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Jadach R, Osypko K, Nelke K, Nowicki A. Croco Eye Technique: Mucous Retention Cyst Excision with Immediate Open Sinus Lift-A Retrospective Cohort Study. J Clin Med 2024; 13:3293. [PMID: 38893004 PMCID: PMC11172874 DOI: 10.3390/jcm13113293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/25/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: A mucous retention cyst is a common, asymptomatic lesion that may cause complications during or after the sinus lift procedure. The goal of this study is to assess the effectiveness of the Croco Eye Technique (CET), which allows simultaneous excision of the cyst and sinus floor elevation. Methods: The technique was thoroughly described in two versions, and the group of 33 patients was analyzed. Patients who qualified for this procedure had insufficient alveolar ridge height, and their CBCT showed radiological images typical for retention cysts. Analyzed parameters included the version of CET, demographic data, anatomical parameters, intraoperative complications, recurrence of the cyst, success rate of the sinus lift and implants, and the follow-up period. Results: Out of the 33 cases, 9 were of the primary version (27.27%) and 24 of the final version (72.73%). The average height of a retention cyst was 24.05 mm, with the average alveolar ridge height of 1.86 mm. In three cases (9.09%), implants were placed immediately. The prevalence of uncontrolled Schneiderian membrane perforation was reduced from 55.56% to 4.17% between the primary and final versions. The cyst's recurrence rate was 3.13%. The implant survival rate was 100%. The mean follow-up period was 48.625 months (max 110 months). Conclusions: The Croco Eye Technique, despite the perforation of the Schneiderian membrane, enables successful sinus lift and implantation with a success rate of 100%. Excision of the retention cyst, which is the cause of perforation, allows for limiting the risk of the cyst's recurrence.
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Affiliation(s)
- Radosław Jadach
- Private Practice, ul. E. Horbaczewskiego 53A, 54-130 Wrocław, Poland;
| | - Karolina Osypko
- Dental Salon, Oral Surgery Academy, ul. E. Horbaczewskiego 53A, 54-130 Wrocław, Poland
| | - Kamil Nelke
- Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland;
| | - Adam Nowicki
- Diamante Clinica Dental Clinic, Sportowa 48 A/C, 59-300 Lubin, Poland;
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Aghaee F, Moudi E, Vahdani N, Bijani A, Haghanifar S. Evaluation of Anatomical Variations of the Maxillary Sinus in Patients With and Without Mucous Retention Cyst. EAR, NOSE & THROAT JOURNAL 2023:1455613231206284. [PMID: 37843070 DOI: 10.1177/01455613231206284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
Objectives: Mucous retention cyst (MRC) is a benign and self-limited lesion that can be caused by many risk factors, including anatomical variations of the sinonasal region. This study aims to investigate the relationship between anatomical variations and the presence of MRC. Materials and Methods: In total, 2109 sinonasal cone beam computed tomography images were evaluated for the presence of MRC, and the sinonasal anatomical regions such as the osteomeatal complex (OMC), infundibulum length, ostium height, the diameter of the ostium, the presence of accessory ostium, concha bullosa, and mucosal thickening of the maxillary sinuses. Shapiro-Wilk normality test, independent sample t-test, and chi-square test were used for statistical analysis, and P < .05 was considered significant. Results: The prevalence of MRC was 119 (5.6%) cases. The average diameter of the ostium in cases with and without MRC was 0.49 ± 0.41 mm and 0.99 ± 0.76 mm, respectively, which showed a significant inverse relationship(P < .001). A significant relationship was found between the septum deviation, the ostium height, the concha bullosa, and the accessory ostium with the presence of MRC (P < .001). Conclusions: Sinonasal anatomical variations such as ostium diameter, ostium height, septal deviation, the presence of accessory ostium, and concha bullosa can cause MRC development, and considering that surgery may be necessary in some cases; this could be of great importance to clinicians and surgeons for treatment and prevention of development or recurrence of these pseudocysts in patients.
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Affiliation(s)
- Fateme Aghaee
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Ehsan Moudi
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Nazmehr Vahdani
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sina Haghanifar
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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3
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Fischborn AR, Andreis JD, Wambier LM, Pedroso CM, Claudino M, Franco GCN. Performance of panoramic radiography compared with computed tomography in the evaluation of pathological changes in the maxillary sinuses: a systematic review and meta-analysis. Dentomaxillofac Radiol 2023; 52:20230067. [PMID: 37192021 PMCID: PMC10304843 DOI: 10.1259/dmfr.20230067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/20/2023] [Accepted: 04/19/2023] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVE A systematic review was performed to evaluate the performance of panoramic radiography (PR) vs CT or cone beam CT (CBCT) in the diagnosis of pathological maxillary sinuses. METHODS This review was registered in the PROSPERO database under the number CRD42020211766. Observational studies that compared PR with CT/CBCT were used to evaluate pathological changes in the maxillary sinuses. A complete search of seven primary databases and gray literature was carried out. The risk of bias was assessed according to the Newcastle-Ottawa tool, and the GRADE tool was used to assess the quality of evidence. A binary meta-analysis was performed to assess the effectiveness of evaluating pathological alterations in the maxillary sinuses in PR and CT/CBCT. RESULTS Seven studies were included in our study, out of which four were included in a quantitative analysis. All studies were classified as low risk of bias. Five studies compared PR with CBCT and two studies compared PR to CT. The most common pathological alteration in maxillary sinuses reported was mucosal thickening. CT/CBCT was seen to be the most effective method for assessing pathological changes in the maxillary sinus when compared to PR (RR = 0.19, 95% confidence interval [CI] = 0.05 to 0.70, p = 0.01). CONCLUSION CT/CBCT are the most appropriate imaging methods to evaluate pathological changes in the maxillary sinuses, while PR is still limited in the evaluation of these changes being considered only for initial diagnosis.
