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Yanık D, Nalbantoğlu AM. Anatomic relationship between the root apex of maxillary molars and maxillary sinus in the presence of antagonist teeth: A Kwak's method with divisions. Arch Oral Biol 2024; 165:105998. [PMID: 38805866 DOI: 10.1016/j.archoralbio.2024.105998] [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: 03/07/2024] [Revised: 04/21/2024] [Accepted: 05/07/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE The purpose of the study was to evaluate the proximity between the root apices of maxillary molars and maxillary sinus floor using cone-beam computed tomography (CBCT) in the southern Turkish subpopulation. DESIGN For the study, 246 CBCT images were analyzed. The absence of antagonist teeth was excluded. Kwak's types III and V were detailed with three divisions. Division M; the penetration of the mesial root only, Division D; the penetration of the distal root only, and Division MD; the penetration of both buccal roots. The distance between the maxillary sinus and the root apices was measured. Student's t-test, one-way ANOVA, and chi-square were used for statistical analysis. RESULTS The penetration of maxillary molars was 24.40%. The highest prevalence belonging to Type I. Division MD was 44.35% for Type III and 40.42% for Type V. Division M was higher than Division D. The distances between the sinus and root apices were 1.35-2.41 mm in Type I. The distance decreased with age (p < 0.05). CONCLUSION Both buccal root penetration into the sinus was higher than the single root penetration. The distance of the second molar root apices to the sinus was closer than the first molar. One-quarter of the first and second molars were inside the sinus. A greater likelihood of penetration of the root apices into the sinus with increased age.
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Affiliation(s)
- Deniz Yanık
- Süleyman Demirel University, Faculty of Dentistry, Department of Endodontics, Isparta, Turkiye.
| | - Ahmet Mert Nalbantoğlu
- Süleyman Demirel University, Faculty of Dentistry, Department of Periodontology, Isparta, Turkiye
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Mays S, Stark S, Zakrzewski S, Vekony A. Which types of bony changes in the maxillary sinus indicate chronic sinusitis? INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2024; 46:16-23. [PMID: 38865933 DOI: 10.1016/j.ijpp.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/31/2024] [Accepted: 05/31/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES To determine which types of bone lesion (spicules, lobules, porous bone) in the maxillary sinus indicate sinusitis METHODS: Subadjacent dental disease is a cause of maxillary sinusitis; if a lesion type indicates sinusitis it should be more common above diseased posterior maxillary teeth than a lesion type that is not indicative of sinusitis. The study sample is a British Mediaeval human skeletal collection. RESULTS Porous bone lesions (chiefly new bone deposits) in maxillary sinuses are associated with subadjacent dental disease; spicules/lobules of bone in the sinus are not. CONCLUSIONS The results support the idea that porous lesions indicate sinusitis but the spicules/lobules may not. Spicules, lobules and porous lesions within the maxillary sinus should be analysed separately in biocultural studies; it would be prudent to regard only the porous lesions as indicative of sinusitis. SIGNIFICANCE Maxillary sinusitis is commonly used as a health indicator in palaeopathology, and spicular deposits are generally the most common type of alterations. By assuming that they are indicative of sinusitis we may have been greatly overestimating the prevalence of bony sinusitis in the past. LIMITATIONS These conclusions are provisional. Further work on larger, more diverse samples, together with more detailed anatomical studies on lesion location and structure is ongoing.
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Affiliation(s)
- S Mays
- Investigative Science, Historic England, UK; Department of Archaeology, University of Southampton, UK; School of History, Classics and Archaeology, University of Edinburgh, UK.
| | - S Stark
- Investigative Science, Historic England, UK; Department of Archaeology, University of Southampton, UK
| | - S Zakrzewski
- Department of Archaeology, University of Southampton, UK
| | - A Vekony
- Department of Archaeology, University of Southampton, UK
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Mularczyk C, Welch K. Maxillary Sinus Anatomy and Physiology. Otolaryngol Clin North Am 2024:S0030-6665(24)00101-4. [PMID: 39142996 DOI: 10.1016/j.otc.2024.07.004] [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: 08/16/2024]
Abstract
This study summaries the anatomy, including neurovascular anatomy, and physiology of the maxillary sinus. As the maxillary sinus is intimately related to the maxillary dentition, the maxillary sinus is the first paranasal sinus to become involved in infections of dental origin. Not only are these infections often very symptomatic but also spread to neighboring paranasal sinuses and extrasinus tissues such as the skin and the orbit.
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Affiliation(s)
- Christopher Mularczyk
- Department of Otolaryngology- Head & Neck Surgery, Northwestern University - The Feinberg School of Medicine, 675 North Street, Clair Street, Suite 15-200, Chicago, IL, USA
| | - Kevin Welch
- Department of Otolaryngology- Head & Neck Surgery, Northwestern University - The Feinberg School of Medicine, 675 North Street, Clair Street, Suite 15-200, Chicago, IL, USA.
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Shin SH, Ye MK, Lee DW, Choi MH. Impact of Zinc Oxide on the Development of Aspergillus-Induced Maxillary Sinusitis Rabbit Model. Curr Issues Mol Biol 2024; 46:5712-5723. [PMID: 38921013 PMCID: PMC11202535 DOI: 10.3390/cimb46060342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 05/29/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Aspergillus fumigatus is commonly found in the airway and is associated with airway inflammatory diseases. Zinc oxide (ZO) is known to be an essential microelement that facilitates fungal survival, growth, and proliferation. This study aimed to investigate the impact of ZO on A. fumigatus-induced fungal sinusitis in rabbits. Twenty-eight New Zealand white rabbits were divided into four groups for this study. Group 1 (6 sides) was treated with intramaxillary phosphate buffer saline (PBS) served as the negative control, Group 2 (6 sides) received intramaxillary PBS and ZO, Group 3 (8 sides) was treated with intramaxillary A. fumigatus alone, and Group 4 (8 sides) treated with intramaxillary A. fumigatus with ZO. After 4 and 12 weeks, sinus mucosal cytokine and transcription factor expressions were determined. A histological analysis was performed to determine inflammatory cell infiltration, number of secretory cells, and mucosal thickness. Fungal biofilm formation was determined using confocal laser microscopy. The intramaxillary instillation of A. fumigatus conidia led to an increase in protein and mRNA expression of interleukin (IL)-1β and IL-8 in the maxillary sinus mucosa. They were associated with mitogen-activated protein kinase and activator protein-1. Furthermore, intramaxillary instillation of fungal conidia resulted in significant enhancement of inflammatory cell infiltration, epithelial thickening, and fungal biofilm formation. However, intramaxillary ZO did not have a significant impact on A. fumigatus-induced cytokine protein and mRNA expression, and inflammatory cell infiltration and epithelial thickness in sinonasal mucosa. While intramaxillary instillation of A. fumigatus increased mucosal inflammation, cytokine production, and biofilm formation, the intramaxillary application of ZO did not have a significant influence on inflammation in the maxillary sinus mucosa.
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Affiliation(s)
- Seung-Heon Shin
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Daegu Catholic University, Daegu 42472, Republic of Korea; (M.-K.Y.); (D.-W.L.); (M.-H.C.)
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Kadan EA, Kiliç R, Miloğlu Ö, Özbek İY, Oral EA. Panoramic Radiography in the Evaluation of the Relationship of Maxillary Molar Teeth and Maxillary Sinuses on the Deep Learning Models Improved with the Findings Obtained by Cone Beam Computed Tomography. Niger J Clin Pract 2024; 27:669-677. [PMID: 38842718 DOI: 10.4103/njcp.njcp_220_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/15/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Panoramic radiography (PR) is available to determine the contact relationship between maxillary molar teeth (MMT) and the maxillary sinus floor (MSF). However, as PRs do not provide clear and detailed anatomical information, advanced imaging methods can be used. AIM The aim of this study was to evaluate the diagnostic performance of deep learning (DL) applications that assess the relationship of the MSF to the first maxillary molar teeth (fMMT) and second maxillary molar teeth (sMMT) on PRs with data confirmed by cone beam computed tomography (CBCT). METHODS A total of 2162 fMMT and sMMT were included in this retrospective study. The contact relationship of teeth with MSF was compared among DL methods. RESULTS DL methods, such as GoogLeNet, VGG16, VGG19, DarkNet19, and DarkNet53, were used to evaluate the contact relationship between MMT and MSF, and 85.89% accuracy was achieved by majority voting. In addition, 88.72%, 81.19%, 89.39%, and 83.14% accuracy rates were obtained in right fMMT, right sMMT, left fMMT, and left sMMT, respectively. CONCLUSION DL models showed high accuracy values in detecting the relationship of fMMT and sMMT with MSF.
