. Oro-maxillaofacial CBCT is a non-invasive and quantitative imaging method for the evaluation of periodontal tissue and maxillary sinus tissues.

Key words: Cone-beam computed tomography, Chronic periodontitis, Maxillary sinus

Qizhi Zhong, Lingjia Kong, Zhenbang Zhou. Clinical application of oro-maxillaofacial cone-beam CT to evaluate the changes of maxillary sinus mucosa in nonoperative treatment of chronic periodontitis[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2019, 13(04): 235-241.

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Figures/Tables 11

References 26

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上颌窦黏膜增厚类型	侧数	上颌第一前磨牙	上颌第二前磨牙	上颌第一磨牙	上颌第二磨牙
轻度增厚	20	2（10）	3（15）	12（60）	3（15）
中度增厚	30	2（7）	0（0）	14（47）	14（47）
重度增厚	8	0（0）	0（0）	6（6/8）	2（2/8）
合计	58	4（7）	3（5）	32（55）	19（33）

上颌窦黏膜增厚类型	侧数	上颌第一前磨牙	上颌第二前磨牙	上颌第一磨牙	上颌第二磨牙
轻度增厚	20	2（10）	3（15）	12（60）	3（15）
中度增厚	30	2（7）	0（0）	14（47）	14（47）
重度增厚	8	0（0）	0（0）	6（6/8）	2（2/8）
合计	58	4（7）	3（5）	32（55）	19（33）

牙周指标	右侧上颌窦（n = 30）		左侧上颌窦（n = 30）
牙周指标	r值	P值	r值	P值
菌斑指数	0.24	0.127	0.28	0.103
出血指数	0.27	0.058	0.22	0.075
探诊深度	0.83^a	0.031	0.79^a	0.007
临床附着丧失	0.69^a	0.006	0.73^a	0.022

牙周指标	右侧上颌窦（n = 30）		左侧上颌窦（n = 30）
牙周指标	r值	P值	r值	P值
菌斑指数	0.24	0.127	0.28	0.103
出血指数	0.27	0.058	0.22	0.075
探诊深度	0.83^a	0.031	0.79^a	0.007
临床附着丧失	0.69^a	0.006	0.73^a	0.022

时间	侧数	菌斑指数	出血指数	探诊深度（mm）	临床附着丧失（mm）	D值（mm）	L值（mm）
治疗前	20	2.0 ± 0.7	3.9 ± 0.4	4.6 ± 0.5	4.1 ± 0.8	2.5 ± 0.7	26.5 ± 3.4
治疗后6个月	20	1.7 ± 0.5^a	2.6 ± 0.8^a	2.8 ± 0.3^a	3.0 ± 0.4^a	1.1 ± 0.6^a	24.3 ± 3.2
t值	?	1.682	2.976	1.365	1.905	2.983	0.587
P值	?	0.015	<0.001	<0.001	<0.001	0.015	0.091

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