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Affiliation(s)
| | | | - Leticia Maíra Wambier
- School of Health and Biological Sciences, Universidade Positivo, Street Prof. Pedro Viriato Parigot de Souza, Curitiba, Brazil
| | - Caique Mariano Pedroso
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Campinas, Brazil
| | - Marcela Claudino
- Dentistry Department, State University of Ponta Grossa (UEPG), Ponta Grossa, Parana, Brazil
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Eberlikose H, Yilmaz D, Gulen O. Characteristics of maxillary sinus ostia and their correlation with anatomic variations of the osteomeatal complex: Indications for sinus floor elevation. Niger J Clin Pract 2023; 26:992-997. [PMID: 37635585 DOI: 10.4103/njcp.njcp_863_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background Knowledge of the anatomy and variations of the maxillary sinus is essential for reducing oral surgery complications, such as sinus floor elevation, and increasing surgery success. The CBCT images of 385 patients were examined. Materials and Methods The prevalence, localization, and height of PMO (Primer Maxillary Ostium) and AMO (Accessory Maxillary Ostium) were evaluated with respect to sex, dentition, dental treatment, Schneiderian membrane (SM) thickness, concha bullosa, Haller Cells, and septal deviation. Results The PMO was present in 87.3% of all patients. Further analysis showed that the mean PMO diameter was 1.42 ± 0.62 mm. Although 11.6% of the PMO was in the inferior region, 60.4% was in the middle and 28% in the superior region. The effect of age and SM on the height and diameter of the PMO was found to be statistically significant. An AMO was present in 20% of the CBCT images. The mean AMO diameter was 2.55 ± 1.25 mm. Although 45.4% of the AMO was in the inferior region, 48% was in the middle and 6.6% was in the superior region. Moreover, SM thickness seemed to influence the height. A significant positive relationship was found between the PMO and AMO height. Also, a significant relationship was observed between the presence of the AMO and septum deviation. Conclusion The presence of the AMO, PMO diameter, and height should be added to the preoperative evaluation criteria for the success of sinus floor evaluation. Specifically, sinonasal and demographic conditions should be carefully examined preoperatively for the long-term success of the surgery.
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Affiliation(s)
- H Eberlikose
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Medipol University, Ankara, Türkiye
| | - D Yilmaz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Türkiye
| | - O Gulen
- Dentomaxillofacial Radiologist, Private Practice Instead of Oral Radiolog, Turkish Ministry of Health, Türkiye
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5
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Betin-Noriega C, Urbano-Del Valle SE, Saldarriaga-Naranjo CI, Obando-Castillo JL, Tobón-Arroyave SI. Analysis of risk variables for association with maxillary sinus mucosal thickenings: a cone-beam computed tomography-based retrospective study. Surg Radiol Anat 2023; 45:417-429. [PMID: 36752834 PMCID: PMC10039820 DOI: 10.1007/s00276-023-03090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/19/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE This study aimed to determine which patient-related, anatomical, pathologic, or iatrogenic variables may be directly associated with and which may have a modifying effect on the generation of maxillary sinus (MS) mucosal thickenings. METHODS A total of 278 cone-beam computed tomography (CBCT) scans obtained from 114 males and 164 females were evaluated. The protocol included the assessment of 21 candidate variables, of which 18 were bilateral and 3 were unique. The relationship among the study variables and the mucosal thickenings were examined individually and adjusted for confounding using univariate and multivariate binary logistic regression models. RESULTS The prevalence of mucosal thickenings was 71.20% at patient level and 53.40% at sinus level. The ostium height > 28.15 mm, the infundibulum length ≤ 9.55 mm, the infundibulum width ≤ 0.50 mm, along the occurrence of periapical lesions and slight-to-severe periodontal bone loss acted as strong/independent risk variables for MS mucosal thickenings. Confounding and interaction relationships between MS height and depth, and between the alveolar process type and the presence of foreign materials with respect to age stratum > 47.50 years might be also associated with the mucosal thickenings. CONCLUSIONS While increased ostium height, decreased infundibulum length/width, the presence of periapical lesions and periodontal involvement might be the foremost indicator variables for MS mucosal thickenings, there are synergistic relationships among the increased sinus height and depth as well as aging regarding atrophic/partially atrophic alveolar process status and the presence of foreign materials that may be also associated with a greater proportion of these mucosal abnormalities.
