Maksiller Üçüncü Molar Dişlerin Konumu ve Maksiller Sinüsle İlişkisinin KIBT ile Değerlendirilmesi

Year 2021, Volume: 7 Issue: 2, 307 - 314, 12.07.2021

Burcu Evlice , Hazal Duyan

https://doi.org/10.53394/akd.958922

Abstract

Amaç: Bu çalışmanın amacı, maksiller üçüncü molar dişlerin konumunu ve maksiller üçüncü molar
dişler ile maksiller sinüs arasındaki ilişkiyi konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleri ile
değerlendirmektir.
Gereç ve Yöntemler: Bu araştırmada çeşitli nedenlerle KIBT taraması mevcut 147 hastanın
maksiller üçüncü molar dişleri incelendi. Maksiller üçüncü molar dişlerin, Modifiye Archer
sınıflandırması kullanılarak komşu ikinci molar dişe göre vertikal olarak gömülülük derecesi, Winter
sınıflandırmasına göre pozisyonları ve maksiller üçüncü molar diş kökleri ile maksiller sinüsün tabanı
arasındaki ilişkiler değerlendirildi. İstatistiksel analizler için Pearson ki kare testi, tek yönlü varyans
analizi (ANOVA) ve post-hoc testler kullanıldı. Anlamlılık düzeyi p<0.05 olarak belirlendi.
Bulgular: Yaş ortalaması 33,32±14,31 olan 147 hastanın toplam 155 maksiller üçüncü molar dişi
incelendi. Maksiller üçüncü molarların derinliği, en sık %58,1 ile sınıf A, maksiller üçüncü molarların
kökleri ile maksiller sinüs tabanı arasındaki en sık vertikal (%31,6) ve horizontal (%53,5) ilişki tip
I, Winter sınıflandırmasına göre en sık görülen angulasyon tipi %53,2 ile vertikal pozisyondu. Bu
sınıflandırmalar ile cinsiyet veya sağ/sol tarafta yer almak arasında anlamlı bir ilişki yoktu.
Sonuç: Bu çalışmada incelenen dişlerin yarısından fazlası sınıf A, tip I (kökler ile sinüs arasındaki
horizontal ilişkiye göre) ve vertikal pozisyon olarak gözlendi. Maksiller üçüncü molar dişler ve maksiller
sinüs arasındaki ilişkiler, özellikle çekim esnasında meydana gelebilecek çeşitli komplikasyon risklerine
karşı dikkatli bir şekilde değerlendirilmelidir.

Keywords

Konik ışınlı bilgisayarlı tomografi, Maksilla, Molar, Sinüs

Supporting Institution

YOK

Project Number

YOK

Evaluation of Position and Relationship of Maxillary Third Molars with Maxillary Sinus Using CBCT

Abstract

Objective: The aim of this study was to evaluate position of maxillary third molars and relationship
between maxillary third molars and maxillary sinus using cone-beam computerized tomography
(CBCT) images.
Material and Methods: In this study, maxillary third molars of 147 patients underwent CBCT
scanning for various reasons, were examined. Vertical position of maxillary third molar teeth
relative to adjacent second molar teeth according to the modified Archer’s classification, their
positions according to Winter’s classification and relationships between the roots of maxillary third
molar teeth with lower wall of the maxillary sinus were evaluated. Pearson chi square test, one way
variance analysis (ANOVA) and post-hoc tests were used for statistical analysis. Significance level was
determined as p<0.05.
Results: A total of 155 maxillary third molars of 147 patients with a mean age of 33,32±14,31 were
included in the study. In our study, depth of the maxillary third molars were the most common class
A (58,1%), most common vertical (31,6%) and horizontal (53,5%) relationship between the roots of
maxillary third molars and maxillary sinus was Type I. Most common type of angulation according
to Winter classification was vertical position (53,2%). No significant relationship was found between
these classifications and gender or location (right / left).
Conclusion: More than half of teeth examined in this study were observed as class A, type I
(according to horizontal relationship between roots and sinus) and vertical position. The relationship
between maxillary third molars and maxillary sinus should be carefully evaluated against various
complications risks, especially during tooth extraction.