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Affiliation(s)
- E A Kadan
- Department of Oral, Dental and Maxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - R Kiliç
- Department of Electrical Electronic Engineering, Faculty of Engineering, Ataturk University, Erzurum, Turkey
| | - Ö Miloğlu
- Department of Oral, Dental and Maxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - İ Y Özbek
- Department of Electrical Electronic Engineering (High Performance Comp Applicat and Res Ctr), Ataturk University, Erzurum, Turkey
| | - E A Oral
- Department of Electrical Electronic Engineering, Faculty of Engineering, Ataturk University, Erzurum, Turkey
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Madi M, Alsaad SS, AlAssiry N, Attia D, AlAssiry M, Zakaria O. Multilevel Modeling Analysis of Odontogenic Risk Factors and Nasal Septum Deviation Associated with Maxillary Sinus Mucosal Thickening: A Cone-Beam Computed Tomography Study. Dent J (Basel) 2024; 12:74. [PMID: 38534298 DOI: 10.3390/dj12030074] [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: 12/04/2023] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
(1) Background: In this study, the impact of odontogenic risk factors with nasal septum deviation on maxillary sinus mucosal thickening was assessed using Cone-beam computed tomography CBCT. (2) Methods: A total of 328 maxillary sinus regions from 164 patients (85 males and 79 females) were examined. Images were interpreted by dental specialists and Otolaryngologists. Coronal and sagittal sections were examined to assess the proximity of the root tips of posterior maxillary teeth (RPMT) to the maxillary sinus. The periodontal bone loss for all maxillary posterior teeth was also assessed. Consequently, maxillary sinus mucosal thickening (MT) was further classified into three gradings. Multilevel modeling regression analysis was used due to the hierarchical structuring of the data. Four models were developed, a null model with no factors, a model with tooth-level factors (RPMT, PBL, tooth condition, and root length), a model with patient-level factors (gender and nasal septum deviation), and a model with combined patient- and tooth-level factors. Regression estimates (AOR) and 95% confidence intervals (CIs) of individual and tooth factors were calculated. (3) Results: Multilevel regression analysis showed that RPMT was significantly associated with MT of maxillary sinus (p < 0.001), where patients who had RPMT > 0 had higher odds of MT of maxillary sinus. Tooth condition was also found to be significantly associated with MT of maxillary sinus, where teeth with failed RCT (p < 0.001) and teeth with restorations (p < 0.008) had higher odds of MT of maxillary sinus (AOR = 2.87, 95%CI 1.65, 4.42, AOR = 1.64, 95%CI 1.14, 2.36, respectively). (4) Conclusions: In order to plan preoperative treatment for maxillary posterior teeth, it is important to assess the anatomical relationship between the sinus floor and the root tips of the maxillary posterior teeth. Additionally, we establish a better understanding of the clinician before surgical intervention is conducted.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Sara S Alsaad
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Nada AlAssiry
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Dina Attia
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
| | - Mansour AlAssiry
- Department of Otolaryngology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Charoenwathana S, Vorakulpipat C, Kaewpradub P, Waikakul A, Kitisubkanchana J. Characteristics of CBCT versus panoramic signs of the surrounding bone of molar root protrusions into the maxillary sinus. Odontology 2024; 112:287-298. [PMID: 37405628 DOI: 10.1007/s10266-023-00833-w] [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: 02/25/2022] [Accepted: 06/25/2023] [Indexed: 07/06/2023]
Abstract
The study aimed to (a) investigate the amount and characteristics of the surrounding bone of protruded molar roots into the maxillary sinus using cone-beam computed tomography (CBCT) and (b) assess the correlation between the amount of bone with panoramic high-risk signs. Radiographs of 408 roots protruding beyond the sinus floor were evaluated. Axial CBCT images were used to investigate then classify eight characteristics of surrounding bone: no bone; bone < half the root girth in the proximal or buccal-palatal aspect; bone covering half the root girth in the proximal or buccal-palatal aspect; bone > half the root girth in the proximal or buccal-palatal aspect; and, complete bone. These were then grouped into four degrees of bone support: no bone; bone ≤ half the root girth; bone > half the root girth; and, complete bone. Panoramic signs were subclassified as: projection of root; interruption of the sinus floor; darkening of the root; upward curving of the sinus floor; absence of periodontal ligament space; and, absence of the lamina dura. Correlation between the degree of bone and the panoramic signs was evaluated using the Chi-square or Fisher's exact tests. Positive and negative predictive values, sensitivity, specificity, accuracy, and receiver operating characteristic analysis were calculated. Complete bone support was the most common. 'Projection of root' had a high negative predictive value and sensitivity. 'Absence of the periodontal ligament space and lamina dura' had a high positive predictive value, specificity, accuracy, and area under the curve. These two signs were significantly correlated with the degree of bone support.
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Affiliation(s)
- Sukanya Charoenwathana
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Ratchathewi District, 6, Yothi Road, Bangkok, Thailand
| | - Chakorn Vorakulpipat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Ratchathewi District, 6, Yothi Road, Bangkok, Thailand
| | - Pariya Kaewpradub
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Ratchathewi District, 6, Yothi Road, Bangkok, Thailand
| | - Aurasa Waikakul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Ratchathewi District, 6, Yothi Road, Bangkok, Thailand
| | - Jira Kitisubkanchana
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Ratchathewi District, No. 6, Yothi Road, Bangkok, 10400, Thailand.
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Ahmed J, Gupta A, Shenoy N, Sujir N, Muralidharan A. Prevalence of Incidental Maxillary Sinus Anomalies on CBCT Scans: A Radiographic Study. Diagnostics (Basel) 2023; 13:2918. [PMID: 37761284 PMCID: PMC10528184 DOI: 10.3390/diagnostics13182918] [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: 08/18/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
CBCT significantly impacts dental procedures and has brought significant reforms to our approach to diagnosis and treatment planning despite its limitations in differentiating soft tissues. It is an excellent imaging modality and quickly identifies sinus opacification and provides valuable insight into paranasal sinus pathologies, with considerably lower radiation exposure. The present study aimed to investigate the occurrence of maxillary sinus abnormalities in CBCT scans, identify the frequency, type, and location of these findings, and find the correlation between the distance of periapical lesions and radiographic changes in the maxillary sinus. Two examiners independently evaluated 117 patients to diagnose and classify the cases into different abnormality subtypes. The periapical lesions most closely related to the sinus were recorded. The diameters of the left and right maxillary sinus ostium and the distance of the ostium's lower border to the sinus's osseous floor were recorded. The findings were correlated with the age and gender of these patients. The present study reveals that sixty-one patients were diagnosed with mucosal thickening (52.1%). The sinus wall most affected by mucosal thickening was the maxillary sinus floor, followed by the medial and lateral walls. Of 19 patients with periapical lesions, 15 had maxillary sinus mucosal thickening, which is statistically significant (p = 0.004). The high occurrence of abnormalities in the maxillary sinus emphasizes the importance for the radiologist to comprehensively interpret the whole volume acquired in CBCT images, including the entire sinus. Incidental findings may be considered in the individual clinical context of signs and symptoms, reducing the risk of overestimating the real impact of radiographic findings.
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Affiliation(s)
| | | | - Nandita Shenoy
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal 575001, Karnataka, India; (J.A.); (A.G.); (N.S.); (A.M.)
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Rangics A, Répássy GD, Gyulai-Gaál S, Dobó-Nagy C, Tamás L, Simonffy L. Management of Odontogenic Sinusitis: Results with Single-Step FESS and Dentoalveolar Surgery. J Pers Med 2023; 13:1291. [PMID: 37763059 PMCID: PMC10532572 DOI: 10.3390/jpm13091291] [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: 07/16/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE Odontogenic sinusitis (OS) is a well-known and important border of specialties in otorhinolaryngology and dentoalveolar surgery. Odontogenic sinusitis can develop due to iatrogenic harm or odontogenic infection. The gold standard diagnostic method is clinical and radiological-CBCT (cone beam computed tomography)-examination. The treatment of this condition requires collaboration between ENT and dentoalveolar surgery specialists and can be non-surgical or surgical based on staging. This paper aims to share the results of our clinical study whereby complex therapy was administered by a dentoalveolar surgeon and an otorhinolaryngologist in cooperation. PATIENTS AND METHODS We conducted a retrospective study comprising 111 OS patients who underwent complex therapy between 2016 and 2023 at Semmelweis University, Budapest, Hungary. All patients were treated with concurrent FESS (functional endoscopic sinus surgery) and dentoalveolar surgery. Follow-up was based on symptoms, clinical examination and CBCT imaging. RESULTS Of the 111 patients, 107 were successfully treated with concurrent FESS and dentoalveolar surgery, and only 4 had further symptoms following the complex therapy and needed retreatment. CONCLUSIONS The complex, single-session therapy involving FESS and oral surgery is an effective treatment method, which is less invasive and associated with fewer complications compared to previous interventions, such as the Luc-Caldwell procedure.
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Affiliation(s)
- Anna Rangics
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary; (A.R.); (S.G.-G.); (C.D.-N.); (L.S.)
| | - Gábor Dénes Répássy
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary;
| | - Szabolcs Gyulai-Gaál
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary; (A.R.); (S.G.-G.); (C.D.-N.); (L.S.)
| | - Csaba Dobó-Nagy
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary; (A.R.); (S.G.-G.); (C.D.-N.); (L.S.)
| | - László Tamás
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary;
- Department of Voice Speech and Swallowing Therapy, Faculty of Health Sciences, Semmelweis University, 1085 Budapest, Hungary
| | - László Simonffy
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary; (A.R.); (S.G.-G.); (C.D.-N.); (L.S.)
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Taschieri S, Corbella S, Francetti L, Alberti A, Morandi B. Endodontic Surgery of the Palatal Root of a Maxillary Molar Associated with Simultaneous Management of a Maxillary Sinus Lesion. Case Rep Dent 2023; 2023:9180800. [PMID: 37475833 PMCID: PMC10356538 DOI: 10.1155/2023/9180800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 04/10/2023] [Accepted: 06/27/2023] [Indexed: 07/22/2023] Open
Abstract
This case report describes a particular application of endodontic microsurgery with a palatal approach in the presence of a radiopaque lesion inside the maxillary sinus. The patient presented complaining of pain related to the first maxillary molar and events of nasal obstruction and facial pain in the cheek and nasal area. The endodontic orthograde treatment and retreatment were done, respectively, 7 and 4 years earlier. The cone-beam computed tomography (CBCT) scan taken before the treatment showed two separate lesions: one associated with the palatine root of the molar and another one inside the maxillary sinus. The patient agreed to solve both problems in one surgical step: endodontic surgery of the palatine root with palatal access with the simultaneous asportation of a lesion from the maxillary sinus floor. Complete bone healing of the periapical area and the maxillary sinus was visualized on intra-oral radiographs, and CBCT was taken one year after the treatment. As far as the authors know, no one in literature has ever described this approach and solved in such a conservative way both the problems at the tooth and in the maxillary sinus.
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Affiliation(s)
- Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20123, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20123, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20123, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20123, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy
| | - Benedetta Morandi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20123, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy
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Siddiqui HK, Arif A, Ghauri K, Aijaz A, Khan FR. Relationship of maxillary third molar root to the maxillary sinus wall: A cone-beam computed tomography (CBCT) based study. J Dent Res Dent Clin Dent Prospects 2023; 17:8-11. [PMID: 37650022 PMCID: PMC10462913 DOI: 10.34172/joddd.2023.30484] [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: 05/06/2022] [Accepted: 12/25/2022] [Indexed: 09/01/2023] Open
Abstract
Background The relationship of the root of the maxillary third molars and the maxillary sinus (MS) is an important predictor of the anticipated difficulty in extraction. The aim of this study was to assess the location of maxillary third molars to the inferior wall of the MS in a sample of Pakistani population evaluated using cone-beam computed tomography (CBCT) imaging and to assess if age or gender has any influence on third molar to MS distance. Methods The CBCT scans of adult patients, carried out keeping image volume at 8 cm×8 cm, and the voxel size 0.2 and 0.1 mm. Images retrieved from the hospital database were included in the study. The relationship of root apices of maxillary third molar with the MS was assessed according to the vertical, horizontal and Winter's classification. Descriptive statistics, t test and chi-square test of association were applied. Results CBCT scans of 93 patients, 56 males and 37 females were evaluated. The mean age was 41.12±17.13 years. The mean distance of third molar roots to the MS wall was 2.38±1.54 mm for males and 1.86±1.04 mm for females, on the left and 2.67±1.81 mm for males and 2.58±1.54 mm in females, on the right side. Independent sample t test showed that there was no significant difference for third molar to sinus wall distance in the two genders. No significant difference was found between the two sides. Conclusion In a sub-population of Pakistani adults, the mean distance between the roots of the upper third molar and MS wall is around 2 mm. Only 5% males and 8% females had their upper third molars roots protruding into the MS.
