Measurement and analysis of CT 3D reconstruction of normal adult maxillary sinus

    With the development of spiral CT and computer software and hardware, the processing power of CT images has been greatly improved, thus enabling us to perform reconstruction of many anatomical structures. The 3D finite element medical model built by CT has a realistic image, the morphology of the model is consistent with that of the solid specimen, and there is no significant difference between the data obtained from the reconstructed model and the solid anatomical measurements, and it can be rotated at will to cut and observe from different angles and make accurate measurements of any distance, angle, surface area and volume, thus it is widely used in clinical and various researches.  The maxillary sinus is the largest sinus cavity in the sphenoid, located in the body of the maxilla in an irregular triangular cone, and is an important anatomical structure within the maxilla. Preoperative assessment of the maxillary sinus situation and understanding of the anatomical structures is a significant guide for surgery concerning the maxillary sinus. The morphology, size and position of the maxillary sinus floor, the relationship with the maxillary posterior teeth and the alveolar ridge are of great reference value to the clinician in selecting the appropriate implant, determining the implant plan, and clarifying the direction and site of implantation. Spiral CT can provide a rich and intuitive three-dimensional image by rotating at different levels and cutting in multiple directions and angles, and its normal value range can provide a reference for clinical operations such as dental implantation by using an applied measurement workstation to measure and analyze the image, which provides a good way to study the morphology, size, structure and the relationship between the maxillary sinus using spiral CT.  Because of the advantages of spiral CT, such as increasing the speed of volume scanning, selecting different layer thicknesses for selective reconstruction, increasing the rate of image separation, and image fidelity, many scholars at home and abroad have used spiral CT to study the lesions, trauma, and anatomical features of the maxillary sinus. At present, spiral CT has been widely used for the diagnosis of nasal bone fracture, maxillary sinus inflammation, cyst, tumor, and the early detection of maxillary sinus developmental malformation; with the application of spiral CT, maxillary ambiguous obstructed teeth, ectopic teeth and foreign bodies can be accurately located with spiral CT; in recent years, as dental implants have gradually become widely carried out in the field of dentistry, it has become a hot spot in the dental community, and spiral CT has also been applied to In recent years, spiral CT has been applied to oral implant technology. Some domestic scholars have used spiral CT to establish a finite element model of the maxillary bone for the study of dental histology and morphology; some scholars have used spiral CT to jointly position the template so as to accurately guide the direction of dental implant placement; some scholars have also used spiral CT to study the relationship between the maxillary sinus and the maxillary posterior region, which provides a certain anatomical basis for dental implants in the maxillary posterior region. Spiral CT was earlier and more widely used in oral implant technology abroad. It was used to guide the plan of implantation before implantation, and to evaluate and observe the success of implants during and after implantation. They have used spiral CT to establish a lot of data on the anatomical characteristics of the maxillary sinus, the relationship between the maxillary sinus and the maxillary posterior region, the morphology of the maxillary sinus floor wall, the changes in the length, height, width and volume of the maxillary sinus, and some scholars have used spiral CT to calculate the changes in the volume of the maxillary sinus to study the pneumatization of the maxillary sinus due to tooth extraction, and the relationship between the height of the elevated maxillary sinus and the volume of bone implants.  The aim of this study was to perform three-dimensional reconstruction and measurement of the maxillary sinus in a normal person by spiral CT scanning in order to establish some reference data about the anatomical pattern of the maxillary sinus and to provide a theoretical basis for fracture of the maxilla, surgery, and especially the development of dental implant surgery protocols to determine the local indications for implant prostheses, improve the success rate of implants and reduce the occurrence of complications.  [Methods] In the radiology department of the First People’s Hospital of Hangzhou, 57 cases (114 sides) of CT images of the paid sinuses of healthy adults were selected, and spiral CT continuous volume scans of the maxillary sinuses were performed with three-dimensional reconstruction, with a layer thickness of 3.7 mm, a layer spacing of 3.75 mm, and a reconstruction thickness of 1.25 mm. The data concerning the maxillary sinuses were measured in the selected cross-sections using a measurement workstation (AW4.2). Statistical analysis was performed on the measured data.  [The CT images of the selected sinuses were well displayed in three dimensions and the images of the maxillary sinus were obtained in a detailed and realistic manner. 2. The data obtained from the measurements were statistically processed to obtain their normal value ranges. 3. The morphology of the maxillary sinus floor wall was mostly flat, accounting for 60.5% of the total, followed by triangular, accounting for 25.4%, and finally crestal, accounting for 14.1%. 4. The lowest point of the maxillary sinus floor wall The most common point of the maxillary sinus floor wall is located between the second premolar and the first molar of the maxilla, accounting for 49.1%, the others are located between the first premolar and the second premolar accounting for 11.4%, the first molar and the second molar accounting for 36.0%, and the second molar and the third molar accounting for 3.5%. 5, the average distance between the maxillary sinus floor wall and the palatal side is 7.1±2.1mm, the average distance between the buccal side is 4.1±1.1mm, the maxillary sinus floor The mean distance from the maxillary sinus floor was 28.5±5.7 mm, with the longest being 41.4 mm and the shortest being 14.0 mm; there was no significant difference between males and females and between the left and right sides (P>0.05).7 The mean volume of the maxillary sinus was 13.83±5.70 mm3, with the longest being 41.4 mm and the shortest being 14.0 mm in males and females, left and right sides, and between the edentulous and edentulous groups. and no significant difference between the edentulous and edentulous groups (P > 0.05).  [Conclusion] The data from the clinical application of spiral CT reliably summarize the anatomical pattern of the maxillary sinus, which is a guide for fracture of the maxilla, surgery, and especially for the preoperative preparation of dental implants.