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Affiliation(s)
- Carolina Betin-Noriega
- Graduate Oral and Maxillofacial Surgery Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | | | | | | | - Sergio Iván Tobón-Arroyave
- Graduate Oral and Maxillofacial Surgery Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
- Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Calle 70 N° 52-21, Medellín, Colombia.
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Areizaga-Madina M, Pardal-Peláez B, Montero J. Maxillary Sinus Pathology and its Relationship with Pathology and Dental Treatments. Systematic Review. REVISTA ORL 2023. [DOI: 10.14201/orl.29553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Introduction and objective: The aim of this review is to evaluate to what extent sinus pathology originates from dental pathology or treatment, and to assess the occurrence frequency of sinus pathology in its different forms using cone beam computed tomography (CBCT).
Method: The literature review was conducted using PubMed, Scopus and the Cochrane Library. Forty-two articles were included (25 case series, ten cross- sectional studies, three case-control studies, two cohort studies, one prospective study, and one retrospective study).
Results: Forty-two articles involving a total of 13,191 patients and 17,374 CBCTs were included in this review. The most frequent pathological findings were, by a considerable degree, inflammatory diseases, which represented 75.16% of the total findings, followed by infection (12.13%), tumours (6.88%), and high pneumatisation (2.07%). Within dental pathology, there is a direct Pearson correlation with polyps (1) and opacification (0.999), and an almost direct correlation with retention cysts (0.981) and sinus-associated dental elements (0.972).
Conclusions: Our results further support the argument that dental modifications and treatments are an important cause of sinus pathology. For this reason, dental aetiologies must be taken into account by both dentists, maxillofacial surgeons and ENT when considering the most appropriate treatment for patients with maxillary sinusitis.
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7
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Yeung AWK, Hung KF, Li DTS, Leung YY. The Use of CBCT in Evaluating the Health and Pathology of the Maxillary Sinus. Diagnostics (Basel) 2022; 12:diagnostics12112819. [PMID: 36428879 PMCID: PMC9689855 DOI: 10.3390/diagnostics12112819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
The use of cone-beam computed tomography (CBCT) has been increasing in dental practice. This narrative review summarized the relevance and utilizations of CBCT to visualize anatomical structures of the maxillary sinus and common pathologies found in the maxillary sinus. The detection/visualization rate, the location and the morphometric characteristics were described. For sinus anatomy, the reviewed features included the posterior superior alveolar artery, sinus pneumatization, sinus hypoplasia, sinus septa, and primary and accessory sinus ostia. For pathology, the following items were reviewed: membrane thickening associated with periapical lesions/periodontal lesions, mucous retention cyst, and antrolith. The visualization and assessment of the maxillary sinus is very important prior to procedures that take place in close proximity with the sinus floor, such as tooth extraction, implant insertion, and sinus floor elevation. Some sinus pathologies may be associated with odontogenic lesions, such as periapical diseases and periodontal bone loss.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Kuo Feng Hung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Dion Tik Shun Li
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Correspondence:
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Evaluation of Mucous Retention Cyst Prevalence on Digital Panoramic Radiographs in the Local Population of Iran. Radiol Res Pract 2022; 2022:8650027. [PMID: 35978990 PMCID: PMC9377968 DOI: 10.1155/2022/8650027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/28/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction. Inflammatory diseases and cysts such as mucous retention cysts (MRCs) and benign tumors include a large proportion of lesions of the mouth, teeth, and jaw. The most common complication of this lesion is sinusitis. Due to the high frequency of these cysts in panoramic radiography of patients referred to dentistry, this study aimed to evaluate the frequency of mucous retention cysts in the maxillary sinus on panoramic images of the local population in Birjand in the year 2020. Methods. In this descriptive research design study, 1624 digital panoramic radiographs of patients referred to the oral and maxillofacial radiology department of Birjand Dental School were selected randomly. Cases were evaluated in terms of MRC appearance by two oral and maxillofacial radiology specialists. Then, based on sex, location, and size of the cysts, the images were assessed. In the predesigned checklists, data were recorded. The MRC diagnosis was confirmed by observation of a dome-shaped radiopaque view on the floor or sinus walls with a smooth surface with no cortical margin. MRCs were categorized into one of three groups by size: 1- less than 10 mm, 2- between 10 and 20 mm, and 3- more than 20 mm. Bilateral or unilateral involvement of lesions was noted. Seasons of the year (
). There was no significant relationship between the month of the year and the prevalence of cysts (
). Results. MRCs were detected in 80 panoramic images of 1624 (9/4), of which 54 patients (67.5%) were male and 26 patients (32.5%) were female. Of those 34 (42.5%), the total cases were between 30 and 40 years old. Most cysts (58.8%) were in the right sinus, and their size was 10–20 mm mainly (43.4%). Based on the results, there was a significant relationship between the prevalence of MRCs with age and sex. Conclusions. Panoramic images are so helpful in MRC detection. In this study, the frequency of MRCs is the highest in males between 30 and 40 years old. These lesions are reported mainly as unilateral and solitary in spring.
