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Craig JR, Saibene AM, Felisati EG, Felisati G. Collaboration between otolaryngologists and oral surgeons in maxillary sinus elevation planning. Clin Implant Dent Relat Res 2024. [PMID: 39187918 DOI: 10.1111/cid.13385] [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: 05/30/2024] [Revised: 07/16/2024] [Accepted: 08/10/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND The collaboration between otolaryngologists and dental providers is crucial for the planning and execution of maxillary sinus elevation (MSE) procedures, which are integral to successful dental implant placements. PURPOSE This article examines the essential role of otolaryngological assessments in identifying potential sinonasal risks that could impact the outcomes of MSE. MATERIALS AND METHODS A comprehensive narrative review of existing literature was conducted. DISCUSSION The review underscores the importance of thorough preoperative evaluations, including patient history, computed tomography (CT) or cone-beam CT (CBCT) scans, and nasal endoscopy, to mitigate sinonasal health risks. It details various clinical scenarios and patient assessments, emphasizing a systematic approach to diagnosing and managing sinonasal conditions proactively. The discussion reveals that while some sinus conditions may not significantly affect MSE success, conditions impacting mucociliary clearance and sinus drainage are critical risk factors requiring otolaryngological intervention. Additionally, the article introduces a grading system to assist clinicians in identifying patients who would benefit from otolaryngological evaluations prior to MSE. CONCLUSION This review highlights the value of interdisciplinary collaboration and standardized protocols in enhancing the predictability and safety of MSE procedures, ultimately improving patient outcomes.
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Affiliation(s)
- John R Craig
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA
| | - Alberto Maria Saibene
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Elena Giulia Felisati
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Felisati
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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Ketabi AR, Hassfeld S, Lauer HC, Piwowarczyk A. The comparison of visibility of the maxillary sinus septa between cone-beam computed tomography scans and panoramic radiograph images as dependent on the cortical bone thickness: a retrospective comparative study. Int J Implant Dent 2024; 10:23. [PMID: 38713411 PMCID: PMC11076433 DOI: 10.1186/s40729-024-00542-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/23/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE To analyze the visibility of the maxillary sinus septa (MSS) in panoramic radiography (PR) versus cone beam computed tomography (CBCT) and to investigate whether the buccal cortical bone thickness (BT) or the septa dimensions influence their visibility. METHODS Corresponding PR and CBCT images of 355 patients were selected and examined for MSS visibility. The septa dimensions (width, height, depth) and the BT were measured. Results were analysed statistically. RESULTS Comparing the corresponding regions on CBCT and PR, 170 MSS were identified; however, only 106 of these were also visible using PR. The MSS visibility was significantly higher on CBCT versus PR images (P1: p = 0.039, P2: p = 0.015, M1: p = 0.041, M2: p = 0.017, M3: p = 0.000), except region C (p = 0.625). Regarding the measurements of MSS dimensions, only the height in region M1 (p = 0.013) and the width in region P2 (p = 0.034) were significantly more visible on CBCT. The BT in the area of the MSS was found to have a marginal influence on its visibility on the PR images only in regions M3 and M1 (M3: p = 0.043, M1: p = 0.047). In terms of MSS visibility based on the dimensions, significance was found for all three influencing variables only in region P2 (width; p = 0.041, height; p = 0.001, depth; p = 0.007). There were only isolated cases of further significance: M3 for width (p = 0.043), M2 for height (p = 0.024), and P1 for depth (p = 0.034), no further significance was noted. CONCLUSION MSS visibility appears significantly higher on CBCT versus PR images. It is concluded that the septa dimensions and BT can influence MSS visibility on PR images just in certain regions.
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Affiliation(s)
- Ali Reza Ketabi
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455, Witten, Germany.
- Private Dental Office of Dr Ali-Reza Ketabi, Epplestraße 29 a, 70597, Stuttgart, Germany.
| | - Stefan Hassfeld
- Department of Oral and Maxillofacial Surgery, Dortmund Hospital and Faculty of Health, Witten/Herdecke University, Muensterstr. 240, 44145, Dortmund, Germany
| | - Hans-Christoph Lauer
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany
| | - Andree Piwowarczyk
- Department of Prosthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 45, 58455, Witten, Germany
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Bernardi S, Bianchi S, Gerardi D, Petrelli P, Rinaldi F, Piattelli M, Macchiarelli G, Varvara G. Anatomy of Maxillary Sinus: Focus on Vascularization and Underwood Septa via 3D Imaging. Tomography 2024; 10:444-458. [PMID: 38668392 PMCID: PMC11054790 DOI: 10.3390/tomography10040034] [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: 02/10/2024] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/29/2024] Open
Abstract
The study of the maxillary sinus anatomy should consider the presence of two features of clinical importance. The arterial supply course and the presence of the so-called Underwood septa are two important factors to consider when planning surgical treatment to reduce the risk of surgical complications such as excessive bleeding and Schneiderian membrane perforations. This study aimed to investigate the above-mentioned anatomical structures to improve the management of eventual vascular and surgical complications in this area. This study included a total of 200 cone-beam computed topographies (CBCTs) divided into two groups of 100 CBCTs to evaluate the arterial supply (AAa) course through the lateral sinus wall and Underwood's septa, respectively. The main parameters considered on 3D imaging were the presence of the AAa in the antral wall, the length of the arterial pathway, the height of the maxillary bone crest, the branch sizes of the artery in the first group, and the position of the septa, the length of the septa, and their gender associations in the second group. The CBCT analysis showed the presence of the arterial supply through the bone wall in 100% of the examined patients, with an average size of 1.07 mm. With regard to the septa, 19% of patients presented variations, and no gender difference was found to be statistically significant. The findings add to the current understanding of the clinical structure of the maxillary sinus, equipping medical professionals with vital details for surgical preparation and prevention of possible complications.
