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Scavia S, Audino E, Salgarello S. Ridge Preservation Combined With Open Barrier Membrane Technique in Case of Postextractive Oroantral Communication: A Case Series Retrospective Study. J ORAL IMPLANTOL 2024; 50:141-152. [PMID: 38839071 DOI: 10.1563/aaid-joi-d-24-00021] [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: 06/07/2024]
Abstract
After dental extraction, a physiological phenomenon of reabsorption of the dentoalveolar process is triggered, especially if periradicular lesions are present, which can sometimes be associated with oroantral communication in the upper posterior maxilla. To investigate a minimally invasive approach, 19 patients undergoing tooth extraction in the posterosuperior maxilla were recruited. All cases presented an oroantral communication with a diameter of 2-5 mm after tooth extraction and the alveolar process and, in some cases, with a partial defect of 1 or more bony walls. In these cases, a single surgical procedure was used to preserve the alveolar ridge using an open barrier technique with an exposed dense polytetrafluoroethylene membrane. The bottom of the extraction socket was filled with a collagen fleece. The residual bone process was reconstructed using a biomaterial based on carbonate-apatite derived from porcine cancellous bone. After 6 months, all patients were recalled and subjected to radiographic control associated with an implant-prosthetic rehabilitation plan. Data relating to the sinus health status and the average height and thickness of the regenerated bone were collected. Radiographic evaluation verified the integrity of the maxillary sinus floor with new bone formation, detecting a vertical bone dimension between 3.1 mm and 7.4 mm (average 5.13 ± 1.15 mm) and a horizontal thickness between 4.2 mm and 9.6 mm (average 6.86 ± 1.55 mm). The goal of this study was to highlight the advantage of managing an oroantral communication and, simultaneously, obtain the preservation and regeneration of the alveolar bone crest. The open barrier technique appears to be effective for the minimally invasive management of oroantral communication up to 5 mm in diameter in postextraction sites, with a good regeneration of hard and soft tissue.
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Affiliation(s)
| | - Elisabetta Audino
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| | - Stefano Salgarello
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
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Saquib Abullais S, AlQahtani SM, Alqahtani S, Alaamri A, Azhar Dawasaz A, Alqahtani A, Dhadse PV. Radiographic assessment of maxillary sinus membrane and lateral wall thickness using cone-beam CT in different facial types in southwestern Saudi Arabia. PLoS One 2024; 19:e0298403. [PMID: 38527039 PMCID: PMC10962825 DOI: 10.1371/journal.pone.0298403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/25/2024] [Indexed: 03/27/2024] Open
Abstract
The anatomy of the edentulous posterior maxilla and maxillary sinus possess unique challenges in implant dentistry. The purpose of this study was to assess maxillary sinus membrane thickness (MT) and lateral wall thickness (LWT) in different facial index profiles and to describe the clinical implications. A retrospective image analysis of 75 CBCT scans was done, which yielded a total of 150 sinus images. The facial index was calculated as per the formula given in the text and grouped as euryprosopic, mesoprosopic and leptoprosopic. The images obtained were of 36 women (48%) and 39 men (52%), with maximum subjects in 30-39 years age group. MT and LWT were measured at three different points on the radiograph at every 3mm from the base of the sinus floor in premolar and molar regions of each image. Results showed females had significant differences from males in LWT in both premolar and molar regions (p = 0.018 and 0.032 respectively). Subjects in 40-49 years of age had significant differences (p = 0.021) in MT in premolar region only. Also, difference in MT in premolar and molar regions were also statistically significant. Lastly, the present study did not find any statistically significant difference in MT and LWT in all three facial indices groups. It can be concluded that different facial indices have no positive correlation with maxillary sinus membrane thickness and lateral wall thickness. Hence, surgical complications are avoidable with proper detailed knowledge and appropriate identification of the anatomic structures characteristic to the maxillary sinus.