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Clinical and Histological Healing after Maxillary Sinus Floor Elevation. Dent J (Basel) 2022; 10:dj10070134. [PMID: 35877408 PMCID: PMC9324517 DOI: 10.3390/dj10070134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/01/2023] Open
Abstract
Sinus floor elevation is a surgical procedure that allows for the insertion of the implant in the posterior region of the maxilla in case of insufficient volume of native bone. Several studies have reported a high success rate, and this has helped to spread this surgical procedure around the world. The subject has been extensively studied and this could lead researchers to think that no new scientific evidence can be provided. However, new ideas and discoveries show that research never reaches a conclusion, and that new information can be added all the time. This collection aimed to provide new evidence that could be added to daily clinical work and to provide new ideas for future research.
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PRESS and Piezo MicroSurgery (Bony Lid): A Seven Year Evolution in a Residency Program Part 1: Surgeon-defined site location. J Endod 2022; 48:787-796.e2. [DOI: 10.1016/j.joen.2022.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/19/2022] [Accepted: 02/25/2022] [Indexed: 12/21/2022]
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Ren L, Chen C, Li N, Hu J, Jiang Z, Yang G. Prevalence of and factors associated with maxillary sinus cyst in a Chinese population. J Oral Sci 2022; 64:22-27. [PMID: 34980822 DOI: 10.2334/josnusd.21-0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE This study used cone-beam computed tomography (CBCT) to assess the prevalence of and factors associated with maxillary sinus cysts (MSCs) in a Chinese population. METHODS A total of 2,571 CBCT scans of 5,000 sinuses were analyzed. MSCs were diagnosed on the basis of imaging features within the maxillary sinus. Sex, age, dental condition, and anatomic condition were assessed. Associations with these factors were evaluated with logistic regression and a generalized estimating equations model. RESULTS The prevalence of MSCs was 15.46% at the sinus level and 23.44% at the patient level. The prevalence of MSCs was higher for men (OR = 1.864, P < 0.001) and for patients with apical lesions (OR = 1.76, P < 0.001), severe bone loss (OR = 1.363, P < 0.05), tooth roots in contact with the sinus floor (OR = 1.68, P < 0.001), and pits or septa on the floor of the maxillary sinus (OR = 1.539, P < 0.001). CONCLUSION This large sample had a high prevalence of MSCs. MSC prevalence was associated with multiple factors, including sex, dental condition, and anatomic condition. Maintenance of healthy dental and periodontal status might help prevent MSCs.
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Affiliation(s)
- Lingfei Ren
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Chaozhen Chen
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Na Li
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Jinxing Hu
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Zhiwei Jiang
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Guoli Yang
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
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Syam S, Maheswari U. Prevalence of Incidental Findings in Maxillary Sinus Using Cone Beam Computed Tomography – A Retrospective. PHARMACOPHORE 2022. [DOI: 10.51847/0kpbfeizzo] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ince Yusufoglu S, Hasanoglu Erbasar GN, Gülen O. Evaluation of the effect of periapical lesions and other odontogenic conditions on maxillary sinus mucosal thickness characteristics and mucosal appearance: A CBCT study. J Dent Res Dent Clin Dent Prospects 2021; 15:163-171. [PMID: 34712406 PMCID: PMC8538141 DOI: 10.34172/joddd.2021.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 03/17/2021] [Indexed: 01/17/2023] Open
Abstract
Background. This retrospective study aimed to investigate the effect of various dental and maxillary sinus variables on maxillary sinus mucosal thickness (MT). The variables included periodontal bone loss (PBL), periapical status, dental restorations of posterior maxillary teeth, and the distance from the root apices to the sinus mucosa.
Methods. Cone-beam computed tomography (CBCT) images of the maxillary sinuses (n = 600) in 300 patients were examined. The sinus MT and the distance of the roots from maxillary sinuses were measured. Apical lesions of the roots, PBL, and situations of adjacent teeth were recorded. The relationships between these conditions and MT and characterization of MT were evaluated. The Kruskal–Wallis H test was used to compare groups due to the non-normal distribution of the data. The relationship between categorical variables was analyzed using chi-squared test.
Results. There was a significant correlation between maxillary sinus MT and periapical lesions, PBL, and restorations (P < 0.05). MT increased as the apical lesions of premolar teeth enlarged (P < 0.05, P = 0.022). MT increased in cases of mild PBL of molar teeth (P = 0.041).
Conclusion. In this retrospective study, the MT significantly increased in patients with periapical lesions, inadequate endodontic treatment, increased PBL, and inadequate dental restorations.