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Affiliation(s)
| | - Aysha Arif
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Kanza Ghauri
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Anum Aijaz
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Farhan Raza Khan
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Vivekananda Pai AR. Factors influencing the occurrence and progress of sodium hypochlorite accident: A narrative and update review. J Conserv Dent 2023; 26:3-11. [PMID: 36908722 PMCID: PMC10003279 DOI: 10.4103/jcd.jcd_422_22] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/12/2022] [Accepted: 08/23/2022] [Indexed: 12/12/2022] Open
Abstract
Sodium hypochlorite (NaOCl) is one of the most commonly used irrigant because of its several advantages. However, it is highly cytotoxic and can lead to severe tissue damage. NaOCl accident occurs when it is extruded beyond root confines into periapical or periradicular tissues. It is an irrigant mishap which can be life threatening and/or cause residual or long term or permanent consequences with malpractice and medico-legal implications. There are many factors which can influence the occurrence and progress of NaOCl accident. These factors can be broadly categorized as patient (host)-, tooth-, operator-, and NaOCl-related factors. They can be further categorized as predisposing and extent factors. It is vital for a clinician to thoroughly understand and identify various influencing factors to prevent NaOCl accident with its associated consequences including any potential medico-legal issues. The purpose of this article is to provide a narrative review on various factors which predispose to the occurrence of NaOCl accident and influence its extent and/or outcome.
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Affiliation(s)
- A. R. Vivekananda Pai
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Manipal University College Malaysia, Jalan Batu Hampar, Bukit Baru, 75150 Melaka, Malaysia
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13
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Jung YH, Cho BH, Hwang JJ. Analysis of the root position and angulation of maxillary premolars in alveolar bone using cone-beam computed tomography. Imaging Sci Dent 2022; 52:365-373. [PMID: 36605857 PMCID: PMC9807791 DOI: 10.5624/isd.20220710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose This study investigated whether the relationship between the maxillary sinus and the root of the maxillary premolar is correlated with the root position and whether there is a difference in the long axis angle of premolars and the buccal bone thickness according to the sinus-root relationship and root position. Materials and Methods Cone-beam computed tomographic images of 587 maxillary first premolars and 580 second premolars from 303 patients were retrospectively reviewed. The maxillary sinus floor-root relationship was classified into 4 types, and the root position in the alveolar bone was evaluated as buccal, middle, or palatal. The long axis angle of the maxillary premolars in the alveolar bone and the buccal bone thickness were measured. The correlation between these parameters was analyzed. Results The maxillary sinus floor-root relationship showed a statistically significant correlation with the root position in the alveolar bone. Most maxillary first premolars were buccally located, and more than half of the second premolars had their roots in the middle. The long axis angle of the premolars was significantly larger in buccal-positioned teeth than in middle-positioned teeth, and the buccal bone was thinner. Conclusion When the root of the maxillary premolar was separated from the sinus floor, the premolar was often located on the buccal side. Most of the maxillary first premolars had a thinner buccal bone and larger inclination than the second premolars. It is recommended to evaluate the root position, sagittal angle and buccal bone thickness using CBCT for implant treatment planning.
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Affiliation(s)
- Yun-Hoa Jung
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Bong-Hae Cho
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jae-Joon Hwang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
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14
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Choi H, Jeon KJ, Kim YH, Ha EG, Lee C, Han SS. Deep learning-based fully automatic segmentation of the maxillary sinus on cone-beam computed tomographic images. Sci Rep 2022; 12:14009. [PMID: 35978086 PMCID: PMC9385721 DOI: 10.1038/s41598-022-18436-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/11/2022] [Indexed: 11/21/2022] Open
Abstract
The detection of maxillary sinus wall is important in dental fields such as implant surgery, tooth extraction, and odontogenic disease diagnosis. The accurate segmentation of the maxillary sinus is required as a cornerstone for diagnosis and treatment planning. This study proposes a deep learning-based method for fully automatic segmentation of the maxillary sinus, including clear or hazy states, on cone-beam computed tomographic (CBCT) images. A model for segmentation of the maxillary sinuses was developed using U-Net, a convolutional neural network, and a total of 19,350 CBCT images were used from 90 maxillary sinuses (34 clear sinuses, 56 hazy sinuses). Post-processing to eliminate prediction errors of the U-Net segmentation results increased the accuracy. The average prediction results of U-Net were a dice similarity coefficient (DSC) of 0.9090 ± 0.1921 and a Hausdorff distance (HD) of 2.7013 ± 4.6154. After post-processing, the average results improved to a DSC of 0.9099 ± 0.1914 and an HD of 2.1470 ± 2.2790. The proposed deep learning model with post-processing showed good performance for clear and hazy maxillary sinus segmentation. This model has the potential to help dental clinicians with maxillary sinus segmentation, yielding equivalent accuracy in a variety of cases.
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Affiliation(s)
- Hanseung Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Young Hyun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Eun-Gyu Ha
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea.
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15
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Doo JG, Min HK, Choi GW, Kim SW, Min JY. Analysis of predisposing factors in unilateral maxillary sinus fungal ball: the predictive role of odontogenic and anatomical factors. Rhinology 2022; 60:377-383. [PMID: 35856790 DOI: 10.4193/rhin22.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The pathogenesis of maxillary sinus fungal ball (MSFB) is explained by aerogenic and odontogenic factors. We evaluated the predisposing factors, including intranasal anatomical and dental factors for increased diagnostic accuracy. METHODOLOGY In this study, 117 patients who underwent endoscopic sinus surgery for unilateral MSFB were included. Preoperative computed tomography (CT) scans were used to analyze the presence of anatomical variations (anterior and posterior nasal septal deviation (NSD), concha bullosa (CB), infraorbital cell (haller cell), paradoxical middle turbinate, everted uncinate process and MS size). Dental factors including history of dental procedures and findings on CT scans were reviewed. RESULTS Anterior and posterior NSD toward non-affected side were significantly associated with the presence of FB. The presence of CB and infraorbital cell was higher in the non-affected side rather than in the lesion side. Compared to non-affected MS, FB-presence MS was shallower and had a larger height to depth ratio. The presence of dental history was significantly higher on FB-presence MS than non-affected MS. In multivariable analysis, posterior NSD toward non-affected side, dental history increased the aOR of MSFB, while the presence of CB and infraorbital cell decreased the aOR of MSFB. CONCLUSIONS The occurrence of MSFB seems to be associated with ipsilateral odontogenic factors, followed by anatomic variations including posterior NSD toward non-affected side and absence of CB and infraorbital cell.
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Affiliation(s)
- J G Doo
- Department of Otorhinolaryngology-Head and Neck Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.,Department of Medicine, Graduate school, Kyung Hee University, Seoul, Korea
| | - H K Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - G W Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - S W Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - J-Y Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University Medical Center, Seoul, Korea
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16
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Setzer FC, Kratchman SI. Present Status and Future Directions - Surgical Endodontics. Int Endod J 2022; 55 Suppl 4:1020-1058. [PMID: 35670053 DOI: 10.1111/iej.13783] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Endodontic surgery encompasses several procedures for the treatment of teeth with a history of failed root canal treatment, such as root-end surgery, crown- and root resections, surgical perforation repair, and intentional replantation. Endodontic microsurgery is the evolution of the traditional apicoectomy techniques and incorporates high magnification, ultrasonic root-end preparation and root-end filling with biocompatible filling materials. Modern endodontic surgery uses the dental operating microscope, incorporates cone-beam computed tomography (CBCT) for preoperative diagnosis and treatment planning, and has adopted piezoelectric approaches to osteotomy and root manipulation. Crown- and root resection techniques have benefitted from the same technological advances. This review focuses on the current state of root-end surgery by comparing the techniques and materials applied during endodontic microsurgery to the most widely used earlier methods and materials. The most recent additions to the clinical protocol and technical improvements are discussed, and an outlook on future directions is given. While non-surgical retreatment remains the first choice to address most cases with a history of endodontic failure, modern endodontic microsurgery has become a predictable and minimally invasive alternative for the retention of natural teeth.
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Affiliation(s)
- F C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - S I Kratchman
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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17
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Abdulghani EA, Al-Sosowa AA, Alhammadi MS, Al-Fakeh H, Al-Gumaei WS, Almashraqi AA, Sharhan HM, Cao B. Three-dimensional assessment of the favorability of maxillary posterior teeth intrusion in different skeletal classes limited by the vertical relationship with the maxillary sinus floor. Head Face Med 2022; 18:13. [PMID: 35413855 PMCID: PMC9003971 DOI: 10.1186/s13005-022-00316-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/02/2022] [Indexed: 12/25/2022] Open
Abstract
Background Understanding the anatomical relationship between the maxillary sinus floor (MSF) and the posterior maxillary teeth (PMT) is important when planning the orthodontic intrusion of the posterior teeth. This study aimed to determine the vertical relationship between posterior maxillary teeth and maxillary sinus floor in different skeletal classes in the Chinese adult population. Methods This is a retrospective cross-sectional study involved cone beam computed tomography images of 298 adult patients (145 males and 153 females) between 20 and 45 years old. The sample was categorized according to A point, Nasion, B point (ANB) angle into 102 Class I, 102 Class II, and 94 Class III malocclusion. Non-parametric Wilcoxon Mann–Whitney U and Kruskal–Wallis tests were used to compare the studied groups. The Intra-class Correlation Coefficient (ICC) was used to assess the intra- and inter-observer reliability analysis. Results Overall, there was a statistically significant difference in the mean distance between both genders (P < 0.001). The measured distance increased with age in all posterior tooth roots (P < 0.001). The root apex in the sagittal view appeared to be closer to the maxillary sinus than in the coronal view; 2.2 ± 4.3 and 3.1 ± 5.5 mm, respectively. The most frequent root scores were Type 1 and Type 2P. In both sagittal and coronal views, Class I demonstrated a higher Type 2P prevalence, whereas Class III showed a lower prevalence. The second molars’ mesiobuccal root had the largest number of penetration in the three examined skeletal classes. Conclusions Maxillary molars of Class I malocclusion with the majority of Type 2P root-sinus relationship have the highest possible risk of root resorption during molar intrusion due to cortical bone encroachment, while Class III malocclusion showed the least possible risk. Supplementary information The online version contains supplementary material available at 10.1186/s13005-022-00316-3.
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Affiliation(s)
- Ehab A Abdulghani
- Department of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Lanzhou University, Lanzhou, China
| | - Abeer A Al-Sosowa
- Department of Periodontics, Faculty of Dentistry, Thamar University, Dhamar, Republic of Yemen.,Department of Periodontics, College of Dentistry, Lanzhou University, Lanzhou, China
| | - Maged Sultan Alhammadi
- Division of Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.,Postgraduate Orthodontic Program, Department of Orthodontics, Pedodontics and Preventive Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Republic of Yemen
| | - Hanan Al-Fakeh
- Department of Prosthodontics, School of Stomatology, Lanzhou University, Lanzhou, China
| | - Waseem Saleh Al-Gumaei
- Department of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Lanzhou University, Lanzhou, China.,School of Dentistry, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
| | - Abeer A Almashraqi
- Department of Pre-clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hasan M Sharhan
- Department of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Lanzhou University, Lanzhou, China
| | - BaoCheng Cao
- Department of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Lanzhou University, Lanzhou, China.