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Affiliation(s)
- Shahabe Saquib Abullais
- Department of Periodontics and Community Dental Sciences, King Khalid University, Abha, Saudi Arabia
| | - Saad M. AlQahtani
- Department of Periodontics and Community Dental Sciences, King Khalid University, Abha, Saudi Arabia
| | - Salman Alqahtani
- Restorative Resident, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Abdulrahman Alaamri
- Department of Periodontics and Community Dental Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ali Azhar Dawasaz
- Department of Diagnostic Dental Sciences, King Khalid University, Abha, Saudi Arabia
| | | | - Prasad V. Dhadse
- Department of Periodontology, Datta Meghe Institute of Higher Education and Research Sawangi, Wardha, India
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Deng Y, Ma R, He Y, Yu S, Cao S, Gao K, Dou Y, Ma P. Biomechanical analysis of the maxillary sinus floor membrane during internal sinus floor elevation with implants at different angles of the maxillary sinus angles. Int J Implant Dent 2024; 10:11. [PMID: 38472687 DOI: 10.1186/s40729-024-00530-5] [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: 10/25/2023] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVE This study analyzed and compared the biomechanical properties of maxillary sinus floor mucosa with implants at three different maxillary sinus angles during a modified internal sinus floor elevation procedure. METHODS 3D reconstruction of the implant, maxillary sinus bone, and membrane were performed. The maxillary sinus model was set at three different angles. Two internal maxillary sinus elevation models were established, and finite element analysis was used to simulate the modified maxillary sinus elevation process. The implant was elevated to 10 mm at three maxillary sinus angles when the maxillary sinus floor membrane was separated by 0 and 4 mm. The stress of the maxillary sinus floor membrane was analyzed and compared. RESULTS When the maxillary sinus floor membrane was separated by 0 mm and elevated to 10 mm, the peak stress values of the implant on the maxillary sinus floor membrane at three different angles were as follows: maxillary sinus I: 5.14-78.32 MPa; maxillary sinus II: 2.81-73.89 MPa; and maxillary sinus III: 2.82-51.87 MPa. When the maxillary sinus floor membrane was separated by 4 mm and elevated to 10 mm, the corresponding values were as follows: maxillary sinus I: 0.50-7.25 MPa; maxillary sinus II: 0.81-16.55 MPa; and maxillary sinus III: 0.49-22.74 MPa. CONCLUSION The risk of sinus floor membrane rupture is greatly reduced after adequate dissection of the maxillary sinus floor membrane when performing modified internal sinus elevation in a narrow maxillary sinus. In a wide maxillary sinus, the risk of rupture or perforation of the wider maxillary sinus floor is reduced, regardless of whether traditional or modified internal sinus elevation is performed at the same height.
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Affiliation(s)
- Yinxin Deng
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
- Department of Stomatology, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, No. 3 Yongding Road East Street, Beijing, HaiDian District, 100039, China
| | - Ruihong Ma
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Yilin He
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Shujia Yu
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Shiyu Cao
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Kang Gao
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Yiping Dou
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China
| | - Pan Ma
- Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 4 Tiantan Xili, Beijing, Dongcheng District, 100050, China.
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Al-Bahrani ZM, Al-Ghurabi ZH. Cone Beam Computed Tomographic Evaluation of Schneiderian Membrane Thickness. J Craniofac Surg 2024; 35:e36-e38. [PMID: 37815390 DOI: 10.1097/scs.0000000000009767] [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: 07/27/2023] [Accepted: 08/26/2023] [Indexed: 10/11/2023] Open
Abstract
OBJECTIVE This study aimed to determine the measurements and classification of Schneider membrane thickness correlated to age and sex factors using cone beam computed tomography (CBCT). METHODS The study included CBCT images for 100 maxillary sinuses of 50 consecutive patients, and the thickness of the maxillary sinus membrane (Schneiderian membrane) was measured in coronal view from the lowest point in the floor of the maxillary sinus to the highest point. The thickness of the Schneiderian membrane was classified into 4 types. RESULTS The study result revealed that out of the total cases, 45% of sinus membranes were classified as type 2, while only 10% were classified as type 4. The most frequent type of membrane thickness diagnosed in the age group 20 to 30 as type 1, whereas in age groups 31 to 40 and 41 to 50, regarding sex, type 4 was more obvious in males with membrane thickening >6 mm. CONCLUSIONS Measurement and classification of sinus membrane thickness can be performed accurately with CBCT, and it is affected by age and sex factors.
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Affiliation(s)
- Zainab M Al-Bahrani
- Department of Oral Diagnosis, College of Dentistry, University of Baghdad, Bab Al-Moadham Campus, Baghdad, Iraq
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Díaz L, Fan S, Urrutia P, Uriarte X, Fodich I, Torres A, Sáenz-Ravello G. Correlation between periodontal phenotype and sinus membrane thickness: A systematic review. Clin Oral Implants Res 2023; 34:881-891. [PMID: 37427881 DOI: 10.1111/clr.14121] [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: 02/11/2023] [Revised: 06/11/2023] [Accepted: 06/14/2023] [Indexed: 07/11/2023]
Abstract
AIM To assess the correlation between the periodontal phenotype (PP) and sinus membrane thickness (SMT) in humans. METHODS This review was conducted according to the PRISMA guidelines. Two reviewers independently carried out electronic and manual literature searches of studies published in English, German, and Spanish, from 1970 to September 2022 in four electronic databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, in addition to gray literature. Studies that assessed the correlation between PP and SMT in adults (aged 18 years) were included. Methodological quality was evaluated using the Appraisal Tool for Cross-Sectional Studies (AXIS) for articles that met the eligibility criteria. RESULTS Six studies, including 510 patients, were considered for qualitative analysis. All included studies were cross-sectional, and the correlation between the PP and SMT was evaluated, finding a positive and high correlation in 83.3% of them, based on a value of ≥0.7. All the included studies were assessed with a high overall risk of bias. CONCLUSIONS Periodontal phenotype and sinus membrane thickness are likely correlated. Nevertheless, further standardized studies are required to draw definitive conclusions.