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Affiliation(s)
- Sara Bernardi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.B.); (D.G.); (G.M.)
| | - Serena Bianchi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.B.); (D.G.); (G.M.)
| | - Davide Gerardi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.B.); (D.G.); (G.M.)
| | - Pierpaolo Petrelli
- Department of Innovative Technologies in Medicine & Dentistry, Dental School, ‘G. D’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy; (P.P.); (F.R.); (M.P.); (G.V.)
| | - Fabiola Rinaldi
- Department of Innovative Technologies in Medicine & Dentistry, Dental School, ‘G. D’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy; (P.P.); (F.R.); (M.P.); (G.V.)
| | - Maurizio Piattelli
- Department of Innovative Technologies in Medicine & Dentistry, Dental School, ‘G. D’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy; (P.P.); (F.R.); (M.P.); (G.V.)
| | - Guido Macchiarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.B.); (D.G.); (G.M.)
| | - Giuseppe Varvara
- Department of Innovative Technologies in Medicine & Dentistry, Dental School, ‘G. D’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy; (P.P.); (F.R.); (M.P.); (G.V.)
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Radmand F, Razi T, Baseri M, Gavgani LF, Salehnia F, Faramarzi M. Anatomic evaluation of the posterior superior alveolar artery using cone-beam computed tomography: A systematic review and meta-analysis. Imaging Sci Dent 2023; 53:177-191. [PMID: 37799745 PMCID: PMC10548151 DOI: 10.5624/isd.20230009] [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: 01/10/2023] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 10/07/2023] Open
Abstract
Purpose This systematic review examined the detection of the posterior superior alveolar artery, along with various anatomic characteristics, on cone-beam computed tomography images. Materials and Methods Studies were identified electronically through the Web of Science, MEDLINE, Scopus, and Embase databases. The quality of the included studies was evaluated using a 5-item binary scale. The detection rate, location, and classified diameter of the posterior superior alveolar artery were estimated as prevalence values. The diameter of this artery, as well as the distances from the artery to the alveolar crest and sinus floor, were estimated as means with associated 95% confidence intervals. Results Thirty-seven studies were enrolled, with 34 of these included in the meta-analysis. The mean detection rate was 79% (range: 72%-84%), and the mean diameter was 1.06±0.05 mm (range: 0.96-1.16 mm). The posterior superior alveolar artery was located intraosseously in 64% of cases. The mean distance of the artery from the alveolar crest was 16.71±0.49 mm (range: 15.75-17.68 mm), while the mean distance from the artery to the sinus floor was 8.85±0.4 mm (range: 8.05-9.64 mm). Conclusion According to the findings of this meta-analysis regarding various anatomic characteristics of the posterior superior alveolar artery, severe hemorrhage after damage to this artery during sinus augmentation procedures is not a substantial clinical problem.
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Affiliation(s)
- Faraz Radmand
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tahmineh Razi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Baseri
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Faraji Gavgani
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Salehnia
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoumeh Faramarzi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Eberlikose H, Yilmaz D, Gulen O. Characteristics of maxillary sinus ostia and their correlation with anatomic variations of the osteomeatal complex: Indications for sinus floor elevation. Niger J Clin Pract 2023; 26:992-997. [PMID: 37635585 DOI: 10.4103/njcp.njcp_863_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background Knowledge of the anatomy and variations of the maxillary sinus is essential for reducing oral surgery complications, such as sinus floor elevation, and increasing surgery success. The CBCT images of 385 patients were examined. Materials and Methods The prevalence, localization, and height of PMO (Primer Maxillary Ostium) and AMO (Accessory Maxillary Ostium) were evaluated with respect to sex, dentition, dental treatment, Schneiderian membrane (SM) thickness, concha bullosa, Haller Cells, and septal deviation. Results The PMO was present in 87.3% of all patients. Further analysis showed that the mean PMO diameter was 1.42 ± 0.62 mm. Although 11.6% of the PMO was in the inferior region, 60.4% was in the middle and 28% in the superior region. The effect of age and SM on the height and diameter of the PMO was found to be statistically significant. An AMO was present in 20% of the CBCT images. The mean AMO diameter was 2.55 ± 1.25 mm. Although 45.4% of the AMO was in the inferior region, 48% was in the middle and 6.6% was in the superior region. Moreover, SM thickness seemed to influence the height. A significant positive relationship was found between the PMO and AMO height. Also, a significant relationship was observed between the presence of the AMO and septum deviation. Conclusion The presence of the AMO, PMO diameter, and height should be added to the preoperative evaluation criteria for the success of sinus floor evaluation. Specifically, sinonasal and demographic conditions should be carefully examined preoperatively for the long-term success of the surgery.