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18
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Lee HS, Kim D, Kim SK. Proximity of maxillary molar apexes to the cortical bone surface and the maxillary sinus. Restor Dent Endod 2022; 47:e33. [PMID: 36090514 PMCID: PMC9436651 DOI: 10.5395/rde.2022.47.e33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives Materials and Methods Results Conclusions
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Affiliation(s)
- Han Shin Lee
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Dokyung Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Sung Kyo Kim
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
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19
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Miyazawa K, Shibata M, Tabuchi M, Kawaguchi M, Shimura N, Goto S. Optimal sites for orthodontic anchor screw placement using panoramic images: risk of maxillary sinus perforation and contact with adjacent tooth roots during screw placement. Prog Orthod 2021; 22:46. [PMID: 34878627 PMCID: PMC8655055 DOI: 10.1186/s40510-021-00393-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/22/2021] [Indexed: 11/11/2022] Open
Abstract
Objectives This study investigated the safety of orthodontic anchor screw (OAS) placement by examining the morphology and degree of depression of the maxillary sinus adjacent to the alveolar bone between the maxillary molars. Methods We reviewed panoramic and CT imaging data of 25 patients. First, the morphology of the maxillary sinus adjacent to the alveolar bone between the maxillary molars on panoramic images was classified into three types: non-depressed sinus, funnel-like sinus depression, and sawtooth-like sinus depression. Then, the distance from the maxillary buccal bone to the maxillary sinus or to the maxillary lingual bone and the distance between the roots of the maxillary second premolar and first molar at heights of 5, 6.5, and 8 mm from the alveolar crest were measured on CT images and compared between the three sinus morphology groups. Results The sawtooth-like depression group had significantly smaller bone thickness than the other two groups, with mean thickness of < 4 mm at any height from the alveolar crest. The funnel-like depression and non-depression groups had mean bone thickness of > 8 mm at any height from the alveolar crest. Conclusions Sawtooth-like sinus depression had increased risk of maxillary sinus perforation, suggesting that OAS placement in this region should be avoided. In contrast, OAS placement between 6.5 and 8 mm from the alveolar crest is advisable in patients with funnel-like sinus depression and at a site > 8 mm from the alveolar crest in those with a non-depressed sinus.
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Affiliation(s)
- Ken Miyazawa
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Momoko Shibata
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Masako Tabuchi
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
| | - Misuzu Kawaguchi
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Noriko Shimura
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Shigemi Goto
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
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20
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Shaul Hameed K, Abd Elaleem E, Alasmari D. Radiographic evaluation of the anatomical relationship of maxillary sinus floor with maxillary posterior teeth apices in the population of Al-Qassim, Saudi Arabia, using cone beam computed tomography. Saudi Dent J 2021; 33:769-774. [PMID: 34803332 PMCID: PMC8589617 DOI: 10.1016/j.sdentj.2020.03.008] [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: 12/26/2019] [Revised: 03/07/2020] [Accepted: 03/10/2020] [Indexed: 11/29/2022] Open
Abstract
Background & objective In current clinical dental practice radiographic imaging plays a major role in exploring the relationship between the maxillary sinus floor (MSF) and maxillary posterior teeth root apices, especially when there is an involvement of pathology in the periapical area that may lead to infectious, inflammatory or traumatic changes in the maxillary sinus (MS). It is also essential for exact implant placement, and therapeutic and surgical plans. The prevalence of different forms of anatomic relationship of the MSF to posterior root apices from one population to another is large. Hence the current research was conceived to evaluate the horizontal and vertical relationship forms of posterior root apices to the MSF in the Al-Qassim population of Saudi Arabia using Cone Beam Computed Tomography (CBCT). Materials and methods To conduct the study, a total of 200 patients' data (100 male and 100 female) were taken from the archives. The linear distances of the root apices to the MSF were measured for maxillary posterior teeth. On cross-sectional CBCT images, the Kwak et al. criteria were used to assess the horizontal and vertical relationships between the root apices of maxillary posterior teeth and the MSF. Results The mean distance between the apices of the maxillary second premolar ranged from 4.63 mm to 6.49 mm. The mean value of the distance between the apices of the posterior teeth and the MSF had a range of 0.68 ± 0.39 mm on the disto-buccal root (DBR) of the maxillary right second molar to 3.93 ± 1.26 mm on the palatal root (PR) of the maxillary left first molar. A similar result was observed in the maxillary second molar DBR in the male group (0.68 ± 1.17 mm) and the female group (0.69 ± 1.17 mm). The most frequently observed vertical relations were type 2 and type 2H horizontal relations. Conclusion This study concludes that maxillary molar roots show greater proximity with the MSF when compared with premolars, and that the type 2 vertical and type 2H horizontal distribution suggests that the anatomy of each tooth and the maxillary sinus floor should be evaluated by CBCT prior to treatment planning.
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Affiliation(s)
- K Shaul Hameed
- Department of Oral and Maxiilofacial Radiology, College of Dentistry, Qassim University, Al-Qassim, Saudi Arabia
| | - Elsantawy Abd Elaleem
- Department of Oral and Maxiilofacial Radiology, College of Dentistry, Qassim University, Al-Qassim, Saudi Arabia
| | - Dhafer Alasmari
- Department of Periodontology & Oral Medicine, College of Dentistry, Qassim University, Saudi Arabia
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21
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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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22
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Khojastepour L, Movahhedian N, Zolghadrpour M, Mahjoori-Ghasrodashti M. Assessment of the relationship between the maxillary sinus and the canine root tip using cone beam computed tomography. BMC Oral Health 2021; 21:338. [PMID: 34246270 PMCID: PMC8272249 DOI: 10.1186/s12903-021-01700-2] [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: 01/29/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of the present study is to investigate the relationship between the maxillary sinus and the canine root apices in cone beam computed tomographic images (CBCT) and to assess the amount of extension of the maxillary sinus to the anterior region of the jaw in different sexes and age groups. METHODS CBCT of 300 individuals (154 males and 146 females) over 20 years (with a mean age of 35.12 ± 8.40 years) were evaluated. The subjects were categorized into three age groups (20-30, 30-40, and 40-50 years). When the maxillary sinus extended to the canine area, the vertical distance between them was measured, and their relationship was classified into three types: I (more than 2 mm distance), II (less than 2 mm distance or in-contact), and III (interlock). RESULTS 413 out of 600 maxillary sinuses (68.8%) were extended into the canine area or beyond. Among them, 15 maxillary sinuses pneumatized into the incisor area (2.5%). The prevalence of the maxillary sinuses extended to the anterior region of the jaw was not significantly different between genders. However, it was significantly less frequent in the older age group and more frequent on the left side. In addition, the mean amount of anterior extension of the maxillary sinus (mm) was significantly lower in the older age group. Type I was the most frequent vertical relationship between the maxillary sinuses and canine apices with no significant difference in gender, side, and age groups. CONCLUSIONS In most cases, the maxillary sinus extended to the canine area and sometimes reached the incisor region. This necessitates paying more attention to the maxillary anterior sextant during surgical procedures.
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Affiliation(s)
- Leila Khojastepour
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Qom Abad, Ghasrodasht St., Shiraz, Iran
| | - Najmeh Movahhedian
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Qom Abad, Ghasrodasht St., Shiraz, Iran.
| | - Mohadeseh Zolghadrpour
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Kuligowski P, Jaroń A, Preuss O, Gabrysz-Trybek E, Bladowska J, Trybek G. Association between Odontogenic and Maxillary Sinus Conditions: A Retrospective Cone-Beam Computed Tomographic Study. J Clin Med 2021; 10:jcm10132849. [PMID: 34199113 PMCID: PMC8268029 DOI: 10.3390/jcm10132849] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 12/16/2022] Open
Abstract
Odontogenic infections can directly trigger maxillary sinusitis. CBCT is an excellent choice for precise examination of maxillary sinuses and hard tissues within the oral cavity. The objective of this retrospective and the cross-sectional study was to analyze the influence of odontogenic conditions on the presence and intensity of maxillary sinus mucous membrane thickening using CBCT imaging. Moreover, periodontal bone loss and anatomic relationship between adjacent teeth and maxillary sinuses were assessed to evaluate its possible impact on creating maxillary thickening. The study sample consisted of 200 maxillary sinuses of 100 patients visible on CBCT examination with a field of view of 13 × 15 cm. The presented study revealed a significant influence of periapical lesions, inappropriate endodontic treatment, severe caries, and extracted teeth on the presence of increased thickening of maxillary sinus mucous membrane. In addition, an increase in the distance between root apices and maxillary sinus floor triggered a significant reduction of maxillary sinus mucous membrane thickening. The presence of periodontal bone loss significantly increases maxillary sinus mucous membrane thickening.
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Affiliation(s)
- Piotr Kuligowski
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (P.K.); (A.J.); (O.P.)
| | - Aleksandra Jaroń
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (P.K.); (A.J.); (O.P.)
| | - Olga Preuss
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (P.K.); (A.J.); (O.P.)
| | - Ewa Gabrysz-Trybek
- Department of Diagnostic Imaging and Interventional Radiology, Pomeranian Medical University, Unii Lubelskiej 1 St., 71-242 Szczecin, Poland;
| | - Joanna Bladowska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Borowska 213 St., 50-556 Wroclaw, Poland;
| | - Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (P.K.); (A.J.); (O.P.)
- Correspondence:
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24
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Taschieri S, Morandi B, Giovarruscio M, Francetti L, Russillo A, Corbella S. Microsurgical endodontic treatment of the upper molar teeth and their relationship with the maxillary sinus: a retrospective multicentric clinical study. BMC Oral Health 2021; 21:252. [PMID: 33980213 PMCID: PMC8114693 DOI: 10.1186/s12903-021-01610-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To assess the clinical and radiographic success rate of microsurgical endodontic treatment of upper molar teeth in relationship with the maxillary sinus, with 12 months follow-up. METHODS Patients treated with microsurgical endodontic treatment of upper molar teeth in the period between 2017 and 2019 were recruited from two dental clinics according to specific selection criteria. The outcomes were determined based on clinical and radiographic results taken three, six and 12 months post-operatively, compared with those taken immediately before and after surgery. Clinical and radiographic outcomes were recorded. The distance between the most apical part of the root and of the lesion to the maxillary sinus was measured on CBCT images before the surgery. Patient-related outcomes were recorded. RESULTS Out of 35 patients evaluated, 21 were selected according with the selection criteria for a total of 27 roots and 29 canals treated. After 12 months, 18 patients showed a complete healing whereas three demonstrated incomplete healing. Consequently, the success rate in this study was 85.7% after one year. In 28.5% (6 patients) there was a perforation of the Schneiderian membrane that didn't seem to affect the outcome. All patients kept the molar one year later. The pain level decreased significantly over the time during the first week after surgery. CONCLUSION Microsurgical Endodontic treatment of the upper molar teeth should be considered a valid and predictable treatment option even in case of Schneiderian membrane perforation. Future clinical studies with a larger sample size are needed to compare the results obtained.
