原文題目

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口腔病理科 On-Line KMU Student Bulletin

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原文題目(出處)： The use of cone beam computed tomography in the management of displaced roots into the maxillary antrum”

Oral Surg 2012;5:18–21.

原文作者姓名： RZ Haidar, V Sivarajasingam, NA Drage 通訊作者學校： Cardiff andVale University

報告者姓名(組別)：謝鎧蔚 Intern H組

報告日期： 2012.04.09

內文：

Abstract:

- Displacement of molar teeth into maxillary antrum: intraoperative complication during extraction

- Norm: Panoramic, intraoral, occipitomental radiography

- Cone beam computed tomography (CBCT) in management of displaced roots in antrum.

Case Reports Case 1.

- 48 year old male

- Referred to ER for displaced roots within left maxillary antrum following an attempted extraction of upper left first molar tooth

- Pain over left cheek and sense of air running through left antrum - Panoramic: probable displaced roots in left antrum

- CBCT (classic iCAT) 6cm 20sec 120KV 0.4mm voxel

- Roots removed via Caldwell-Luc procedure under local anesthesia

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Case 2.

 24 year old female

4 third molars removed under genera



 l anesthesia

 Curved root of 28 fractured and displaced into maxillary antrum

 Panoramic: radiopacity superimposed on zygomatic buttress

 CBCT 8cm height

 Root removed under general anesthesia

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Discussion

 Oroantral communication (OAC) commonly occurs with fractured root displaced into antrum or after tooth extraction

 May heal spontaneously if left untreated

 May epithelialise and persist as oroantral fistula

 Visualisation of roots difficult on occipitomental radiographs: superimposition of petrous temporal bone

 Blood or fluid obscure root image

 Localization difficult with traditional radiography

 Case 1: CBCT to confirm number of roots in antrum

 Case 2: CBCT to confirm presence of root in antrum

 Dosages:

Occipitomental: 22 uSv Panoramic: 20 uSv Periapical: 5 uSv

CBCT 6cm height: 36.5 uSv CBCT 8cm: 50 uS

 Limitations of CBCT: low contrast resolution

 Difficult to distinguish soft tissues

 Root high contrast

 Suggest usage for situations were conventional imaging is equivocal for root displacement into antrum

 Lower dosage: may be used as initial choice of imaging

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題號題目

1 Which maxillary tooth extraction is the cause of most of the oroantral fistulas (OAFs)?

(A) Canine (B) 1^st molar (C) 2^nd molar (D) 3^rd molar 答案

(B )

出處：Differential diagnosis of oral and maxillofacial lesions, 5^th edition.

p.214

題號題目

2 Which of the following is the most common symptom for OAF patients?

(A) Passage of fluids from oral cavity into nose (B) Eversion of antral polyp through the fistula

(C) Aspiration of air into the mouth through the tooth socket (D) Facial pain

答案 (A )

出處：Differential diagnosis of oral and maxillofacial lesions, 5^th edition.

p.214