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Affiliation(s)
- H Eberlikose
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Medipol University, Ankara, Türkiye
| | - D Yilmaz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Türkiye
| | - O Gulen
- Dentomaxillofacial Radiologist, Private Practice Instead of Oral Radiolog, Turkish Ministry of Health, Türkiye
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Alves N, Torres-Villar C, Ceballos F, Deana NF. Frequency, location, and diameter of the anastomosis between the posterior superior alveolar artery and the infraorbital artery in imaging studies: systematic review and meta-analysis. Surg Radiol Anat 2023; 45:431-443. [PMID: 36754890 DOI: 10.1007/s00276-023-03091-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/21/2023] [Indexed: 02/10/2023]
Abstract
The anastomosis between the posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA) courses along half of the lateral wall of the maxillary sinus. Risk of injury to the anastomosis between PSAA and IOA during surgical procedures has been reported. The aim of the present study was to carry out a systematic review and meta-analysis to determine the frequency, location, and diameter of the anastomosis between PSAA and IOA in imaging studies (cone-beam computed tomography, spiral cone-beam computed tomography, and computed tomography). A search was carried out in the PubMed, EMBASE, and LILACS. Original works were included reporting imaging studies to analyze the frequency, location, and diameter of the anastomosis in humans. The risks of bias were analyzed using the AQUA tool. Generalized linear mixed models were used to estimate the frequency and the 95% CI in the meta-analysis. The variance in prevalence estimates was stabilized by logit transformation. The qualitative analysis included 49 studies with 10,837 patients. The frequency of the anastomosis between PSAA and IOA was 74% (prediction interval 0.20-0.97%). The anastomosis was most frequently located in the intraosseous region (60.0%), followed by the submembranous region (33.0%), and least frequently in an extraosseous location (5.0%). Arteries with diameter of 1.0-1.9 mm were most frequent (32.0%), followed by arteries with diameter less than 1 mm (23.0%); a small number with diameter greater than 2 mm was recorded (4.0%). These data can be used as a reference to help surgeons when planning interventions in the lateral wall of the maxillary sinus. Registration number: INPLASY, number 202120071.
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Affiliation(s)
- Nilton Alves
- Center of Excellence in Surgical and Morphological Research (CEMyQ), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
- Applied Morphology Research Center (CIMA), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
| | - Carlos Torres-Villar
- Department of Morphological Sciences, Faculty of Medicine and Science, Universidad San Sebastián, Lago Panguipulli 1390, 5501842, Puerto Montt, Chile
- School of Medical Technology, Universidad Austral de Chile, Puerto Montt, Chile
- Doctoral Program in Morphological Sciences, Universidad de La Frontera, Temuco, Chile
| | | | - Naira Figueiredo Deana
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.
- Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.
- Doctoral Program in Morphological Sciences, Universidad de La Frontera, Temuco, Chile.
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Ayyildiz H, Akgunlu F. Are maxillary sinus variations related to maxillary sinus diameters? Oral Radiol 2023; 39:425-436. [PMID: 36094776 DOI: 10.1007/s11282-022-00655-6] [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: 01/25/2022] [Accepted: 09/05/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The reasons why the maxillary posterior region is challenging for dentists are its structure and anatomical variations. For this reason, it is necessary to have complete knowledge about the anatomy of this region. In dentistry, necessary information for the desired evaluation in this region can be provided by CBCT. The fact that it provides a three-dimensional evaluation and has measurement reliability emphasizes its importance in surgical applications. The septa, haller cell, and accessory ostium are variations of the maxillary sinus. There are few studies in the literature examining the relationship between maxillary sinus diameters and its variations. The aims of this study are to determine the prevalence of maxillary sinus variations and the average of maxillary sinus diameters, to examine their relationships according to age and gender, and to evaluate the effects of maxillary sinus diameters on variations. METHODS In this retrospective study, CBCT images of 212 patients were examined. The examined CBCT images were analysed and recorded in more than one section. Descriptive statistics, chi-square tests, independent t test, one-way Anova tests were used to evaluate the data. RESULTS As a result, a statistically significant difference was observed between the variations, gender and age groups in terms of morphometric characteristics of the maxillary sinus. The most common variation was observed to be accessory ostium. CONCLUSIONS The rate of patients with at least one anatomical variation was 77.8%. For this reason, a detailed analysis should be performed to avoid complications before surgical procedures are performed in the area.