Keywords

Cone-beam computerized tomography, Maxilla, Molar, Sinus

Project Number

YOK

References

• 1. Bishara SE. Impacted maxillary canines: A review. Am J Orthod Dentofacial Orthop 1992; 101: 159-71.
• 2. Hashemipour MA, Tahmasbi-Arashlow M, Fahimi-Hanzaei F. Incidence of impacted mandibular and maxillary third molars: A radiographic study in a Southeast Iran population. Med Oral Patol Oral Cir Bucal 2013; 18: 140-5.
• 3. Lysell L, Rohlin M. A study of indications used for removal of the mandibular third molar. Int J Oral Maxillofac Surg 1988; 17: 161-4.
• 4. Brauer HU. Unusual complications associated with third molar surgery: a systematic review. Quintessence Int 2009; 40: 565-72.
• 5. Sanchez Fernandez JM, Anta Escuredo JA, Sanchez Del Rey A, Montoya FS. Morphometric study of the paranasal sinuses in normal and pathological conditions. Acta Otolaryngol 2000; 120: 273-8.
• 6. Misch CE. Contemporary implant dentistry. 2nd ed. St.Louis: CV Mosby Co, 1999: 76-194.
• 7. Hauman CH, Chandler NP, Tong DC. Endodontic implications of the maxillary sinus: a review. Int Endod J 2002; 35: 127-41.
• 8. Bouquet A, Coudert JL, Bourgeois D, Mazoyer JF, Bossard D. Contributions of reformatted computed tomography and panoramic radiography in the localization of third molars relative to the maxillary sinus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98: 342-7.
• 9. Tyndall DA, Brooks SL. Selection criteria for dental implant site imaging: a position paper of the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 89: 630-7.
• 10. Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IAB. A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results. Eur Radiol 1998; 8: 1558-64.
• 11. Saccucci M, Cipriani F, Carderi S, Di Carlo G, D’Attilio M, Rodolfino D, Festa F, Polimeni A. Gender assessment through three-dimensional analysis of maxillary sinuses by means of Cone Beam Computed Tomography. Eur Rev Med Pharmacol Sci 2015; 19: 185-93.
• 12. Nakagawa Y, Ishii H, Nomura Y, Watanabe NY, Hoshiba D, Kobayashi K, Ishibashi K. Third molar position: reliability of panoramic radiography. J Oral Maxillofac Surg 2007; 65: 1303-8.
• 13. Lim AAT, Wong CW, Allen JC. Maxillary third molar: patterns of impaction and their relation to oroantral perforation. J Oral Maxillofac Surg 2012; 70: 1035-9.
• 14. Yurdabakan ZZ, Okumuş O, Pekiner FN. Evaluation of the maxillary third molars and maxillary sinus using cone-beam computed tomography. Nijer J Clin Pract 2018; 21: 1050-8.
• 15. Iwai T, Chikumaru H, Shibasaki M, Tohnai I. Safe method of extraction to prevent a deeply-impacted maxillary third molar being displaced into the maxillary sinus. Br J Oral Maxillofac Surg 2013; 51: 75-6.
• 16. Ventä I, Turtola L, Ylipaavalniemi P. Radiographic follow-up of impacted third molars from age 20 to 32 years. Int J Oral Maxillofac Surg 2001; 30: 54-7.
• 17. Mollaoglu N , Çetiner S , Güngör K. Patterns of third molar impaction in a group of volunteers in Turkey. Clin Oral Invest 2002; 6: 109-13.
• 18. Sağlam AA, Tüzüm MS. Clinical and radiologic investigation of the incidence, complications, and suitable removal times for fully impacted teeth in the Turkish population. Quintessence Int 2003; 34: 53-9.
• 19. Etöz M, Şekerci AE, Şişman Y. Türk Toplumunda üçüncü molar dişlerin retrospektif radyografik analizi. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 2011; 21: 170-4.
• 20. Demirtas O, Harorli A. Evaluation of the maxillary third molar position and its relationship with the maxillary sinus: A CBCT study. Oral Radiol 2016; 32: 173-9.
• 21. Jung YH, Cho BH. Assessment of maxillary third molars with panoramic radiography and cone-beam computed tomography. Imaging Sci Dent 2015; 45: 233-40.
• 22. De Andrade PF, Silva JNN, Sotto-Maior BS, Ribeiro CG, Devito KL, Assis N. Three-dimensional analysis of impacted maxillary third molars: A cone-beam computed tomographic study of the position and depth of impaction. Imaging Sci Dent 2017; 47: 149-55.
• 23. Kwak HH, Park HD, Yoon HR, Kang MK, Koh KS, Kim HJ. Topographic anatomy of the inferior wall of the maxillary sinus in Koreans. Int J Oral Maxillofac Surg 2004; 33: 382-8.
• 24. Kilic C, Kamburoglu K, Yuksel SP, Ozen T. An assessment of the relationship between the maxillary sinus floor and the maxillary posterior teeth root tips using dental cone-beam computerized tomography. Eur J Dent 2010; 4: 462-7.
• 25. Pagin O, Centurion BS, Rubira-Bullen IR, Alvares Capelozza AL. Maxillary sinus and posterior teeth: Accessing close relationship by cone-beam computed tomographic scanning in a Brazilian population. J Endod 2013; 39: 748-51.
• 26. Wang D, He X, Wang Y, Li Z, Zhu Y, Sun C, Ye J, Jiang H, Cheng J. External root resorption of the second molar associated with mesially and horizontally impacted mandibular third molar: evidence from cone beam computed tomography. Clin Oral Investig 2017; 21: 1335-42.
• 27. Quek SL, Tay CK, Tay KH, Toh SL, Lim KC. Pattern of third molar impaction in a Singapore Chinese population: A retrospective radiographic survey. Int J Oral Maxillofac Surg 2003; 32: 548-52.
• 28. Ventä I, Kylätie E, Hiltunen K. Pathology related to third molars in the elderly persons. Clin Oral Investig 2015; 19: 1785-9.
• 29. Garaas R, Moss KL, Fisher EL, Wilson G, Offenbacher S, Beck JD, White RP. Prevalence of visible third molars with caries experience or periodontal pathology in middle-aged and older Americans. J Oral Maxillofac Surg 2011; 69: 463-70.
• 30. Moss KL, Beck JD, Mauriello SM, Offenbacher S, White RP. Third molar periodontal pathology and caries in senior adults. J Oral Maxillofac Surg 2017; 65: 103-8.
• 31. Kruger E, Thomson WM, Konthasinghe P. Third molar outcomes from age 18 to 26: Findings from a population-based New Zealand longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92: 150-5.