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Affiliation(s)
- Selen Ince Yusufoglu
- Department of Endodontics, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Güzin Neda Hasanoglu Erbasar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Orhan Gülen
- Private Practice, Oral and Maxillofacial Radiology, Ankara, Turkey
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14
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Zhang T, He Z, Tian H. Association between periodontal status and degree of maxillary sinus mucosal thickening: a retrospective CBCT study. BMC Oral Health 2021; 21:392. [PMID: 34380478 PMCID: PMC8359030 DOI: 10.1186/s12903-021-01737-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is well known that periodontitis can stimulate thickening of the maxillary sinus mucosa, but the association between periodontitis status and the degree of maxillary sinus mucosal thickening (maxMT) has not been reported. The objectives of this study were to investigate the effect of periodontal status of maxillary molars on the degree of maxMT. METHODS Retrospective analysis of cone-beam computed tomographic (CBCT) images of 203 periodontitis cases with maxMT. Parameters related to periodontitis in maxillary molars were measured and recorded on CBCT images. The dimension and length of the maxMT were also recorded. Multiple linear regression analysis was used to identify periodontal factors influencing the severity of maxMT, and multivariate logistic regression analysis was used to identify the odds ratio of these factors. RESULTS The factors affecting the degree of maxMT were mainly the amount of alveolar bone loss (ABL) and the minimum residual alveolar bone height (miniRABH). Compared to mild ABL, severe and moderate ABL were more likely to display severe maxMT. And the lower the miniRABH, the more severe the maxMT. CONCLUSIONS The severity of periodontal status of maxillary molars can influence the degree of maxMT.
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Affiliation(s)
- Tianyi Zhang
- School of Stomatology, Shanxi Medical University, 56th Xinjian South Road, Taiyuan, 030001, China
| | - Zhengquan He
- Department of Orthodontics, Changsha Stomatological Hospital, Hunan University of Traditional Chinese Medicine, 389th Youyi Road, Changsha, 410004, China
| | - Huan Tian
- Department of Orthodontics, Changsha Stomatological Hospital, Hunan University of Traditional Chinese Medicine, 389th Youyi Road, Changsha, 410004, China.
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15
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Omori Y, Nakajima Y, Imai H, Yonezawa D, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of Anatomical Parameters on the Dimensions of the Subantral Space and Sinus Mucosa Thickening after Sinus Floor Elevation. A Retrospective Cone Beam Computed Tomography Study. Dent J (Basel) 2021; 9:dj9070076. [PMID: 34202457 PMCID: PMC8304157 DOI: 10.3390/dj9070076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Various anatomical parameters might influence the surgical approach for maxillary sinus floor elevation. The objective of the present study was to retrospectively evaluate the influence of anatomical parameters on the dimensions of the subantral space and of the sinus mucosa thickening after sinus floor elevation. MATERIAL AND METHODS Seventy-eight maxillary sinuses in sixty-five patients were evaluated on cone beam computed tomographies taken before surgery and after one week (t1w) and nine months (t9m). Several parameters such as the distance XF between an axis parallel to the base of the nose (X-axes) and the sinus floor (F) were correlated with the height gain (IF) at t1w and t9m and the post-surgical edema. RESULTS A weak significant positive correlation was observed between height gain vs. sinus height of interest (XF), the balcony, and the sinus floor angle. The post-surgical edema was influenced by the initial mucosa thickness and the xenograft used. CONCLUSIONS Various parameters might affect height gain and sinus mucosa thickening after sinus floor elevation. The height of interest, the balcony, and the sinus floor angle showed significant correlations with height gain. The initial thickness of the mucosa and the biomaterial used influenced the post-surgical edema.
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Affiliation(s)
- Yuki Omori
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan; (Y.O.); (Y.N.); (H.I.)
| | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan; (Y.O.); (Y.N.); (H.I.)
| | - Hideki Imai
- Department of Oral Implantology, Osaka Dental University, Osaka 573-1144, Japan; (Y.O.); (Y.N.); (H.I.)
| | - Daichi Yonezawa
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8102, Japan
- Correspondence:
| | - Mauro Ferri
- ARDEC Foundation, 130001 Cartagena de Indias, Colombia;
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Incidental findings in maxillary sinus area on cone-beam-computed-tomographic-scans: A retrospective study with emphasis on gender and ethnicity. Saudi Dent J 2021; 33:184-187. [PMID: 34025079 PMCID: PMC8117362 DOI: 10.1016/j.sdentj.2020.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/27/2020] [Accepted: 03/02/2020] [Indexed: 11/30/2022] Open
Abstract
Aim The aim was to assess the presence of incidental-findings (IFs) on cone-beam computed tomography (CBCT) scans of faciomaxillary region with emphasis on gender and ethnicity. Materials and methods A retrospective analysis of incidental findings (IFs) in the maxillary sinus was performed. All CBCT-scans were performed using a Cone Beam 3D imaging system and examined using a software program. These images were taken for treatment planning for dental implant therapy of partially edentulous individuals. Four-hundred CBCT scans were retrospectively evaluated. Data regarding age, gender and ethnicity (Saudi Arabian, Egyptian, Filipino and Pakistani) of the patients was recorded. When P-value were lesser than 0.05, the difference was deemed significant. Results Four hundred CBCT-based scans were investigated. The IFs were seen in 30.2%, 32.1%, 35.1% and 34.4% individuals belonging to the Egyptian, Saudi Arabian, Pakistani and Filipino ethnicities, respectively. Mucosal-thickening was more often identified in Saudi-Arabian (P < 0.05), Pakistani (P < 0.05) and Filipino males (P < 0.05) than females in the respective ethnic group. There was no difference in the identification of IFs (mucous retention cysts, opacifications, sinus septa and sinus floor discontinuation) related to the maxillary sinus region among males belonging to the Egyptian, Saudi-Arabian, Filipino and Pakistani ethnic groups. Interpretations and conclusion The CBCT-based technology is valuable resource for the identification of IFs.