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Affiliation(s)
- Halil Ayyildiz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kütahya Health Sciences University, Kütahya, Türkiye.
| | - Faruk Akgunlu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Selcuk University, Konya, Türkiye
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la Encina ACD, Martínez-Rodríguez N, Ortega-Aranegui R, Cortes-Bretón Brinkmann J, Martínez-González JM, Barona-Dorado C. Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography. Int J Implant Dent 2022; 8:59. [PMID: 36441355 PMCID: PMC9705638 DOI: 10.1186/s40729-022-00459-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/12/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity. METHODS 212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes. P < 0.05 was considered statistically significant. RESULTS PSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males. CONCLUSIONS The use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery.
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Affiliation(s)
- Augusto Cimolai-de la Encina
- grid.4795.f0000 0001 2157 7667Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Natalia Martínez-Rodríguez
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
| | - Ricardo Ortega-Aranegui
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain
| | - Jorge Cortes-Bretón Brinkmann
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
| | - José María Martínez-González
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
| | - Cristina Barona-Dorado
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, Faculty of Dentistry, Universidad Complutense de Madrid, Pza Ramon y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Surgical and Implant Therapies in the Oral Cavity Research Group; University Complutense, Madrid, Spain
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Yu M, Luo Y, Yang X, Man Y. Application of an assembled surgical guide for lateral approach sinus augmentation and sinus septum management: A technical note. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 124:101307. [PMID: 36216032 DOI: 10.1016/j.jormas.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/25/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022]
Abstract
The presence of maxillary septa may render sinus augmentation more challenging particularly when encountered at the ideal implant position. This article demonstrated a novel technique for lateral access sinus augmentation using an assembled surgical guide to achieve proper lateral window outline, precise septum identification and osteotomy, and secure membrane detachment. This technique increases the predictability and efficiency of the procedure while reducing the risk of complications.
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Anatomical Characteristics of the Accessory Maxillary Ostium in Three-Dimensional Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091243. [PMID: 36143920 PMCID: PMC9501023 DOI: 10.3390/medicina58091243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: The accessory maxillary ostium (AMO) can interfere with ventilation and drainage of the maxillary sinus, and therefore the importance of evaluating the anatomical features of the AMO has been emphasized. This study aimed to evaluate anatomical characteristics of the AMO together with the natural ostium (NO) using three-dimensional (3D) analysis and to assess the relationship between the AMO and maxillary sinus pathologies. Materials and Methods: This retrospective study included 394 sinuses in 197 patients. Using 3D computed tomography images, the prevalence of the AMO and concurrent sinus pathologies were examined. For patients with an AMO, 3D spatial positions of the AMO and NO related to adjacent anatomic structures and dimensions of the AMO and NO were evaluated. Results: A total of 84 sinuses showed single or multiple AMO, with a prevalence of 21.3%. The AMO was located superiorly by 30.1 mm from the maxillary sinus floor, inferiorly by 1.3 mm from the orbital floor, and posteriorly by 22.4 mm from the anterior sinus wall. The AMO was located 5.4 mm posteriorly and 0.7 mm inferiorly from the NO. On the same coronal plane as the NO or AMO, height from the maxillary sinus floor to the NO and AMO ranged from 19.4 to 45.8 mm and 14.5 mm to 41.9 mm, respectively. The mean horizontal and vertical dimensions were 5.9 mm and 4.6 mm for the NO and 2.8 mm and 3.0 mm for the AMO. We detected a significant association between the presence of the AMO and the mucosal thickening (p = 0.029). Conclusions: The results of this study suggest that, although the AMO and NO are mostly located in positions that do not limit sinus-related surgeries, such as maxillary sinus floor augmentation, the AMO and NO are also found in lower positions, which may be a detriment to the postoperative physiological function of the maxillary sinus and affect treatment outcomes.
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Prevalence of canalis sinuosus and accessory canals of canalis sinuosus on cone beam computed tomography: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2022; 52:118-131. [PMID: 35840447 DOI: 10.1016/j.ijom.2022.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 11/22/2022]
Abstract
The aim of this systematic review was to determine the prevalence of the canalis sinuosus (CS) and accessory canals of the canalis sinuosus (ACCS) as identified on cone beam computed tomography (CBCT). Online searches were conducted in the MEDLINE (via PubMed), Scopus, LILACS, Cochrane CENTRAL, Web of Science, and SIGLE (via OpenGrey) databases. Primary studies that determined the prevalence of canalis sinuosus and/or its anatomical variations using CBCT were included. The risk of bias assessment was performed using the AQUA tool. The quality effects model using double arcsine transformation was used for the meta-analysis of prevalence. Heterogeneity, publication bias, and sensitivity analyses were performed. Of 3237 initial results, 17 papers were included for systematic review. The meta-analysis comprising 1994 patients showed a pooled prevalence of CS of 0.80 (95% confidence interval (CI) 0.51-0.99; P = 0.001; I2 = 99%). Publication bias analysis revealed minor asymmetry (LFK index 1.84). The meta-analysis of 4605 patients showed a pooled prevalence of ACCS of 0.54 (95% CI 0.38-0.69; P = 0.001; I2 = 99%). The sensitivity analysis showed a pooled prevalence of ACCS of 0.53 (95% CI 0.32-0.74; P = 0.001; I2 = 99%) for studies with ≥ 1000 patients and 0.55 (95% CI 0.33-0.76; P = 0.001; I2 = 98%) for studies with< 1000 patients. Canalis sinuosus showed a pooled prevalence of 0.80 and ACCS showed a pooled prevalence of 0.54; hence both should be considered as anatomical structures, which means that they are present in most people. Surgeons must be aware of the CS and ACCS on CBCT analysis during pre-surgical planning. PROSPERO REGISTRATION NUMBER: CRD42020154195.