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Affiliation(s)
- S Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, 20123, Milan, Italy.,Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.,IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy
| | - B Morandi
- Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, 20123, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy
| | - M Giovarruscio
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia.,Department of Endodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - L Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, 20123, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy
| | - A Russillo
- Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, 20123, Milan, Italy.,Maxillofacial and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy
| | - S Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, 20123, Milan, Italy. .,Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia. .,IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy.
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Matsuda H, Sato I, Asaumi R, Omotehara T, Kawata S, Nagahori K, Li ZL, Itoh M. Comparison of CGRP distributions in the maxillary sinus and trigeminal ganglion between elderly dentulous and edentulous humans. Eur J Histochem 2021; 65. [PMID: 33787056 PMCID: PMC8054570 DOI: 10.4081/ejh.2021.3234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/24/2021] [Indexed: 11/22/2022] Open
Abstract
Thickening of the Schneiderian membrane (SM, mucosa of the maxillary sinus) appears in the paranasal sinus. Information on SM thickening is available for patients receiving sinus lift treatments, which is a risk factor for SM excretory dysfunction. However, more information is needed on the structure of the SM and the relationship between the maxilla sinus and palatine with the alveolar bone and the SM for dental implant treatment in the human maxilla. One hundred twenty-six sides of the maxilla from 71 cadavers were subjected to cone-beam computed tomography analysis and macroscopic and immunohistochemical observations in this study. A thickened SM was mainly observed in the middle region of the basal layer of the maxillary sinus (MS). Strong calcitonin gene-related peptide (CGRP)-positive reactions were observed in the alveolar bone, oral mucosa, mucosa of the MS, and trigeminal ganglion (TG) cells in dentulous samples compared with edentulous samples. TG cells play important roles in delivering CGRP through axons to the mucosal gland and in regulating the maxilla-related thickening of the SM. These data could help determine CGRP functions in the mucosal gland and bone formation between dentulous and edentulous samples and indicate that CGRP may pass from the TG to the MS glands.
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Affiliation(s)
| | - Iwao Sato
- Department of Anatomy, Tokyo Medical Univsersity.
| | - Rieko Asaumi
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo.
| | | | | | | | - Zhong-Lian Li
- Department of Anatomy, Tokyo Medical University, Tokyo.
| | - Masahiro Itoh
- Department of Anatomy, Tokyo Medical University, Tokyo.
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Jung YH, Cho BH, Hwang JJ. Comparison of panoramic radiography and cone-beam computed tomography for assessing radiographic signs indicating root protrusion into the maxillary sinus. Imaging Sci Dent 2021; 50:309-318. [PMID: 33409139 PMCID: PMC7758264 DOI: 10.5624/isd.2020.50.4.309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/17/2020] [Accepted: 09/01/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose This study investigated correlations between findings on panoramic radiographs and cone-beam computed tomography (CBCT) to assess the relationship between the maxillary sinus floor and the roots of maxillary posterior teeth. In addition, radiographic signs indicating actual root protrusion into the maxillary sinus were evaluated on panoramic radiographs. Materials and Methods Paired panoramic radiographs and CBCT images from 305 subjects were analyzed. This analysis classified 2,440 maxillary premolars and molars according to their relationship with the maxillary sinus floor on panoramic radiographs and CBCT images. In addition, interruption of the sinus floor was examined on panoramic radiographs. Results Root protrusion into the maxillary sinus occurred most frequently in the mesiobuccal roots of the second molars. The classification according to panoramic radiographs and CBCT images was the same in more than 90% of cases when there was no contact between the root apex and the sinus floor. When the panoramic radiograph showed root protrusion into the sinus, the CBCT images showed the same classification in 67.5% of second molars, 48.8% of first molars, and 53.3% of second premolars. There was a statistically significant relationship between interruption of the sinus floor on panoramic radiographs and root protrusion into the sinus on CBCT images. Conclusion The presence of root protrusion into the sinus on panoramic radiographs demonstrated a moderate ability to predict root protrusion into the maxillary sinus. Interruption of the maxillary sinus floor could be considered an indicator of actual root protrusion into the maxillary sinus.
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Affiliation(s)
- Yun-Hoa Jung
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Bong-Hae Cho
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jae Joon Hwang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
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Talo Yildirim T, Oztekin F, Tozum MD. Topographic relationship between maxillary sinus and roots of posterior teeth: a cone beam tomographic analysis. Eur Oral Res 2021; 55:39-44. [PMID: 33937761 PMCID: PMC8055262 DOI: 10.26650/eor.20210052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: The objective of the research was to determine the relationship between root apices
and maxillary sinus wall, and to analyze pulpoapical conditions of 2nd premolars, 1st
molars, 2nd molars, 3rd molars using cone beam computerized tomography (CBCT). Materials and methods: This study was conducted on a retrospective manner of CBCT images of 1000
maxillary sinus with 500 subjects, who visited the Department of Dento-Maxillofacial
Radiology. The association of each teeth with sinus floor and pulpoapical status
were categorized. The association among gender, age, lateralization of sinus cavity
were evaluated. Results: A total of 602 second premolars, 500 first molars, 623 second molars, 347 third
molars were evaluated. There were no significant differences between pulpoapical
condition of teeth and gender or left and right sides (p=0.065, p=0.072). There
were significant associations between pulpoapical condition of all teeth and age
(p=0.023), and the relationship of each root with maxillary sinus and age (p=0.037).
There was significant association between vertical position and right/left sides in
second and third molars (p=0.033). Conclusion: Age seems to have relationship with periapical condition of teeth, and the
association of root with the sinus cavity.
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Affiliation(s)
- Tuba Talo Yildirim
- Department of Periodontology, Faculty of Dentistry,Firat University, Elazig,Turkey
| | - Faruk Oztekin
- Department of Endodontic, Faculty of Dentistry,Firat University, Elazig,Turkey
| | - Melek Didem Tozum
- Pre-Doctoral Clinics, College of Dentistry, University of Illinois at Chicago, Chicago, IL,U.S.A
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Association between Maxillary Posterior Teeth Periapical Odontogenic Lesions and Maxillary Sinus Mucosal Thickening: A 3D Volumetric Computed Tomography Analysis. SINUSITIS 2020. [DOI: 10.3390/sinusitis4010003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: The detailed relationship between apical periodontitis and maxillary sinus mucosal thickening is still unknown. The aim of this study was to evaluate the association between maxillary posterior teeth periapical odontogenic lesions and maxillary sinus mucosal (MSM) thickening by using volumetric 3D CT analysis. Methods: A total of 83 subjects with apical periodontitis around maxillary posterior teeth and maxillary sinus mucosal thickening were selected. 3D models of maxillary sinus mucosa and apical lesions were reconstructed from CT, and their volume, mean diameter were calculated. Results: Mean MSM thickening was 8.81 ± 12.59 mm with an average volume of 5092.58 ± 7435.38 mm3. Men had higher MSM thickening than women. Mean diameter of apical lesion was 5.94 ± 2.68 mm; average volume was 200.5 ± 197.29 mm3. Mean distance between MSM and apical lesion was 1.83 ± 2.07 mm. Mucosal volume was the highest in the S1 and D1 configuration and the lowest in R3. Reducing the distance between apical lesion and MSM by each millimetre, the volume of MSM increases by 759.99 mm3. Conclusions: Volumetric CT analysis is a circumstantial method to evaluate the association between maxillary posterior teeth apical periodontitis and MSM thickening. This relationship is not related to the size of the apical lesion but depends on their anatomical position and the distance from the maxillary sinus mucosa.
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Silberman JJ, Moldauer BI, Torres J, Gallardo C, Sanabria-Liviac D. Palatal root surgery of a maxillary molar using a piezosurgery transantral approach with simultaneous sinus lift grafting: a case report. Int Endod J 2020; 54:464-475. [PMID: 33012051 DOI: 10.1111/iej.13423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
AIM To report a case involving transantral palatal root piezoelectric surgery followed by a sinus floor augmentation procedure with the purpose of minimizing and managing complications associated with sinus lining perforations and optimizing bone regeneration at the site of the surgical defect. SUMMARY An asymptomatic 28-year-old male patient with the diagnosis of chronic apical periodontitis on a previously root filled right maxillary first molar (FDI tooth 16) and second premolar (No. 15) was managed by transantral apical surgery. Cone-beam computerized tomography (CBCT) revealed the position of the palatal root of the first molar within the maxillary sinus. The case highlights the management of the palatal root and the handling of a perforation of the Schneiderian membrane through a combination of piezosurgery and a sinus lift grafting procedure involving a second-generation of platelet concentrates. No postoperative complications were observed. Sinus bone augmentation after a 26-month recall period was confirmed by CBCT in the clinically asymptomatic teeth. KEY LEARNING POINTS The selective bone tissue cutting and enhanced visibility obtained by piezoelectric surgery in comparison with current rotary techniques make this technology the preferred tool for apical surgery when the mucosal lining of the maxillary sinus could be compromised. The wound healing and physical properties of the platelet-rich fibrin membranes in combination with an allograft material can be considered as sinus bone graft options when a transantral approach is performed on a palatal root of a maxillary molar. A preoperative tomographic examination is essential for apical surgery using a transantral approach with sinus bone augmentation, because of the information obtained from the axial and coronal views on the CBCT scan.
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Affiliation(s)
- J J Silberman
- Department of Endodontics, Nova Southeastern University College of Dental Medicine, Fort-Lauderdale, FL, USA
| | - B I Moldauer
- Department of Endodontics, Nova Southeastern University College of Dental Medicine, Fort-Lauderdale, FL, USA
| | - J Torres
- Department of Endodontics, Universidad Privada San Juan Bautista, Lima, Perú
| | - C Gallardo
- Department of Endodontics, Universidad Científica del Sur, Lima, Peru
| | - D Sanabria-Liviac
- Department of Endodontics, Universidad Inca Garcilaso de la Vega, Lima, Peru
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Lee JH, Ahn HN, Park JT. Three-dimensional visualization of the alveolar bone and posterior superior alveolar foramen in gender. Surg Radiol Anat 2020; 43:261-266. [PMID: 32960307 DOI: 10.1007/s00276-020-02576-7] [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: 08/07/2020] [Accepted: 09/12/2020] [Indexed: 11/24/2022]
Abstract
The present study applied a three-dimensional (3D) program to measure the distances from the maxillary sinus floor (MSF) to the lingual and buccal alveolar bone and also to the posterior superior alveolar foramen (PSAF), with the aim of determining differences according to gender. The study also attempted to verify the accuracy of measurements obtained from 3D images by performing comparisons with the results obtained in a preliminary study. The results showed that the alveolar bone length and the MAF-PSAF were generally larger in males than in females. It is also predicted that the accuracy of data obtained from a 3D program will be higher than that of data derived from conventional two-dimensional (2D) images. The accurate measurements obtained in this study are anticipated to prove useful in assessments related to dental implantation and anatomical structures. The fundamental data obtained in this study may also assist in setting the goals of future studies utilizing 3D programs.
