Maksiller sinüs pnömatizasyonu ve diş çekimi arasındaki ilişkinin radyografik değerlendirmesi

Öz

Amaç: Posterior diş çekimi sonrası maksiller sinüs pnömatizasyonunu radyografik olarak değerlendirmek ve sonuçları hem çekim sonrası geçen süreye hem de çekilen diş tipine göre karşılaştırmak. Gereç ve Yöntem: Bu retrospektif çalışma, kök uçları maksiller sinüs tabanına yakın konumda olan en az bir premolar veya molar dişi çekilmiş 54 hastayı kapsamaktadır. Toplam 186 panoramik radyografi, standart referans çizgileri ve noktaları kullanılarak sinüs tabanındaki değişiklikleri ölçmek amacıyla değerlendirildi. Hastalar, takip sürelerine göre 0–6, 7–12, 13–18 ve 19–24 ay olmak üzere beş gruba ayrıldı. Büyütme düzeltmesi uygulandı ve takip süresi ile diş tipine göre ortalama pnömatizasyon değerleri hesaplandı. Bulgular: Maksiller sinüs pnömatizasyonu, çekim sonrası geçen süre ile progresif olarak artış gösterdi. Ortalama pnömatizasyon değerleri; 0–6 aylık grupta 1,1 mm, 7–12 aylık grupta 1,7 mm, 13–18 aylık grupta 2,1 mm ve 19–24 aylık grupta 3,9 mm olarak bulundu. Diş tipine göre analizde ortalama değerler; premolar çekimlerinde 1,5 mm, birinci molar çekimlerinde 2,0 mm, ikinci ve üçüncü molar çekimlerinde ise 2,4 mm olarak saptandı. Sinüs tabanına kökleri yakın olan ve kronik periapikal enfeksiyon nedeniyle çekilen dişlerde daha fazla pnömatizasyon gözlendi. Sonuçlar: Maksiller sinüs pnömatizasyonu, zamana bağlı ilerleyen, diş tipinden, kök–sinüs ilişkisinden ve mevcut patolojiden etkilenen bir süreçtir. Yüksek riskli olgularda erken implant uygulaması veya alveoler kret koruma teknikleri, kemik kaybını en aza indirmek ve kapsamlı sinüs yükseltme işlemlerine duyulan ihtiyacı azaltmak için önerilmelidir.

Anahtar Kelimeler

• Maksiller sinüs pnömatizasyonu
• diş çekimi
• sinüs tabanı
• kret koruma

Radiographic evaluation of the relationship between maxillary sinus pneumatization and tooth extraction

Öz

Aim: To assess maxillary sinus pneumatization radiographically after posterior tooth extraction and to compare the results based on both the post-extraction time interval and the tooth type. Material and Methods: This retrospective study included 54 patients who underwent extraction of at least one premolar or molar with roots close to the maxillary sinus floor. A total of 186 panoramic radiographs were assessed using standardized reference lines and points to measure sinus floor changes. Patients were categorized into five groups based on follow-up periods: 0–6, 7–12, 13–18, and 19–24 months. Magnification correction was applied, and mean pneumatization values were calculated by follow-up group and tooth type. Results: Maxillary sinus pneumatization demonstrated a progressive increase with longer post-extraction intervals. The mean pneumatization values were 1.1 mm in the 0–6 month group, 1.7 mm in the 7–12 month group, 2.1 mm in the 13–18 month group, and 3.9 mm in the 19–24 month group. Analysis by tooth type revealed mean values of 1.5 mm for premolar extractions, 2.0 mm for first molars, and 2.4 mm for both second and third molars. Greater pneumatization was observed in teeth with roots in close proximity to the sinus floor and in those extracted due to chronic periapical infection. Conclusion: Maxillary sinus pneumatization is a time-dependent process influenced by tooth type, root–sinus relationship, and pre-existing pathology. Early implant placement or ridge preservation techniques should be considered in high-risk cases to minimize bone loss and reduce the need for extensive sinus augmentation procedures.

Anahtar Kelimeler

• maxillary sinus pneumatization
• tooth extraction
• sinus floor
• ridge preservation

Kaynakça

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