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Ren L, Chen C, Li N, Hu J, Jiang Z, Yang G. Prevalence of and factors associated with maxillary sinus cyst in a Chinese population. J Oral Sci 2022; 64:22-27. [PMID: 34980822 DOI: 10.2334/josnusd.21-0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE This study used cone-beam computed tomography (CBCT) to assess the prevalence of and factors associated with maxillary sinus cysts (MSCs) in a Chinese population. METHODS A total of 2,571 CBCT scans of 5,000 sinuses were analyzed. MSCs were diagnosed on the basis of imaging features within the maxillary sinus. Sex, age, dental condition, and anatomic condition were assessed. Associations with these factors were evaluated with logistic regression and a generalized estimating equations model. RESULTS The prevalence of MSCs was 15.46% at the sinus level and 23.44% at the patient level. The prevalence of MSCs was higher for men (OR = 1.864, P < 0.001) and for patients with apical lesions (OR = 1.76, P < 0.001), severe bone loss (OR = 1.363, P < 0.05), tooth roots in contact with the sinus floor (OR = 1.68, P < 0.001), and pits or septa on the floor of the maxillary sinus (OR = 1.539, P < 0.001). CONCLUSION This large sample had a high prevalence of MSCs. MSC prevalence was associated with multiple factors, including sex, dental condition, and anatomic condition. Maintenance of healthy dental and periodontal status might help prevent MSCs.
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Affiliation(s)
- Lingfei Ren
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Chaozhen Chen
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Na Li
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Jinxing Hu
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Zhiwei Jiang
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
| | - Guoli Yang
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine.,Key Laboratory of Oral Biomedical Research of Zhejiang Province
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13
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Henriques I, Caramês J, Francisco H, Caramês G, Hernández-Alfaro F, Marques D. Prevalence of maxillary sinus septa: systematic review and meta-analysis. Int J Oral Maxillofac Surg 2021; 51:823-831. [PMID: 34742634 DOI: 10.1016/j.ijom.2021.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/16/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
The aim of this systematic review and meta-analysis was to determine the prevalence and characteristics of maxillary sinus septa using cone beam computed tomography and computed tomography data. Publications were searched until October 5, 2020 in three electronic databases. Additionally, article bibliographies were searched, and authors were contacted if required. This review has been registered in PROSPERO (CRD42019124933). Two independent evaluators assessed methodological quality using the Joanna Briggs Institute levels of evidence; inter-rater reliability tests were performed (Cohen's κ). The prevalence of maxillary sinus septa was expressed as a proportion; differences according to sex were reported in terms of the odds ratio (OR) and 95% confidence interval (95% CI). Heterogeneity and sources of heterogeneity were evaluated by meta-regression. Publication bias was assessed by visual analysis of the funnel plot. Statistical significance was set at P < 0.05. The 62 studies identified and included in the review involved 13,701 patients (22,460 sinuses). The meta-analysis of 35 studies (14,664 sinuses) revealed an overall mean sinus septa prevalence per sinus of 33.2% (95% CI 27.8-38.5%; I2 = 98.32%). The meta-analysis of 42 studies (9631 patients) found an overall mean sinus septa prevalence per patient of 41.0% (95% CI 36.0-46.0%, I2 = 96.45%). The OR for the difference in septa prevalence between sexes was 0.785 (95% CI 0.590-1.046; P = 0.098, I2 = 73.24%). Septa were most frequent in the middle area of the sinus and with a transverse orientation (86.0%). Within the limitations, the results suggest a high proportion of septa in the sinus, commonly in the middle area, which can interfere with the success of sinus floor elevation required for implant rehabilitation.
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Affiliation(s)
- I Henriques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - J Caramês
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Instituto de Implantologia, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Lisbon, Portugal
| | - H Francisco
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Instituto de Implantologia, Lisbon, Portugal
| | - G Caramês
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Instituto de Implantologia, Lisbon, Portugal
| | | | - D Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Instituto de Implantologia, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Lisbon, Portugal; Evidence Based Dentistry Research Centre, Cochrane Collaboration Portugal, Lisbon, Portugal.
