JOURNAL ARTICLE

[Effect of nonoperative periodontal treatment on changes of schneiderian membrane thickness of maxillary sinus in the chronic periodontitis patients using cone-beam CT]

S Ren, G H Zhuang, J Sun, H J Zhao, Y P Pan
Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology 2019 February 9, 54 (2): 87-93
30695909
Objective: To analysis the effect of nonoperative periodontal treatment on morphological changes of the schneiderian membrane of maxillary sinus in the chronic periodontitis patients by using oro-maxillaofacial cone-beam CT (CBCT) in order to provide the foundation in the diagnosis and treatment of maxillary sinusitis caused by chronic periodontitis. Methods: Totally 30 chronic periodontitis patients with schneiderian membrane thickening [(40.0±5.6) years old (ranged 26-55 years old), 18 males and 12 females] were randomly recruited in Department of Periodontics, School of Stomatology, China Medical University from June 2014 to December 2016. All patients were scanned by CBCT. The probing depth (PD), clinical attachment loss (CAL), plaque index (PLI) and bleeding index (BI) of the maxillary first and second premolars and molars were recorded. All patients received systematic nonoperative periodontal treatment. After six months, patients were reviewed, periodontal indexes and CBCT scanning were recorded. The thickness of the schneiderian membrane of maxillary sinus were analyzed by the software of CBCT. The changes of clinical parameters, parameter dimensional values of membrane thickness before and after treatment were statistically compared by t test. Results: In 30 chronic periodontitis patients, there was no statistically significant difference in the dimension and length of the maxillary sinus mucosa between the right and the left ( P> 0.05). 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] ( P< 0.05). 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] ( P< 0.01). 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] ( P< 0.01). The periodontal indexes of patients with mild, moderate and severe mucosal thickening in maxillary sinus showed statistically significant difference after treatment compared with before treatment ( P< 0.05). Conclusions: Nonoperative periodontal treatment has a positive therapeutic significance for improving the schneiderian membrane thickening of maxillary sinus.

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