The Relationship between Maxillary Sinus Lateral Wall Thickness, Alveolar Bone Loss, and Demographic Variables: A Cross-Sectional Cone-Beam Computerized Tomography Study

The Impact of Maxillary Sinus Pneumatization on the Quality of the Alveolar Bone in Dentated and Edentulous Patients: A Cone-Beam Computed Tomography Radiographic Analysis

Background This study aimed to describe the morphometric differences of maxillary alveolar bone's height, width, and densitometric differences in the posterior region where maxillary sinus pneumatization occurred. Methodology A cross-sectional, cone-beam computed tomography (CBCT) study used 123 CBCT images as a non-randomized convenient sample of sinus pneumatized cases. Bone height, bone width (in mm), and average density of the remaining ridge of all patients were used as study variables. Analysis of the qualitative variables were as frequency and percentages. Parametric Student's t-test and non-parametric chi-squared tests were used to compare the groups. The significance level was set at a p-value ≤0.05. Results The sample included CBCT radiographs for patients who had a mean age of 42.79 ± 12.32 with males constituting 69 (56.1%) of the patients. There was no gender difference between the present and missing teeth at the measured sites of the first premolar, second premolar, first molar, and second molar (p > 0.05). The mean measurements of height and average bone density were significantly higher in the dentate sites; however, the mean width was higher in the edentulous sites (p = 0.001). Conclusions Average bone height and density were significantly decreased at the edentulous sites of sinus pneumatized cases than the dentate sites with no gender difference.

Study of Lateral Wall Thickness of the Maxillary Sinus in Left and Right Sides for Female and Male: A Cross Sectional Retrospective Study Using Cone Beam Computed Tomography

BACKGROUND

Dental implants are considered the first option to replace missing teeth. Alveolar bone resorption gradually progresses following tooth extraction leading to loss of vertical bone dimension for implant placement. The lateral window approach is the most commonly used procedure to treat vertical bone loss.

OBJECTIVES

The aim of the present study is to evaluate the lateral wall thickness (LWT) of the maxillary sinus and determine the influence of gender and side on maxillary LWT.

METHODS

This study involved a cross sectional retrospective study. Cone- beam computed tomography data were collected from 99 patients with a total of 198 maxillary sinuses that met the inclusion criteria. The patient age ranged from 18 to 35 years. On the selected sagittal section, the points of measurement are determined by a perpendicular line at 5 mm from the lowest point of the sinus floor. Measurements were done at four different areas; first premolar (P1), second premolar (P2), first molar (M1), and second molar (M2). Descriptive statistics were used to calculate mean lateral wall thickness for each tooth, and student's t-test was used to test the effect of gender and side on maxillary LWT.

RESULTS

The greatest mean LWT was observed around the left first maxillary molar (2.43±0.82), while the lowest mean LWT was observed around the right second maxillary premolar (1.62±0.61). There was no significant difference in the LWT around any tooth (M1 p=0.56, M2 p=0.92, P1 p=0.14, P2 p=0.19).

CONCLUSION

There was no significant difference in both males and females of the lateral wall thickness in the left and right side of maxillary sinus.

Risk factors for sinus membrane perforation during lateral window maxillary sinus floor elevation surgery: A retrospective study

PURPOSE

To analyze the sinus membrane perforation (SMP) rate and its potential risk factors during lateral window maxillary sinus floor elevation (LSFE).

MATERIALS AND METHODS

For patients with LSFEs at Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang Universitiy during January 2014 to December 2020, patient-related risk factors (age/sex/smoking habit), surgery-related risk factors (operator experiment/number of tooth units/technique of osteotomy/surgical approach), and maxillary sinus-related risk factors (residual bone height/sinus membrane thickness/lateral wall thickness/maxillary sinus contours/presence of septa/blood vessels at the lateral maxillary sinus wall) were compared between perforated and nonperforated sites and were evaluated for their influence affecting SMP.

RESULTS

The study sample comprised 278 LSFE procedures in 278 patients; a total of 47 LSFE procedures (16.91%) presented SMP. Four significant factors were identified: smoking habit (p < 0.001), thin (≤1.5 mm) sinus membrane (p = 0.027), maxillary sinus contours (p < 0.001), and presence of septa (p = 0.001). The SMP rate of irregular, narrow tapered, and tapering sinus contours was significantly higher than that of ovoid and square one (p < 0.05).

CONCLUSION

In general, smoking habit, thin sinus membrane, irregular, narrow tapered, and tapering sinus contours, and presence of septa may increase the risk of SMP during LSFE.

Comparison of CGRP distributions in the maxillary sinus and trigeminal ganglion between elderly dentulous and edentulous humans

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.

[Surgical anatomy of the maxillary sinus]

BACKGROUND

Improved understanding of the microanatomy of the paranasal sinuses, including its individual variations, makes a substantial contribution to current progress in endonasal endoscopic microsurgery. Microanatomy of the sinuses is an active field of present scientific investitations.

MATERIALS AND METHODS

A comprehensive review on microanatomy of the maxillary sinus is presented from the perspective of contemporary endonasal endoscopic microsurgery.

RESULTS

The range of variation of the individual microanatomy of all sections of the maxillary sinus is presented, in particular to minimize secondary sugical tissue trauma, to avoid complications (e.g. on orbital tissues) and as a basis for the prelacrimal access to the maxillary sinus.

CONCLUSION

Improved understanding of the range of microanatomical variations reduced the burden on the patient while opimizing the effectiveness of the necessary surgical manipulations.