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Affiliation(s)
- Jeong-Hyun Lee
- Department of Oral Anatomy, Dental College, Dan-Kook University, Cheonan, 330-714, South Korea
| | - Hyun-Na Ahn
- Department of Oral Anatomy, Dental College, Dan-Kook University, Cheonan, 330-714, South Korea
| | - Jong-Tae Park
- Department of Oral Anatomy, Dental College Dankook Institute For Future Science and Emerging Convergence, Dan-Kook University, Cheonan, 330-714, South Korea.
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Oishi S, Ishida Y, Matsumura T, Kita S, Sakaguchi-Kuma T, Imamura T, Ikeda Y, Kawabe A, Okuzawa M, Ono T. A cone-beam computed tomographic assessment of the proximity of the maxillary canine and posterior teeth to the maxillary sinus floor: Lessons from 4778 roots. Am J Orthod Dentofacial Orthop 2020; 157:792-802. [PMID: 32487309 DOI: 10.1016/j.ajodo.2019.06.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION When tooth roots protrude into the maxillary sinus, apical root resorption and tipping may occur during horizontal tooth movement across the sinus floor. Three-dimensional cone-beam computed tomography (CBCT) images may provide detailed information without distortion and overlap. We evaluated the relationships between the maxillary tooth root apices and the maxillary sinus floor using CBCT. METHODS We evaluated 4778 roots from 76 men (aged 27.6 ± 10.4 [mean ± standard deviation] years; range, 18-69 years), and 225 women (aged 30.4 ± 12.0 years; range, 18-68 years). The positional relationships between the maxillary tooth root apices, including the canine, premolar (first and/or second), and molar (first and/or second), and the inferior wall of the maxillary sinus were comprehensively evaluated on 2 cross-sectional CBCT images (ie, the sagittal and coronal planes). These distances were measured in both images simultaneously. RESULTS The sagittal plane distances were significantly larger than coronal plane distances, except for the distobuccal root of the first molar. Pearson correlation test revealed a significant negative correlation between the distance and the patient's age. CONCLUSIONS Our study provides valuable information for planning orthodontic tooth movement through the maxillary sinus, which may help to predict the occurrence and severity of root resorption.
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Affiliation(s)
- Shuji Oishi
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuji Ishida
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Tomonari Matsumura
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Soma Kita
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomomi Sakaguchi-Kuma
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshihiro Imamura
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuhei Ikeda
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayako Kawabe
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makiko Okuzawa
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Psillas G, Papaioannou D, Petsali S, Dimas GG, Constantinidis J. Odontogenic maxillary sinusitis: A comprehensive review. J Dent Sci 2020; 16:474-481. [PMID: 33384837 PMCID: PMC7770314 DOI: 10.1016/j.jds.2020.08.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 08/08/2020] [Indexed: 02/07/2023] Open
Abstract
Odontogenic maxillary sinusitis (OMS) is a well-recognized condition in both the dental and otolaryngology communities. Close to 30% of cases of unilateral maxillary sinusitis may have an underlying dental pathology. Failure to identify a dental cause usually lead to cases recalcitrant sinusitis often associated with serious complications. The aim of this study is to describe the literature findings on odontogenic maxillary sinusitis that discuss anatomy, epidemiology, etiology, bacteriology, diagnosis and treatment. The present review is based on a current search using bibliographic database and academic search engine. All the articles on odontogenic maxillary sinusitis published after 2000 were included. This study seeks to provide clinicians with evidence that motivates a comprehensive approach to the evaluation and management of OMS. Controversies on diagnosis and management have been addressed and data from different treatment plans were collected by exploring relevant publications. The surgical treatment of OMS is based essentially on the dental surgery, combined with endoscopic sinus surgery, in order to completely remove the infection, restore the physiological drainage of the sinus and prevent recurrences of sinusitis. A multidisciplinary otolaryngology and dental team is mandatory to successfully manage the dental pathology and the complications resulting from the dental treatments.
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Affiliation(s)
- George Psillas
- 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Despoina Papaioannou
- School of Dentistry, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Spyridoula Petsali
- School of Dentistry, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Grigorios George Dimas
- 1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Jiannis Constantinidis
- 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Wuokko-Landén A, Blomgren K, Suomalainen A, Välimaa H. Odontogenic causes complicating the chronic rhinosinusitis diagnosis. Clin Oral Investig 2020; 25:947-955. [PMID: 32500403 PMCID: PMC7878247 DOI: 10.1007/s00784-020-03384-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/27/2020] [Indexed: 11/10/2022]
Abstract
Objectives Chronic rhinosinusitis (CRS) frequently stems from a dental origin, although odontogenic sinusitis (OS) remains underdiagnosed amongst different professionals. This study aimed to explore how often odontogenic causes are considered when diagnosing CRS. Materials and methods Patient records from 374 new CRS patients treated at a tertiary-level ear, nose, and throat (ENT) clinic were selected. Entries and radiological reports were assessed exploring how often dentition was mentioned and OS was suspected, how often radiologists reported maxillary teeth, and how commonly typical OS microbial findings and unilateral symptoms occurred. Results Although 10.1% of the CRS diagnoses were connected to possible dental issues, teeth were not mentioned for 73.8% of patients. Radiological reports were available from 267 computed or cone beam computed tomographies, of which 25.1% did not mention the maxillary teeth. The reported maxillary teeth pathology was not considered in 31/64 (48.4%) cases. Unilateral symptoms associated with apical periodontitis (OR = 2.49, 95% CI 1.27–4.89, p = 0.008). Microbial samples were available from 88 patients, for whom Staphylococcus aureus was the most common finding (17% of samples). Conclusions Odontogenic causes are often overlooked when diagnosing CRS. To provide adequate treatment, routine assessment of patient’s dental history and status, careful radiograph evaluation, and utilization of microbial findings should be performed. Close cooperation with dentists is mandatory. Clinical relevance Dental professionals should be aware of difficulties medical professionals encounter when diagnosing possible OS. Thus, sufficient knowledge of OS pathology is essential to both medical and dental professionals.
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Affiliation(s)
| | - Karin Blomgren
- Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anni Suomalainen
- HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannamari Välimaa
- Department of Virology, University of Helsinki, Helsinki, Finland
- Department of Oral and Maxillofacial Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Abstract
Patients sometimes present to a medical practitioner with dental pain if they cannot see a dentist Doctors need to be aware of the common dental diseases that result in pain so they can help to manage the patient’s symptoms until they are able to see a dentist Appropriate advice regarding analgesics for dental pain is important. Paracetamol and ibuprofen are more effective in combination than either of them alone, with or without opioids Antibiotics are only indicated as an adjunct to dental treatment when there are signs of systemic involvement, progressive and rapid spread of infection, or when the patient is immunocompromised
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Maspero C, Farronato M, Bellincioni F, Annibale A, Machetti J, Abate A, Cavagnetto D. Three-Dimensional Evaluation of Maxillary Sinus Changes in Growing Subjects: A Retrospective Cross-Sectional Study. MATERIALS 2020; 13:ma13041007. [PMID: 32102278 PMCID: PMC7078883 DOI: 10.3390/ma13041007] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/20/2020] [Accepted: 02/20/2020] [Indexed: 12/16/2022]
Abstract
This study aims to evaluate changes of maxillary sinuses in growing subjects. Cone Beam Computed Tomography (CBCT) scans of 146 patients were divided according to gender and age (6–8, 9–11, 12–14 years old). Left, right and total maxillary sinus volume (MSV-R, MSV-L, MSV-Tot) and surface (MSS-R, MSS-L, MSS-Tot), left and right linear maximum width (LMW-L, LMW-R), depth (LMD-R, LMD-L) and height (LMH-R, LMH-R) were calculated using Mimics Research 22. Kruskal–Wallis Test and showed a statistically significant increase in both genders for all variables. Pairwise comparisons in females are always statistically significant in: LMH-R, LMH-R, MSS-Tot, MSV-Tot. All other variables showed a statistical significant increase between 9–11 and 12–14, and between 6–8 and 12–14 age groups, apart from LMSW-R, LMSW-L, LMSD-R, LMSD-L between 6–8 and 12–14 age groups. Pairwise comparisons in males are always and only statistically significant between 9–11 and 12–14, and between 6–8 and 12–14 groups. Symmetrical measurements (right and left) evaluated using Wilcoxon test retrieved no statistical significant difference. Comparisons between measurements on male and female subjects using Mann–Whitney test showed a statistical significant difference in 6–8 years group in MSV-R, MSV-L and MSV-Tot, and in 12–14 age group in MSV-R, MSV-L, MSV-Tot, MSS-r, MSS-l, MSS-Tot, MSW-R, MSW-L, MSD-R, MSD-L. Intraclass Correlation Coefficient (ICC) assessing inter-operator and intra-operator concordance retrieved excellent results for all variables. It appears that maxillary sinus growth resembles the differential peak of growth in male and female subjects. Sinuses starts to develop early in female subjects. However, in the first and last age group female sinuses are statistically significantly smaller compared to male ones. In male subjects, sinus growth occurs mainly between the second and third age group whilst in female subjects it starts between the first and second age group and continues between the second and the last. Sinus has a vertical development during the peak of growth, which is the main reason for its increase in volume.
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Affiliation(s)
- Cinzia Maspero
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (M.F.); (F.B.); (A.A.); (J.M.); (A.A.); (D.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
- Correspondence:
| | - Marco Farronato
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (M.F.); (F.B.); (A.A.); (J.M.); (A.A.); (D.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Francesca Bellincioni
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (M.F.); (F.B.); (A.A.); (J.M.); (A.A.); (D.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Alessandro Annibale
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (M.F.); (F.B.); (A.A.); (J.M.); (A.A.); (D.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Jacopo Machetti
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (M.F.); (F.B.); (A.A.); (J.M.); (A.A.); (D.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Andrea Abate
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (M.F.); (F.B.); (A.A.); (J.M.); (A.A.); (D.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Davide Cavagnetto
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; (M.F.); (F.B.); (A.A.); (J.M.); (A.A.); (D.C.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
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Monaghan L, Jadun S, Darcey J. Endodontic microsurgery. Part one: diagnosis, patient selection and prognoses. Br Dent J 2019; 226:940-948. [PMID: 31253911 DOI: 10.1038/s41415-019-0415-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Historically, surgical endodontics has been viewed as a treatment of last resort, mainly due to poor outcomes as a result of limitations in materials and techniques. Contemporary techniques, modern materials and better visualisation have all led to an improvement in success rates, making endodontic microsurgery a valuable treatment option to certain patients. Such advances, however, are no substitute for skill in endodontic diagnosis and treatment planning, which can often prove challenging. A variety of tools are available to test for fractures and assess both periodontal and pulpal health. More advanced techniques such as cone beam computed tomography are often invaluable in pre-surgical assessment and diagnosis. Once an accurate diagnosis has been established, a favourable prognosis is explicitly linked to careful patient selection. Orthograde treatment, or retreatment, remains the gold standard for the majority of endodontic problems. However, there are a number of indications for surgery where orthograde treatment is either impossible, or less likely to be successful. It is paramount for any clinician undertaking endodontic surgery to have a detailed understanding of the local and systemic factors associated with successful treatment. Whilst there are few absolute medical contraindications, there are a number of conditions which may influence patient management and make treatment more challenging.
