• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권1호
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• pp.21-25
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• 2009

Objective: The purpose of this study is to determine the prevalence of sinus disease and abnormalities in patients scheduled for dental implant in maxillary posterior area using cone beam CT. Patients and Method: One hundred five maxillary sinuses in eighty-seven patients who underwent cone beam CT for dental implant in maxillary posterior area were included. Any patients who had previous history of sinus operations were not included. The sinus abnormalities were classified as follows ; normal (membrane thickness <2 mm), mucosal thickening (membrane thickness ${\geq}$ 2 mm and < 6 mm), partial opacification (membrane thickness > 6 mm but not full), full opacification and mucous retention cyst. The relationship between the remaining bone height, sinus symptoms and maxillary sinus abnormality was statistically surveyed. Results: Of 105 maxillary sinuses in 87 patients, 80 (76%) maxillary sinuses showed abnormalities ; 4 of 4 symptomatic patients and 76 of 101 asymptomatic patients. Mucosal thickening was the most common sinus abnormality. Only 3 (4%) of 80 maxillary sinus abnormalities were caused by the odontogenic origin. The prevalence of maxillary sinus abnormalities was higher in the symptomatic group than asymptomatic one (p<0.05). Conclusion: Maxillary sinus abnormalities were very common in the patients who were planning implantation in maxillary posterior areas. This result supports that thorough evaluation for maxillary sinus is recommended when implant treatment is planned for those areas.

• Imaging Science in Dentistry
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• 제46권2호
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• pp.109-115
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• 2016

Purpose: Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Materials and Methods: Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Results: Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Conclusion: Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy.

• Journal of Oral Medicine and Pain
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• 제48권3호
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• pp.81-86
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• 2023

Purpose: To evaluate the clinical and radiologic findings of the postoperative maxillary cysts (POMCs) and investigate the relationship between lesion size and clinical symptoms depending on the time elapsed after radical maxillary sinus surgery. Methods: A total of 29 patients who were diagnosed with POMCs at Chonnam National University Dental Hospital were selected. Clinical and radiologic findings were investigated. POMC cases were divided into two groups: those with <24 years between maxillary sinus surgery and POMC diagnosis and those with >24 years. The chi-square test was used to compare the differences between the two groups. Results: The average period from surgery to POMC detection was 24.32 years; however, the period could not be confirmed in four patients. The average patient age was 52.75 years, and 12 (41.3%) patients were in their 50s. POMC-related clinical symptoms were as follows: buccal pain and swelling, dull pain, toothache, abscess, sensory abnormality, and asymptomatic. Twenty (69.0%) cases showed unilocular radiolucency and 9 (31.0%) revealed multilocular radiolucency. Seven cases (35.0%) were misdiagnosed as odontogenic lesions, resulting in the delayed treatment of POMCs. No statistical significance was found between the two groups with respect to symptoms, expansion to the surrounding area, presence of secondary cysts, and mesiodistal length of cyst on cone-beam computed tomography (CBCT) images. However, the buccopalatal length of the cyst on CBCT images was significantly different between the two groups. Conclusions: The buccopalatal length of POMCs observed on CBCT images was related to the time elapsed since surgery. The lack of awareness of POMCs may lead to misdiagnosis as an odontogenic infection and delayed treatment. Therefore, dentists must recognize the clinical and radiologic features of POMCs to differentiate it from dental infections.

• 치과방사선
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• 제29권2호
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• pp.459-475
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• 1999