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Wang T, Ye L, Sun Y, Wu Y. Fabricating a surgical template for guiding sinus floor elevation in the maxillary sinus septa with simultaneous implant placement: A dental technique. J Prosthet Dent 2021:S0022-3913(21)00404-2. [PMID: 34493391 DOI: 10.1016/j.prosdent.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
The presence of sinus septa, common anatomic structures of the maxillary sinus, may increase the incidence of surgical complications during sinus floor elevation. This article introduces a digital protocol for achieving safe and precise sinus floor elevation with an individualized surgical template that combines implant placement and the lateral sinus window technique. This technique facilitates precise preplanning and preparation of the lateral osteotomy window and the implant site and reduces surgical complications, shortens surgical duration, and improves patient-related outcomes.
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Affiliation(s)
- Tingting Wang
- Resident, Department of 2nd Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Lijuan Ye
- Attending, Department of 2nd Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology, National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Yuanyuan Sun
- Attending, Department of 2nd Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology, National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, PR China
| | - Yiqun Wu
- Professor, Department of 2nd Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology, National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, PR China.
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15
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Shetty S, Al Bayatti SW, Al-Rawi NH, Samsudin R, Marei H, Shetty R, Abdelmagyd HA, Reddy S. A study on the association between accessory maxillary ostium and maxillary sinus mucosal thickening using cone beam computed tomography. Head Face Med 2021; 17:28. [PMID: 34261509 PMCID: PMC8278720 DOI: 10.1186/s13005-021-00284-0] [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: 12/16/2020] [Accepted: 07/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accessory maxillary ostium (AMO) has a major role to play in the aetiology of maxillary sinusitis. Mucosal thickening is one of the key radiographic features of chronic maxillary sinusitis. The aim of this study was to identify the location of the AMOs and investigate the association between Mucosal Thickening [MT] and AMO using Cone Beam Computed Tomography [CBCT]. METHODS CBCT scans of 400 maxillary sinuses from the records of 200 patients who seeked various dental treatments at the Thumbay Dental Hospital, Gulf Medical University, Ajman, United Arab Emirates were evaluated. The incidence, anatomical position and maximal length of accessory maxillary ostia (AMO) in the maxillary antrum were reviewed using CBCT by two examiners. The association between MTs and AMOs were also analysed. RESULTS Among the 200 CBCT scans, 131 belonged to male patients and 69 scans belonged to female subjects within the age group of 18-65 years (mean age 41.32 years). AMOs were found in 142 maxillary antra (35.5 %). The inter-observer reliability for using CBCT to detect AMO was (k = 0.83). There was no significant difference in the frequency of AMOs when the age (P = 0.19) and gender (P = 0.54) distribution were considered. Sinuses with AMOs, showed significantly greater frequency of MTs (p = 0.001). AMOs with maximal length of less than 1mm were most commonly observed (51.40 %). AMOs with larger greater maximal length were associated with higher degrees of MT. The location of the AMOs, were not affected by the degree of MT. CONCLUSIONS The study demonstrates a clear association between degree of MT and occurrence of AMO in the maxillary sinus. However, the location of the AMO is independent of the degree of the MT. There is a greater probability of finding an AMO in the maxillary sinus if the MT in the sinus is more than 3 mm.
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Affiliation(s)
- Shishir Shetty
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Saad Wahby Al Bayatti
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Natheer Hashim Al-Rawi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rani Samsudin
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hesham Marei
- College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| | | | | | - Sesha Reddy
- College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
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Tran TB, Estrin NE, Saleh MHA, Yoon TYH, Tattan M, Wang HL. Evaluation of length and location of the maxillary sinus intraosseous artery using computerized tomography. J Periodontol 2020; 92:854-862. [PMID: 33107598 DOI: 10.1002/jper.20-0560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/08/2020] [Accepted: 09/20/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND The intraosseous artery is a branch of the posterior superior alveolar artery that supplies the lateral wall of the maxillary sinus. The present study seeks to analyze the location of the intraosseous artery and its site of termination. METHODS Cone beam computed tomography was used to evaluate 200 patients making up 400 maxillary sinuses. The following criteria were measured: (1) the distance of the lower border of the intraosseous artery to the floor of the sinus, (2) the average length of the artery, (3) the diameter of the artery, (4) the site at which the artery terminates at, and (5) the distance of the artery from the first premolar, second premolar, first molar, second molar, and third molar. RESULTS The intraosseous artery was identified in 336 (84.0%) quadrants. The most common site of termination was at the mesial of the second molar (22%), regardless of dental status and right or left quadrant. Its overall mean diameter was 0.91 ± 0.56 mm, with no difference within the dental status. Its overall mean length was 7.40 ± 3.39 mm, with a statistically significant difference between dentate and edentulous quadrants (P < 0.001). Its overall mean distance from the floor was 6.95 ± 6.49 mm, with no difference within the dental status. All parameters showed no difference between right or left quadrants. CONCLUSIONS The chances of encountering the intraosseous artery at the premolar area is <21% during a lateral window sinus floor elevation. The most common (22%) site of termination of the intraosseous artery is at the mesial of the second molar. Understanding of the course, location, and termination of the artery enhances the precision of a clinician when it comes to pre-operative treatment planning.