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Affiliation(s)
- Liam Monaghan
- University Dental Hospital of Manchester, Orthodontic Department, Higher Cambridge Street, Manchester, UK
| | - Sarah Jadun
- University Dental Hospital of Manchester, Oral Surgery, Higher Cambridge Street, Manchester, UK
| | - James Darcey
- University Dental Hospital of Manchester, Restorative Department, Higher Cambridge Street, Manchester, UK.
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Hu X, Lei L, Cui M, Huang Z, Zhang X. Anatomical analysis of periapical bone of maxillary posterior teeth: a cone beam computed tomography study. J Int Med Res 2019; 47:4701-4710. [PMID: 31370722 PMCID: PMC6833425 DOI: 10.1177/0300060519860960] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives To investigate the periapical bone thicknesses of maxillary posterior teeth at the preferred level for root resection (3 mm apical to the root end) and to determine vertical distances from apex to maxillary sinus floor (MSF) using cone beam computed tomography (CBCT) scans. Methods CBCT scans were collected from 341 subjects (2389 teeth). Associations of bone thicknesses and vertical distances with age and sex were determined by one-way analysis of variance. Results At the level of root-end resection, buccal bone was the thickest over the mesiobuccal roots of second molars (mean, 2.99 mm) and thinnest over the double-root first premolars (mean, 0.29 mm). In maxillary posterior teeth, thicker buccal bone was found in men than in women. The mesiobuccal roots of second molars were nearest to the MSF (mean, 1.33 mm), and were also most frequently extended into the sinus cavity (15.81%). Subjects more than 40 years of age had larger vertical distances from root apices to MSF in the molar region, compared with younger subjects. Conclusions Generally, periapical bone was thicker in men, and root apices were located nearer to the MSF in younger subjects. Age and sex should be considered before endodontic microsurgery.
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Affiliation(s)
- Xiaoli Hu
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lizhen Lei
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
| | - Minyi Cui
- Department of Radiology, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuwei Huang
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaolei Zhang
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Sun Yat-sen University, Guangzhou, China
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Terlemez A, Tassoker M, Kizilcakaya M, Gulec M. Comparison of cone-beam computed tomography and panoramic radiography in the evaluation of maxillary sinus pathology related to maxillary posterior teeth: Do apical lesions increase the risk of maxillary sinus pathology? Imaging Sci Dent 2019; 49:115-122. [PMID: 31281788 PMCID: PMC6597370 DOI: 10.5624/isd.2019.49.2.115] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/29/2019] [Accepted: 04/07/2019] [Indexed: 11/26/2022] Open
Abstract
Purpose The aims of this study were first, to compare panoramic radiography with cone-beam computed tomography (CBCT) for evaluating topographic relationships, such as the classification of maxillary posterior teeth and their distance to the maxillary sinus floor; and second, to determine the relationship between maxillary sinus pathology and the presence of apical lesions. Materials and Methods In total, 285 paired CBCT and panoramic radiography records of patients (570 maxillary sinuses) were retrospectively analyzed. Both imaging modalities were used to determine the topographic relationship of the maxillary posterior teeth to the sinus floor. Mucosal thickening >2 mm was considered a pathological state. Data were analyzed using the chi-square, Wilcoxon, and Mann-Whitney U tests. Odds ratios (ORs) and confidence intervals (CIs) were calculated. Results The closest vertical distance measurements made between posterior maxillary teeth roots and the maxillary sinus on panoramic radiography and CBCT scans showed statistically significant differences from each other (P<0.05). Compared to panoramic radiography, CBCT showed higher mean values for the distance between the maxillary sinus floor and maxillary posterior teeth roots. The CBCT images showed that at least 1 apical lesion adjacent to the right maxillary sinus increased the risk of maxillary sinus pathology by 2.37 times (OR, 2.37; 95% CI, 1.58-3.55, P<0.05). Conclusion Panoramic radiography might lead to unreliable diagnoses when evaluating the distance between the sinus floor and posterior roots of the maxillary teeth. Periapical lesions anatomically associated with maxillary sinuses were a risk factor for sinus mucosal thickening.
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Affiliation(s)
- Arslan Terlemez
- Department of Endodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Melek Tassoker
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Makbule Kizilcakaya
- Department of Endodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Melike Gulec
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
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Themkumkwun S, Kitisubkanchana J, Waikakul A, Boonsiriseth K. Maxillary molar root protrusion into the maxillary sinus: a comparison of cone beam computed tomography and panoramic findings. Int J Oral Maxillofac Surg 2019; 48:1570-1576. [PMID: 31235390 DOI: 10.1016/j.ijom.2019.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/05/2019] [Accepted: 06/06/2019] [Indexed: 02/07/2023]
Abstract
This study aimed to examine the prevalence of molar roots protruding into the maxillary sinus and to determine the panoramic radiographic signs as correlated with cone beam computed tomography (CBCT). CBCT images of 354 roots were assessed and classified into three types, according to the relationship between the root and maxillary sinus. The prevalence of root protrusion into the maxillary sinus was calculated then the panoramic images assessed. After excluding some unidentified roots on the panoramic images, 200 were investigated for panoramic signs, including (i) projection of the root apex into the sinus cavity, (ii) interruption of the maxillary sinus floor's cortex, (iii) absence of periodontal ligament space, (iv) darkening of the involved root region, and (v) upward curving of the sinus floor. The respective correlation between the panoramic signs and CBCT types was assessed. Forty-six percent of roots showed protrusion into the sinus with the palatal root of the first molar having the greatest prevalence (33/200 roots). The panoramic signs 'projection of the root apex in the sinus cavity' and 'darkening of the involved root apical region' both strongly indicated root protrusion into the maxillary sinus (P<0.05).
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Affiliation(s)
- S Themkumkwun
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - J Kitisubkanchana
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
| | - A Waikakul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - K Boonsiriseth
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Bajoria AA, Sarkar S, Sinha P. Evaluation of Odontogenic Maxillary Sinusitis with Cone Beam Computed Tomography: A Retrospective Study with Review of Literature. J Int Soc Prev Community Dent 2019; 9:194-204. [PMID: 31058071 PMCID: PMC6489515 DOI: 10.4103/jispcd.jispcd_435_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/21/2019] [Indexed: 12/20/2022] Open
Abstract
Aim and Objectives: The purpose of this study was to describe the radiographic characteristics of odontogenic maxillary sinusitis as seen on cone beam computed tomography (CBCT) scans and determine whether any tooth or any tooth root, was more frequently associated with this disease. Materials and Methods: The present study included 500 CBCT images that included the entire maxillary sinus of both the sides in all the three planes. The modified classification of Abrahams and Glassberg was used to assess maxillary sinusitis of odontogenic origin. Furthermore, the proximity of the tooth root to the sinus floor, periapical pathology, and the septae within the maxillary sinus were also assessed. Results: In the present study, 1000 hemimaxillas were analyzed. Majority of the cases (74.9%) the apex of either tooth was touching the floor of the sinus. While 16.9% were in close relationship to the sinus while 8.2% of the cases, the apices were present within the sinus. Furthermore, in the present study, 38 of the total cases had an odontogenic cause of maxillary sinusitis, whereas 273 of them had a nonodontogenic cause, 96 have an undetermined cause, and the rest 593 cases had healthy sinus. Conclusion: The incidence of odontogenic sinusitis is likely under-reported in the available literature. The introduction of low-dose CBCT is particularly useful to establish a definitive diagnosis to augment in the treatment of chronic maxillary sinusitis of odontogenic origin.
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Affiliation(s)
- Atul Anand Bajoria
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Shromona Sarkar
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Pallawi Sinha
- Consultant Prosthodontist, KIIT University, Bhubaneswar, Odisha, India
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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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El Hachem R, Wassef E, Mokbel N, Abboud R, Zogheib C, El Osta N, Naaman A. Influence of the Maxillary Sinus on the Accuracy of the Root ZX Apex Locator: An Ex Vivo Study. Dent J (Basel) 2019; 7:dj7010003. [PMID: 30609762 PMCID: PMC6473460 DOI: 10.3390/dj7010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/15/2018] [Accepted: 12/11/2018] [Indexed: 11/30/2022] Open
Abstract
This study evaluated the accuracy of the Root ZX (J. Morita, Tokyo, Japan) electronic apex locator in determining the working length when palatal maxillary molar roots are in a relationship with the sinus. Seventeen human maxillary molars with vital pulp were scheduled for an extraction and implant placement as part of a periodontal treatment plan. The access cavity was prepared, and a #10 K file (Dentsply Maillefer, Ballaigues, Switzerland) was inserted into the palatal root using the Root ZX apex locator in order to determine the electronic working length (EWL); then, the teeth were extracted. To determine the real working length (RWL), a #10 K file was introduced into the root canal until its tip touched a glass plate. EWL and RWL were compared. Images reconstructed with CBCT (cone beam computerized tomography) revealed that eight palatal roots were related to the maxillary sinus, whereas nine were not. The results showed a significant difference between the EWL and the RWL of the palatal roots related to the sinus (p < 0.001). No significant difference was observed in measurements of roots not in contact with the sinus (p > 0.05). Within the study limitations, the reliability of Root ZX was influenced by the relationship of the roots with the maxillary sinus.
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Affiliation(s)
- Roula El Hachem
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Elie Wassef
- Department of Periodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Nadim Mokbel
- Department of Periodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Richard Abboud
- Department of Maxillo-Facial Radiology, Saint Joseph University, B.P. 11-514 Riad el-Solh, Beirut 1107 2050, Lebanon.