Objectives : The purpose of this study is to evaluate the computed tomographic (CT) images of the paranasal sinusitis(PNS). Materials and Methods : The author examined the extent and recurring patterns of the paranasal sinusitis and some important anatomic landmarks. The author analyzed PNS images retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. Results : The most frequently affected sinus was maxillary sinus (82.9％), followed by anterior ethmoid sinus(67.9％), posterior ethmoid sinus(48.9％), frontal sinus(42.0％) and sphenoid sinus(41.4％). The characteristic features of CT images of the sinusitis were sinus opacification(22.4％), mucoperiosteal thickening(34.3％), and polyposis(2.0％). Sinonasal inflammatory diseases were categorized into 5 patterns according to Babber s classification. They were 1) infundibular(13.0％), 2) ostiomeatal unit(67.4％), 3) sphenoethmoidal recess (13.0％), 4) sinonasal polyposis (9.6％) and 5) unclassifiable patterns(18.0％). The incidences of contact between sinus and optic nerve were as follows ; the incidences of contact with posterior ethmoid sinus, sphenoid sinus. both posterior sinuses were 11.4％. 66.8％, 6.3％. respectively. The incidences of contact between sphenoid sinus and maxillary nerve, vidian nerve, internal carotid artery were 74.5％. 79.2％. 45.1％. respectively. The incidences of pneumatization of the posterior ethmoid sinus were as follows ; normal 70.6％ and overriding type 29.4％. The incidences of sphenoid sinus pneumatization were as follows; normal 56.9％ , rudimentary 12.5％, pterygoid recess 22.7％, anterior clinoid recess 2.7％, and both pterygoid and anterior clinoid recess type 5.2％. Conclusions : The inflammatory sinonasal diseases were classified into five patterns using the CT of PNS, which was proven to be an excellent imaging modality providing detailed information about mucosal abnormality, pathologic patterns, and the proximity of the important structures to the posterior paranasal sinuses. This result will aid in the interpretation of CT of PNS functionally and systemically.

• 대한두개안면성형외과학회지
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• 제20권4호
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• pp.255-259
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• 2019

Craniofacial cleft is a rare disease, and has multiple variations with a wide spectrum of severity. Among several classification systems of craniofacial clefts, the Tessier classification is the most widely used because of its simplicity and treatment-oriented approach. We report the case of a Tessier number 3 cleft with wide soft tissue and skeletal defect that resulted in direct communication among the orbital, maxillary sinus, nasal, and oral cavities. We performed soft tissue reconstruction using the straight-line advanced release technique that was devised for unilateral cleft lip repair. The extension of the lateral mucosal and medial mucosal flaps, the turn over flap from the outward turning lower eyelid, and wide dissection around the orbicularis oris muscle enabled successful soft tissue reconstruction without complications. Through this case, we have proved that the straight-line advanced release technique can be applied to severe craniofacial cleft repair as well as unilateral cleft lip repair.

• Journal of Oral Medicine and Pain
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• 제32권4호
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• pp.455-460
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• 2007

치아의 통증을 호소하는 환자 중 임상검사 및 방사선학적 검사소견에서 특기할 병적 소견이 관찰되지 않는 경우 비치성 치통을 의심해보아야 하며, 근육질환, 상악동염, 신경병성 통증, 신경혈관 질환 등의 원인으로 치통이 유발될 수 있다. 이러한 비치성 치통의 경우 진성 치통과 구별하기 위하여 철저한 병력 조사 및 전반적인 임상검사가 시행되어야 하며, 진단용 국소마취를 통하여 보다 정확한 진단을 확립할 수 있다. 이러한 비치성 치통의 가장 흔한 원인 중의 하나인 근막동통은 근육조직을 촉진 시 단단한 띠가 만져지는 것이 특징적이며 이것이 발통점으로 작용하여 근육이 뻣뻣한 느낌과 피로감, 연관통, 치아에 전이되는 통증, 근긴장성 두통, 통각과민 등의 증상을 유발할 수 있으며, 특히 교근은 상악 구치부 및 하악 구치부의 통증을 유발한다. 본 증례는 우측 교근부의 근막동통에 기인한 하악 우측 구치부의 치통 양상을 운동요법, 물리치료, 약물치료 등의 통상적이고 가역적인 근육질환의 치료법을 통해 증상의 호전을 보인 증례이다. 비치성 치통은 정확하게 진단되지 않을 경우 근관치료, 치주치료, 발치 등의 불필요한 치과치료가 시행될 수 있으며, 이러한 치료를 통하여도 환자의 통증은 경감되지 않기 때문에 치과치료가 시행되기 전에 반드시 정확한 감별진단이 필요하리라 사료된다.