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Affiliation(s)
- Troy B Tran
- Graduate Periodontics, School of Dentistry, University of Louisville, Louisville, Kentucky, USA.,Lake Erie College of Osteopathic Medicine School of Dental Medicine, Bradenton, Florida, USA
| | - Nathan E Estrin
- Lake Erie College of Osteopathic Medicine School of Dental Medicine, Bradenton, Florida, USA.,Department of Periodontology, Stony Brook School of Dental Medicine, Stony Brook, New York, USA
| | - Muhammad H A Saleh
- Graduate Periodontics, School of Dentistry, University of Louisville, Louisville, Kentucky, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Thomas Y H Yoon
- Lake Erie College of Osteopathic Medicine School of Dental Medicine, Bradenton, Florida, USA
| | - Mustafa Tattan
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Jung J, Park JS, Hong SJ, Kim GT, Kwon YD. Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis. J ORAL IMPLANTOL 2020; 46:415-422. [PMID: 32315428 DOI: 10.1563/aaid-joi-d-18-00229] [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] [Indexed: 11/22/2022]
Abstract
The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.
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Affiliation(s)
- Junho Jung
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Jung Soo Park
- Department of Periodontology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Seoung-Jin Hong
- Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Gyu-Tae Kim
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Yong-Dae Kwon
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
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Sandhu R, Kheur MG, Lakha TA, Supriya M, Valentini P, Le B. Anatomic variations of the osteomeatal complex and its relationship to patency of the maxillary ostium: A retrospective evaluation of cone-beam computed tomography and its implications for sinus augmentation. J Indian Prosthodont Soc 2020; 20:371-377. [PMID: 33487964 PMCID: PMC7814679 DOI: 10.4103/jips.jips_113_20] [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: 03/18/2020] [Revised: 06/27/2020] [Accepted: 08/05/2020] [Indexed: 11/30/2022] Open
Abstract
Aim: The aim of this study is to determine the incidence of obliterated osteomeatal complex (OMC) due to the presence of anatomic variants. Settings and Design: Retrospective Study. Materials and Methods: In this retrospective study, a total of 71 patients, 34 males and 37 females, aged 35–65 years were included in the study. Cone beam computed tomography (CBCT) scans of patients were assessed to identify the status of the OMC in the presence of anatomic variants and their incidence was recorded. The radiological assessment of the anatomical variants was made by viewing the coronal sections of the scans. The variants observed were deviated nasal septum, uncinate process), agger nasi, Haller cells, middle turbinate variants, enlarged bulla, accessory ostium, and maxillary sinus abnormalities). Ostium patency was evaluated in the coronal section of each sinus and classified as “patent” or “obstructed.” The most common variants observed were then correlated with the patency of the ostium. Statistical Analysis Used: Chi square test was performed to assess the association between the anatomic variants and the patency of the OMC. Results: In the present study, the incidence of an obliterated OMC due to the presence of anatomic variants was 73.2%. The four most common variants associated with the possibility of an obliterated OMC were the deviated nasal septum (76.2%), middle turbinate (86.4%), enlarged bulla (77.8%), and sinus cavity variants (80.0%). A statistically significant association was noted between middle turbinate variants and Haller cells and the patency of the OMC. Conclusion: Thorough pretreatment CBCT evaluation should be performed to assess the presence of anatomic variants and thereby, the patency of the ostium before sinus floor elevation procedures. The pre and postsurgical treatment plans and regimes can be modified according to anticipated postsurgical sequelae, thereby avoiding postsurgical complications and enhancing the success of the graft procedure.
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Affiliation(s)
- Ramandeep Sandhu
- Department of Fixed Prosthodontics, Holland Bloorview, University of Toronto, Toronto, Canada
| | - Mohit Gurunath Kheur
- Department of Prosthodontics, M.A. Rangoonwala Dental College, Pune, Maharashtra, India
| | - Tabrez Amin Lakha
- Department of Prosthodontics, M.A. Rangoonwala Dental College, Pune, Maharashtra, India
| | - M Supriya
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Pascal Valentini
- Department of Implant Surgery, Institute of Health, Tattone Hospital, University of Corsica, Corte, France
| | - Bach Le
- Department of Oral and Maxillofacial Surgery, The Herman Ostrow School of Dentistry of USC, Los Angeles, CA, United States
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Amine K, Slaoui S, Kanice FZ, Kissa J. Evaluation of maxillary sinus anatomical variations and lesions: A retrospective analysis using cone beam computed tomography. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:484-489. [PMID: 31931183 DOI: 10.1016/j.jormas.2019.12.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/12/2019] [Accepted: 12/16/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The residual bone height in the posterior edentulous maxilla is frequently limited by the maxillary sinuses. Sinus floor elevation (SFE) is then considered to restore sufficient bone height. The preoperative analysis of the maxillary sinus is necessary for the success of this surgery. Therefore, we investigated the frequency of maxillary sinus anatomic variations and lesions by using cone beam computed tomography (CBCT). MATERIALS AND METHODS We retrospectively analysed all CBCTs performed at a private radiological center between January and November 2014. The following anatomical variations and lesions were assessed: sinus ventilation, sinus septa, the sinus totally compartmentalized, the hypoplastic sinus, sinus aplasia, the prolapsed sinus, thickness of the anterolateral wall, the position of antral artery, mucosa thickening, sinus opacity, the polyps and the cysts. RESULTS A total of 300 cone beam images were analyzed. The findings consisted in: ventilation 91%, septa 34.66%, total compartmentalized sinus 6%, hypoplastic sinus 5%, aplastic sinus 0%, prolapsed sinus 1.66%, endorsed position of the antral artery 53%, submucosa position 43%, thickening of the sinus mucosa 41%, sinus opacity 4%, polyps and the cysts 20.33%. The average thickness of the anterolateral wall was about 1.16±0.48mm. CONCLUSION The maxillary sinus has great interindividual anatomical variability. The cone beam is highly beneficial for the analysis of the anatomical structures in relationships with any sinus surgery.