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Hung K, Hui L, Yeung AWK, Wu Y, Hsung RTC, Bornstein MM. Volumetric analysis of mucous retention cysts in the maxillary sinus: A retrospective study using cone-beam computed tomography. Imaging Sci Dent 2021; 51:117-127. [PMID: 34235057 PMCID: PMC8219453 DOI: 10.5624/isd.20200267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of this study was to evaluate the volumetric characteristics of mucous retention cysts (MRCs) in the maxillary sinus and to analyze potential associations of MRCs with dentoalveolar pathologies. Materials and Methods Cone-beam computed tomography (CBCT) scans exhibiting bilateral maxillary sinuses that were acquired from January 2016 to February 2019 were initially screened. A total of 227 scans (454 sinuses) that fulfilled the inclusion criteria were included. The presence, location, and volumetric characteristics of the diagnosed MRCs were evaluated on CBCT images using the 3D-Slicer software platform. The presence of MRCs was correlated with potential influencing factors including age, sex, and dentoalveolar pathology. For MRCs located on the sinus floor, factors with a potential impact on the volume, surface, and diameter were analyzed. Results An MRC was present in 130 (28.6%) of the 454 sinuses. Most MRCs were located on the sinus walls and floor. The mean MRC volume, surface, and diameter were 551.21±1368.04 mm3, 228.09±437.56 mm2, and 9.63±5.40 mm, respectively. Significantly more sinuses with associated endodontically treated teeth/periapical lesions were diagnosed with an MRC located on the sinus floor. For MRCs located on the sinus floor, endodontic status exhibited a significant association with increased volume, surface, and diameter. Conclusion Periapical lesions might be a contributing factor associated with the presence and volume of MRCs located on the sinus floor. The 3D-Slicer software platform was found to be a useful tool for clinicians to analyze the size of MRCs before surgical interventions such as sinus floor elevation procedures.
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Affiliation(s)
- Kuofeng Hung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Liuling Hui
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yiqun Wu
- Second Dental Clinic, Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Richard Tai-Chiu Hsung
- School of Information Engineering, Guangdong University of Technology, Guangzhou, China.,Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Michael M Bornstein
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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18
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Sakuma S, Ferri M, Imai H, Fortich Mesa N, Blanco Victorio DJ, Apaza Alccayhuaman KA, Botticelli D. Involvement of the maxillary sinus ostium (MSO) in the edematous processes after sinus floor augmentation: a cone-beam computed tomographic study. Int J Implant Dent 2020; 6:35. [PMID: 32743707 PMCID: PMC7396408 DOI: 10.1186/s40729-020-00233-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023] Open
Abstract
Background After sinus floor augmentation, a thickening of the sinus mucosa has been described. The aim of the present study was to evaluate the involvement of the maxillary sinus ostium in the edematous processes after a sinus floor augmentation procedure. Methods Seventy-two cone-beam computerized tomographies (CBSTs) were taken before sinus floor augmentation and after 1 week and 9 months from surgery and analyses. Sinus mucosa thickness and area, ostium diameter and patency, and extension of the post-surgical transient mucosal thickening in relation to the ostium were evaluated on the CBCTs for all three periods. The term “virtual” when referring to sinus mucosa thickness and area was introduced because of the edema and bleeding that both contributed to a transient thickening and additional elevation of the sinus mucosa. Results The mean virtual thickness of the sinus mucosa was 2.7 ± 4.0 mm, 7.7 ± 7.1 mm, 1.7 ± 2.0 mm before surgery, and after 1 week and 9 months. The virtual mucosa area was 37.2 ± 52.5 mm2, 184.5 ± 153.8 mm2, and 34.0 ± 50.7 mm2. The ostium diameter at the three periods evaluated was 1.8 ± 0.5 mm, 1.1 ± 0.6 mm, 1.5 ± 0.8 mm, respectively. Three infundibula (4.2%) were found out of patency before surgery while this number increased to 14 (19.4%) after 1 week. Nine months after surgery, only one infundibulum (1.4%) was out of patency, however, without presenting signs of sinus pathologies. The extension of the mucosal edema on the palatal sinus was reduced after 9 months of healing. Conclusions One week after sinus floor augmentation, the maxillary sinus mucosa increased in dimensions and in several cases involved the ostium, reducing its diameter and producing a transient loss of patency. After 9 months of healing, the initial conditions were recovered.