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Nada El Osta
- Department of Prosthodontics, Saint Joseph University, B.P. 11-514 Riad el-Solh, Beirut 1107 2050, Lebanon.
| | - Alfred Naaman
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
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Razumova S, Brago A, Howijieh A, Manvelyan A, Barakat H, Baykulova M. Evaluation of the relationship between the maxillary sinus floor and the root apices of the maxillary posterior teeth using cone-beam computed tomographic scanning. J Conserv Dent 2019; 22:139-143. [PMID: 31142982 PMCID: PMC6519191 DOI: 10.4103/jcd.jcd_530_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The relationship between the maxillary sinus (MS) and the root apices of the posterior teeth is of clinical relevance in diagnosing and treatment planning in the posterior area of the maxilla. This study aimed to assess the relationship between the MS floor and the root apices of the posterior teeth using cone-beam computed tomography (CBCT) scanning. Materials and Methods 325 CBCT scans of patients aged 20-70 years were analyzed. Patients were divided into three age groups: young group (20-44 years), middle age group (45-59 years), and elderly group (60-70). The distance from the MS floor and the root apices of posterior teeth was measured in each group. The relationship between the MS and the posterior roots was also recorded according to Kwak classification. The results were analyzed by IBM statistic SPSS. Results Type II was most commonly seen in the first and second molars. For premolars, Type I was often observed. The shortest distance to the floor of MS was recorded for the mesiobuccal root of the second molar and the longest distance for the palatal root of the first and second molars. No statistical differences were found between age groups (P > 0.01). Conclusion The anatomical relationship between the MS and the root apices of the posterior teeth is of clinical importance and should be taken into consideration during surgical or endodontic treatment.
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Affiliation(s)
- Svetlana Razumova
- Department of Propaedeutics of Dental Diseases, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - Anzhela Brago
- Department of Propaedeutics of Dental Diseases, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - Ammar Howijieh
- Department of Propaedeutics of Dental Diseases, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - Ashot Manvelyan
- Department of Propaedeutics of Dental Diseases, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - Haydar Barakat
- Department of Propaedeutics of Dental Diseases, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - Malina Baykulova
- Department of Propaedeutics of Dental Diseases, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
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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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Ly D, Hellgren J. Is dental evaluation considered in unilateral maxillary sinusitis? A retrospective case series. Acta Odontol Scand 2018; 76:600-604. [PMID: 30045653 DOI: 10.1080/00016357.2018.1490966] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Are patients with symptomatic unilateral maxillary sinusitis sent for a dental evaluation of odontogenic maxillary sinusitis (OMS)? PATIENTS AND METHODS The medical records of all patients diagnosed with sinusitis at a university Ear-nose and throat (ENT) clinic from 2010 to 2015 were scrutinized for symptomatic unilateral maxillary sinusitis verified on CT. Any dental evaluation was recorded, as well as symptoms of OMS, duration to dental evaluation, diagnosis of OMS and dental treatment. RESULTS A total of 1338 patients diagnosed with sinusitis were screened; 172 had unilateral maxillary sinusitis and 48% (82/172) OMS. 34% did not have any dental evaluation at all. Patients referred to local specialist dental care waited a median of 11 weeks for evaluation and a median of 15 weeks further for dental treatment. Symptoms more frequently reported in OMS patients were foul smell or taste (43.9% vs 11.1%, p < .0001), purulent rhinorrhea (40% vs 19.1%, p = .015) than non-OMS patients. The OMS group also reported more frequently that they were active smokers (31.7% vs 10%, p = .0005). CONCLUSIONS OMS was found in 48% of unilateral maxillary sinusitis and one-third of the patients with unilateral maxillary sinusitis had no dental evaluation. Low awareness of OMS could delay diagnosis and treatment.
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Affiliation(s)
- Don Ly
- Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Science, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Johan Hellgren
- Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Science, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
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Endoscopic-Assisted Sinus Floor Augmentation Combined With Removal of an Antral Pseudocyst of the Ipsilateral Maxillary Sinus. J Craniofac Surg 2018; 28:1549-1551. [PMID: 28045811 DOI: 10.1097/scs.0000000000003376] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to present an endoscopic-assisted intraoral surgical technique for sinus floor augmentation and removal of an antral pseudocyst simultaneously. The patient underwent sinus floor augmentation combined with removal of an antral pseudocyst in the ipsilateral maxillary sinus. Transoral endoscopic technique was applied to check the status of sinus mucosa during the operation. Complications were evaluated. Perforation of the sinus membrane was observed during augmentation procedure, and was covered with an absorbable membrane. No leakage of bone grafts was verified by the endoscope. The patient recovered uneventfully and final dental implants were inserted successfully. Therefore, sinus floor augmentation and removal of the maxillary sinus pseudocyst can be fulfilled at the same time, to reduce the time before dental rehabilitation. Transoral endoscopic technique can be of great helpful to the treatment of maxillary sinus diseases and sinus floor augmentation, owing to minimal invasion and optimal visualization.
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Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study. Clin Oral Investig 2018; 23:123-131. [PMID: 29549441 DOI: 10.1007/s00784-018-2418-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/07/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This study aimed to assess the maxillary sinus mucosal thickening and to associate them with odontogenic conditions using cone-beam computed tomographic (CBCT) images. MATERIALS AND METHODS CBCT images of 294 patients (143 female, 151 males; age range 18-78 years) with 588 maxillary sinuses were evaluated retrospectively. The anatomic relationship between maxillary sinuses and teeth was determined and classified. The presence of root canal fillings and the periapical lesions of these teeth was also recorded. Sinus mucosal thickenings were classified as grade 1 (normal) (< 2 mm), grade 2 (moderate) (2-10 mm), and grade 3 (severe) (> 10 mm). Alveolar bone loss was measured on all maxillary premolar/M teeth. RESULTS More than 2-mm mucosal thickening (grade 2 and grade 3) in either one or both maxillary sinuses was found in 172 (58.5%) of the patients. The prevalence of mucosal thickening (> 2 mm) for maxillary sinuses with and without any periapical lesions was 42.1 and 53.6%, respectively (p < 0.05). The prevalence of mucosal thickening increased in patients with periodontal alveolar bone loss (p < 0.05). There was a significant correlation between mucosal thickening with age, gender and missing teeth (p < 0.05). CONCLUSIONS Multiple conditions, including periapical infection, root canal treatment, and close relationship maxillary teeth and sinus, may have a precursor effect on the occurrence of mucosal thickening in the maxillary sinus. Periodontal status and its role as a risk factor in triggering maxillary sinus infections should be also considered by not only dental professionals but also the medical professionals to plan for the treatment of maxillary sinus lesions. CLINICAL RELEVANCE Maxillary sinuses are significantly influenced by various odontogenic conditions, including periodontal bone loss, periapical lesions, and missing teeth, which may result in thickening of the maxillary sinus mucosa.
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Ahn NL, Park HS. Differences in distances between maxillary posterior root apices and the sinus floor according to skeletal pattern. Am J Orthod Dentofacial Orthop 2017; 152:811-819. [PMID: 29173860 DOI: 10.1016/j.ajodo.2017.05.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the distances from the maxillary posterior root apices to the inferior wall of the maxillary sinus using cone-beam computed tomography images and the relationships between roots and maxillary sinus according to age, sex, and skeletal pattern. METHODS Three-dimensional images of each root were checked, and the distances were measured along the true vertical axis from the apex of the root to the sinus floor in 118 patients (63 male, 55 female) aged 10 to 28 years. Compare-means statistic tests were done to assess the differences between groups classified according to age, sex, and skeletal pattern. RESULTS The frequency of root contact with the sinus floor increased from 70% at the second premolar to more than 80% at the buccal roots of the first and second molars. Male and older age (20-28 years) groups had significantly smaller distances or more protrusion of the root into the sinus than female and younger age (10-20 years) groups. The distances were shorter, or there was more protrusion of the root into the sinus in the hyperdivergent, down-canted palatal plane, and large gonial angle groups. CONCLUSIONS Male, older age, hyperdivergent skeletal pattern, and large gonial angle groups had significantly closer distances between maxillary root tips and the sinus floor or more protrusion of the roots into the sinus. The intrusion of the maxillary molars in those situations may be difficult and slow because of the pneumatized maxillary sinus.
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Affiliation(s)
- Nguyen-Lan Ahn
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Hyo-Sang Park
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea.
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Nino-Barrera JL, Ardila E, Guaman-Pacheco F, Gamboa-Martinez L, Alzate-Mendoza D. Assessment of the relationship between the maxillary sinus floor and the upper posterior root tips: Clinical considerations. ACTA ACUST UNITED AC 2017; 9:e12307. [PMID: 29178271 DOI: 10.1111/jicd.12307] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 09/11/2017] [Indexed: 11/28/2022]
Abstract
AIM The purpose of the present study was to evaluate the relationship between the maxillary sinus floor and the upper posterior root tips in the Colombian population using cone-beam computed tomography. METHODS A total of 1656 roots were analyzed (1104 molars and 552 premolars), classified as types I (outside the maxillary sinus) and II (inside the maxillary sinus). RESULTS The results showed that the palatal root of the maxillary first molar was most frequently found inside the antrum. CONCLUSIONS Understanding the relationship between the maxillary sinus floor and the upper posterior root tips is important to the clinician when performing conventional or surgical endodontic treatment and conventional surgery procedures in order to minimize or avoid the risk of damaging the maxillary sinus.
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Affiliation(s)
- Javier Laureano Nino-Barrera
- Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia.,Department of Basic Sciences and Oral Medicine, Universidad Nacional de Colombia School of Dentistry, Bogota, Colombia
| | - Edith Ardila
- Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
| | | | - Luis Gamboa-Martinez
- Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
| | - Diana Alzate-Mendoza
- Department of Endodontics, Universidad El Bosque, School of Dentistry, Bogota, Colombia
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Frequency, location, and association with dental pathology of mucous retention cysts in the maxillary sinus. A radiographic study using cone beam computed tomography (CBCT). Clin Oral Investig 2017; 22:1175-1183. [PMID: 28920140 DOI: 10.1007/s00784-017-2206-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/07/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The purpose of the present study was to evaluate the frequency, locations, and dimensions of mucous retention cysts of the maxillary sinus and analyze potential associated dental pathology. MATERIALS AND METHODS A total of 156 cone beam computed tomography (CBCT) scans were included in the analysis, resulting in an evaluation of 310 maxillary sinuses. The presence of mucous retention cysts (MRC) manifesting as dome-shaped radiopacities in the sinus was diagnosed. Their locations were recorded, and dimensions (mm) were measured in coronal and sagittal/axial slices. The patients were grouped into (a) patients/sinuses with MRCs (test), and (b) patients/sinuses with healthy or any other changes (control) for further comparison and evaluation. RESULTS There were 40 sinuses (12.9%) with a presence of a total of 56 MRCs. The mean age of involved patients was 29.0 years. The analysis showed that gender, age, sinus side, status of dentition, endodontic status, and periodontal status did not have a significant influence on the presence of MRCs when compared between test and control groups. Age and endodontic status exhibited a significant association with cyst location. CONCLUSIONS Most of the sinuses analyzed (79.5%) did not present any MRC, and only 28.6% of the cysts diagnosed were found on the floor of the maxillary sinus. The mean dimension of the MRCs measured 6.28 ± 2.93 mm. No influencing factors on the presence or absence of MRCs were found in the present study. CLINICAL RELEVANCE Most MRCs were not located on the floor of maxillary sinus. Future studies should assess their impact on surgical interventions in the sinus.
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