한국인의 위턱굴바닥과 이틀돌기의 형태계측학적 분석
Morphometric Analysis of Maxillary Sinus Floor and Alveolar Process in Korean
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임플란트 식립과 위턱굴 거상술 시 위턱굴바닥의 형태와 이틀돌기의 높이에 대한 이해는 성공적인 시술을 위해 매우 중요한 요소이다. 본 연구에서는 한국인의 위턱굴바닥의 형태와 이틀돌기와의 관계를 계측, 분석하여 유용한 자료를 제공하고자 한다. 정상 치아를 가지고 있는 해부학 연구실습용 시신 29구(남 18구, 여 11구)의 위턱을 이용하였다. 사망 시 연령은 40~90세였으며 평균연령은 59.9세였다. 위턱뼈 절편을 코안 바닥의 높이와 평행하게 절단한 후, 치아장축에 평행하게 첫째작은어금니, 둘째작은어금니, 첫째큰어금니, 둘째큰어금니의 가운데 부위를 절단하였다. 각 절편의 절단면을 스캐너(HP Scanjet G4050)로 스캔한 다음, 얻어진 영상을 Adobe Photoshop CS3에서 0.01 mm 수준까지 계측하였다. SPSS를 이용하여 평균, 표준편차 및 상관계수(r)를 구하였다. 위턱굴바닥의 너비는 첫째작은어금니, 둘째작은어금니, 첫째큰어금니, 둘째큰어금니 순으로 7.87±3.04 mm,11.05±4.40 mm, 13.21±4.78 mm, 12.47±4.32 mm였다. 위턱굴바닥의 깊이는 첫째작은어금니, 둘째작은어금니,첫째큰어금니, 둘째큰어금니 순으로 -3.74±4.57 mm, -4.77±4.80 mm, -4.84±4.69 mm, -4.19±6.24mm였다. 이틀돌기의 높이는 첫째작은어금니, 둘째작은어금니, 첫째큰어금니, 둘째큰어금니 순으로 19.02±3.36 mm, 15.71±4.44 mm, 13.59±3.22 mm, 12.50±2.99mm였다. 위턱굴바닥의 너비와 이틀돌기의 높이 사이의 상관계수(r)는치아순으로 각각 0.342, 0.631, 0.602, 0.543으로 상관관계가 낮았다. 위턱굴바닥의 깊이와 이틀돌기의 높이 사이의 상관계수(r)는 치아순으로 각각 0.808, 0.899, 0.789, 0.805로, 위턱굴바닥의 깊이가 깊을수록 이틀돌기의 높이도 낮아지는 결과를 보여 높은 상관관계를 보였다. 이를 종합하여 보면, 한국인의 위턱굴바닥은 첫째큰어금니에서 가장 깊고 넓었으며, 이틀돌기의 높이는 둘째큰어금니에서 가장 낮았다. 이러한 계측 결과는 임플란트 식립과 위턱굴 거상술 시 위턱굴바닥에 대한 중요한해부학적 자료를 제공해 줄 것이다.
Abstract
The implant placement and sinus floor elevation on maxillae have required the accurate understanding of maxillary sinus floor and alveolar process. Therefore, the purpose of this study was to investigate the maxillary sinus floor morphology and the correlation between maxillary sinus floor and alveolar process in Korean. Twenty-nine cadaveric maxillae with normal teeth were used, with age at death ranging from 40 to 90 years (mean: 59.9 years). After the maxilla was cut above the nasal cavity floor, it was sectioned at midline of the tooth from 1st premolar to 2nd molar by parallel to long axis of the tooth. The specimens were scanned using the Scanner (HP Scanjet G4050). The scan image was measured using Adobe Photoshop CS3 at the 0.01 mm. Mean, SD, and correlation coefficient (r) were took using SPSS. The width of maxillary sinus floor at nasal cavity floor level was 7.87±3.04 mm at 1st premolar (P1), 11.05±4.40 mm at 2nd premolar (P2), 13.21±4.78 mm at 1st molar (M1), and 12.47±4.32 mm at 2nd molar (M2). The depth of maxillary sinus floor at nasal cavity floor level was -3.74±4.57 mm, -4.77±4.80 mm, -4.84±4.69mm, and -4.19±6.24 mm at P1, P2, M1, and M2, respectively. The height of alveolar process bone was 19.02±3.36 mm, 15.71±4.44 mm, 13.59±3.22 mm, and 12.50±2.99 mm at P1, P2, M1, and M2, respectively. The correlation coefficient (r) between the width of maxillary sinus floor and the height of alveolar process was 0.342,0.631, 0.602, and 0.543 at P1, P2, M1, and M2, respectively, which were lack of correlations. The correlation coefficient (r) between the depth of maxillary sinus floor and the height of alveolar process was 0.808, 0.899, 0.789,and 0.805 at P1, P2, M1, and M2, respectively. It represented that the deeper the depth of maxillary sinus floor,the lower the height of alveolar process was. In conclusion, the maxillary sinus floor in Korean was the deepest and the widest at M1, and the height of alveolar process was the lowest at M2. This result provided useful anatomic information about maxillary sinus floor for the implant placement and sinus floor elevation.
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