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Affiliation(s)
- K Amine
- Faculty of dentistry, University Hassan II of Casablanca, Casablanca, Morocco.
| | - S Slaoui
- Faculty of dentistry, University Hassan II of Casablanca, Casablanca, Morocco
| | - F-Z Kanice
- Faculty of dentistry, University Hassan II of Casablanca, Casablanca, Morocco
| | - J Kissa
- Faculty of dentistry, University Hassan II of Casablanca, Casablanca, Morocco
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Kawakami S, Botticelli D, Nakajima Y, Sakuma S, Baba S. Anatomical analyses for maxillary sinus floor augmentation with a lateral approach: A cone beam computed tomography study. Ann Anat 2019; 226:29-34. [PMID: 31330302 DOI: 10.1016/j.aanat.2019.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/06/2019] [Accepted: 07/08/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Various anatomical references and structures should be analyzed prior approaching a surgery in the maxillary sinus. The objective of the present study was to evaluate the anatomical structures and references involved in sinus floor elevation with a lateral approach. MATERIALS AND METHODS Seventy-five patients planned for sinus floor elevation were included in the study. Eighty-eight maxillary sinuses were evaluated using cone beam computed tomographies (CBCTs). The nasal floor was used as main reference (X) and sinus mucosa width, bone crest height, palatal-nasal recess angle (PNR), sinus width at the level of the nasal floor, distance from the nasal floor to the base of the sinus (X-F), position of the posterior superior alveolar artery (PSAA height) and diameter (PSAA diameter), lateral bone wall width at 3mm (LW 3mm) and 9mm (LW 9mm) from the base of the sinus (F), patency of the ostium (OP), and presence and position of septa have been evaluated. RESULTS The mean dimensions and standard deviations were the following: mucosa thickness was 2.0±1.4mm, bone crest height 2.8±1.4mm, distance X-F 8.3±1.9mm, PNR angle 135.5±23.1, sinus width 12.6±4.2mm, X-F 8.3±1.9mm, PSAA height 14.4±2.9mm, PSAA diameter 1.1±0.4mm, LW 3mm 1.5±1.2, LW 9mm 1.3±0.6mm, OP 1.9±0.4mm. Septa were present in 19.3% of the sinuses evaluated and were located mostly in the molar region. CONCLUSIONS In conclusion, the analysis of the CBCT before sinus floor elevation allows the identification of anatomical structures and references that might be used for the planning of the surgical approach, aiming to improve the outcome of the treatment and to avoid possible complications.
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Affiliation(s)
- Shunsuke Kawakami
- Department of Oral Implantology, Osaka Dental University, Osaka, Japan
| | | | - Yasushi Nakajima
- Department of Oral Implantology, Osaka Dental University, Osaka, Japan
| | | | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, Osaka, Japan
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SOUZA CFD, LOURES ADO, LOPES DGDF, DEVITO KL. Analysis of maxillary sinus septa by cone-beam computed tomography. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.03419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Abstract Introduction Pneumatization of the maxillary sinus may make it impossible to insert implants directly in the posterior region of the maxilla, and in these cases, the solution is to submit the patient to maxillary sinus floor augmentation surgery. The most common complication of this surgery is sinus membrane perforation. Anatomical variations of the internal space of the sinus, such as the bone septa, may further hamper detachment of this membrane. Objective To evaluate the prevalence and characteristics of sinus septa in patients from the Zona da Mata Mineira (Minas Gerais, Brazil), to offer relevant information for a safer planning of surgeries involving this region. Material and method A total of 120 patients (240 sinuses) were analyzed using cone-beam computed tomography (CBCT) images, verifying the presence of sinus septa and classifying them for size and anteroposterior location. Result Of the 120 patients analyzed, 45 (37.50%) had sinus septa, 66 septa in total. Of these, 33 (50%) were present in the middle region of the maxillary sinus and the mean septum size was 7.23 mm. There was no significant difference in the septum size between the genders or between the right and left sides. Conclusion The high rates of incidence of sinus septa justify their study, which should be based mainly on accurate exams, such as CBCT, since they represent one of the most relevant anatomical variations for the cases of sinus surgeries.
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