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Affiliation(s)
- Shigeru Sakuma
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923, Rimini, Italy
| | - Mauro Ferri
- ARDEC Foundation, Cartagena, de Indias, Colombia
| | - Hideki Imai
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923, Rimini, Italy.,Department of Oral Implantology, Osaka Dental University, Osaka, Japan
| | | | | | - Karol Alí Apaza Alccayhuaman
- ARDEC Academy, Viale Giovanni Pascoli 67, 47923, Rimini, Italy.,Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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French Otorhinolaryngology Society (SFORL) good practice guidelines for dental implant surgery close to the maxillary sinus. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 137:53-58. [PMID: 31837968 DOI: 10.1016/j.anorl.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To draw up guidelines for ENT management associated with dental implant surgery with or without sinus lift. MATERIALS AND METHODS The methodology followed the rules of laid down by the French Health Authority (HAS): "Methodological bases for drawing up professional recommendations by formalized consensus". The chosen method was the RAND/UCLA "RAND appropriateness method" (short version). RESULTS In the pre-implantation check-up, it is recommended to systematically screen for sinonasal pathology on medical interview and to favor 3D CT or cone-beam imaging. It is recommended that imaging include the entire maxillary sinus when the patient does not have sinonasal history or functional signs on interview. Otherwise, examination of all sinonasal cavities is recommended. This attitude enables simultaneous analysis of maxillary infrastructure for pre-implantation work-up and assessment of sinonasal cavity status. Sinus mucosal incidentalomas are very common in the healthy population and must be assessed with reference to the clinical, endoscopic and radiological context. CONCLUSION This formalized expert consensus establishes a common base of knowledge, to clarify the issues and clinical situations and to standardize practices.
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Prevalence of Maxillary Sinus Pathology Based on Cone-Beam Computed Tomography Evaluation of Multiethnicity Dental School Population. IMPLANT DENT 2019; 28:356-366. [PMID: 31135648 DOI: 10.1097/id.0000000000000902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The goal of the study was to evaluate prevalence of maxillary sinus pathology among populations considered for possible sinus augmentation procedures for dental implants. STUDY DESIGN Eight hundred twenty-one cone-beam computed tomography (CBCT) scans were retrospectively evaluated for prevalence of maxillary sinus pathology. Scans were classified based on the type of sinus pathology detected. Categories of sinus findings were healthy, mucosal thickening larger than 3 mm, polypoidal mucosal thickening, partial opacification, complete opacification, and others. Age, sex, ethnicity, and dentition status were evaluated to determine associated relationships with the incidence of pathology. RESULTS Sixty-two percent (62.79%) of scans presented with bilateral healthy sinuses and 37.21% of scans exhibited pathology. 73.38% of sinuses were classified as clinical healthy, 14.93% presented with mucosal thickening, 8.53% with polypoidal mucosal thickening, 2.13% with partial opacification, 0.66% with complete opacification, and 0.37% with a foreign body. Sex is found to be a significant factor with higher pathology incidence rates in male patients. Age is a significant factor with higher pathology incidence rates in older subjects. Dentition status and ethnicity did not have a significant association with pathology incidence rates. CONCLUSIONS The prevalence of maxillary sinus pathologies and associations with age, sex, ethnicity, and dentition status were obtained. Thirty-seven percent of scans would require further medical consultation before proceeding with maxillary sinus augmentation surgery for dental implants.
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Yeung AWK, Colsoul N, Montalvao C, Hung K, Jacobs R, Bornstein MM. Visibility, location, and morphology of the primary maxillary sinus ostium and presence of accessory ostia: a retrospective analysis using cone beam computed tomography (CBCT). Clin Oral Investig 2019; 23:3977-3986. [PMID: 30737619 DOI: 10.1007/s00784-019-02829-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/24/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This retrospective study evaluated the visibility, location, and morphology of the primary maxillary ostium (PMO), as well as the presence and number of accessory maxillary ostia (AMO) in the maxillary sinus using cone beam computed tomography (CBCT). MATERIALS AND METHODS CBCT scans with a large field of view with both maxillary sinuses entirely visible, acquired from February 2016 to February 2018, were initially screened. Patients were included if there was no history of surgical intervention/trauma in the sinus region. Two observers evaluated the CBCTs for PMO and AMOs independently. PMO and AMOs were evaluated in axial, coronal, and sagittal CBCT views. In case of disagreement, a third observer served as a referee. The findings were correlated with age, gender, condition of the sinus mucosa, and status of the dentition to assess for potential influencing factors. RESULTS A total of 184 patients (368 maxillary sinuses) were included. PMO was present and patent in 346 (94.0%) of the 368 analyzed sinuses. Most of the PMOs were located above the attachment of and in the middle third of the inferior turbinate (76.1%) and exhibited a slit shape (71.1%). An AMO was present in 167 (45.5%) of the 368 analyzed sinuses, and 66 (17.9%) sinuses had multiple AMOs. Gender and sinus mucosa morphology were found to be influencing factors for the patency of the PMO. Furthermore, gender seems to be influencing the presence of an AMO. CONCLUSIONS Most of the analyzed maxillary sinus cavities in the present population had a patent PMO. Being male and having morphological changes of the sinus mucosa were factors associated with a reduced prevalence of a patent PMO. CLINICAL RELEVANCE A maxillary sinus with pathological findings of the mucosa seems to have a reduced prevalence of patent PMOs. Therefore, clinicians should take care to assess any clinical and radiographical sign indicating a potential maxillary sinusitis prior to surgical interventions in this region, especially in cases with planned sinus floor elevation.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Nicolas Colsoul
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Carla Montalvao
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Kuofeng Hung
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michael M Bornstein
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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Environmental temperature and air humidity and prevalence of maxillary sinus retention cysts: possible relationships (preliminary study). Oral Radiol 2018; 35:296-300. [PMID: 30523545 DOI: 10.1007/s11282-018-0362-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/25/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aims of this study were to determine the prevalence of maxillary sinus retention cysts (MSRCs) and to evaluate the effects of mean temperature and mean air humidity on the prevalence of MSRCs in two cities in Turkey. METHODS This retrospective study was conducted in Antalya and Erzurum, two cities with different air humidities and temperatures in Turkey. Panoramic images of patients who visited the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University and Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ataturk University for diagnostic purposes were evaluated. A total of 4800 panoramic images were included in the study. The mean age of the patients was 27.03 ± 6.48 years. The prevalence of MSRCs was analyzed according to sex, mean temperature, and mean air humidity. Values of p < 0.05 were considered statistically significant. RESULTS Among the 4800 panoramic images evaluated, 228 indicated the presence of MSRCs. MSRCs were found significantly more frequently in males than in females. The prevalence was 3% in Antalya and 6.5% in Erzurum, with a total prevalence of 4.8%. While there was a significant correlation between the total amount of cysts and monthly mean air humidity in Erzurum, the correlation effect size was very low. CONCLUSIONS The total prevalence of MSRCs was 4.8%. There were no correlations between the frequency of MSRCs and the mean air humidity or mean temperature.
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Kawai T, Tanaka R, Yeung AWK, von Arx T, Bornstein MM. Frequency and type of incidentally detected radiodensities in the maxillary sinus: a retrospective analysis using cone beam computed tomography (CBCT). Clin Oral Investig 2018; 23:1091-1099. [PMID: 29951976 DOI: 10.1007/s00784-018-2541-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 06/20/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the frequency, location, and characteristics of radiodensities in the maxillary sinus using cone beam computed tomography (CBCT). MATERIALS AND METHODS All CBCT scans with a large field of view with both maxillary sinuses entirely visible were initially screened. Patients were included, if there was no suspicion of sinus pathology and no history of surgical intervention/trauma in the sinus region. The location and shape of the radiodensities were evaluated in axial, coronal, and sagittal CBCT views. The findings were correlated with age, gender, condition of the sinus mucosa, and status of the dentition. RESULTS A total of 169 patients (338 maxillary sinuses) were included. Radiodensities were found in 35 sinuses (10.4%) of 28 patients (16.6%) with a mean age of 32.0 years. Most of the 35 affected sinuses had one radiodensity (19/54.2%). The radiodensities were typically located at the sinus floor (22/62.9%). Of the sinuses presenting with radiodensities, 17 (48.6%) were exhibiting reactive changes of the Schneiderian membrane. The presence of periodontal pathology was found to be associated with the presence of radiodensities. Age and sinus pathology were influencing factors on the shape of radiodensities, and the status of the dentition was an influencing factor on the number of lesions. CONCLUSIONS One-sixth of the patients analyzed had incidentally diagnosed radiodensities in their maxillary sinuses. As almost 50% of the sinuses with radiodensities exhibited a form of chronic rhinosinusitis, the diagnosed ectopic calcifications may have formed as a result of mucosal changes of inflammatory origin. The presence of periodontal pathology was associated with a higher incidence of radiodensities. Nevertheless, this finding has to be interpreted with some caution due to the limited sample size available. CLINICAL RELEVANCE Incidentally detected radiodensities in the maxillary sinus are not an infrequent finding in CBCT scans of asymptomatic patients, and are located typically on the sinus floor. Future studies are needed to assess the clinical significance of these findings especially with regard to planned surgical interventions in the posterior maxilla.
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Affiliation(s)
- Taisuke Kawai
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, Nippon Dental University, Tokyo, Japan
| | - Ray Tanaka
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Thomas von Arx
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Michael M Bornstein
- Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
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