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Affiliation(s)
- Leonardo Díaz
- Faculty of Dentistry, Postgraduate School, University of Chile, Santiago, Chile
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany
- Perioplastic Institute, Santiago, Chile
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany
| | - Pablo Urrutia
- Perioplastic Institute, Santiago, Chile
- Postgraduate Implant Dentistry Department, School of Dentistry, Universidad Andrés Bello, Santiago, Chile
| | | | - Ivo Fodich
- Postgraduate Implant Dentistry Department, School of Dentistry, Universidad Andrés Bello, Santiago, Chile
| | - Alfredo Torres
- Faculty of Dentistry, Postgraduate School, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Gustavo Sáenz-Ravello
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile
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Zhang L, Zhang Y, Xu Q, Shu J, Xu B, Liu L, Chen H, Hu Y, Li Y, Song L. Increased risks of maxillary sinus mucosal thickening in Chinese patients with periapical lesions. Heliyon 2023; 9:e18050. [PMID: 37519707 PMCID: PMC10372233 DOI: 10.1016/j.heliyon.2023.e18050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives This study aimed to evaluate the effects of factors related to periapical lesions (PALs) on sinus membrane thickening (SMT) in the Chinese population using cone-beam computed tomography (CBCT). Methods In this retrospective study, CBCT images (n = 512) of maxillary sinuses of 446 patients were evaluated by two examiners for SMT and PALs, PAL size, and the distance between the maxillary sinus floor (MSF), and the PAL's edge/root apex. The data were analyzed using analysis of variance, the Kruskal-Wallis test, χ2-test, and logistic regression. Results A binary logistic regression model showed that the prevalence and severity of SMT > 2 mm were significantly associated with older age (>60 years) (odds ratio [OR]: 4.03, 95% confidence interval [CI]): 2.24-7.72, P < 0.001], male sex (OR: 2.08, 95% CI: 1.21-3.56, P < 0.006), and PALs (OR: 6.89, 95% CI: 3.93-12.08, P < 0.001). The type of contact and penetration between the MSF and PALs or root apex showed a more significant relation with SMT > 2 mm than did distance after adjusting for confounding factors, including age and sex (PALs: OR = 10.17 and 14.57, P < 0.001; root apex: OR = 3.49 and 5.86, P < 0.001). Conclusions The prevalence and severity of SMT were significantly associated with older age, male sex, PALs, PAL size, and the distance between the MSF and PALs/root apex. Therefore, communication between dental surgeons and an otolaryngology specialist is important for the timely diagnosis and treatment of SMT of dental origin.
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Affiliation(s)
- Limin Zhang
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yanan Zhang
- Department of Stomatology, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan 250001, China
| | - Qimei Xu
- School of Stomatology, Bengbu Medical College, Bengbu, Anhui 233000, China
| | - Jingjing Shu
- Department of Periodontology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Bin Xu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Liuhui Liu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Huijuan Chen
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yue Hu
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Yinghua Li
- Clinical Laboratory, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Liang Song
- Department of Stomatology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai 200240, China
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Nemati M, Khodaverdi N, Hosn Centenero SA, Tabrizi R. Which factors affect the risk of membrane perforation in lateral window maxillary sinus elevation? A prospective cohort study. J Craniomaxillofac Surg 2023; 51:427-432. [PMID: 37423790 DOI: 10.1016/j.jcms.2023.06.010] [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: 04/04/2023] [Revised: 05/13/2023] [Accepted: 06/25/2023] [Indexed: 07/11/2023] Open
Abstract
It was the aim of this prospective cohort study to assess the various anatomical and other patient-related factors that increase membrane perforation risk. Patients underwent cone-beam computed tomography (CBCT) before surgery. The presence of septa, presence of mucous retention cyst, lateral wall thickness, membrane thickness, and residual bone height were predictive factors. Age, gender, and smoking were covariates for the study. The presence or absence of membrane perforation was the study outcome. In total, 140 subjects were studied. The hazard ratio (HR) for the presence of septa with membrane perforation was 8.07 (2.93-22.29) (p < 0.001). The HR for perforation with a single edentulous area relating to two or more teeth was 68.09 (9.52-49.16). The risk of membrane perforation in smokers was 25 times more than in non-smokers - HR 25 (7.58-82.51) (p < 0.001). The HR for membrane perforation in subjects with mucous retention cysts compared with subjects without retention cysts was 27.75 (8.73-88.23) (p < 0.001). Within the limitations of the study it seems that anatomical, habitual, and pathological factors may increase the risk of Schneiderian membrane perforation when a lateral window approach is used for sinus floor augmentation.
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Affiliation(s)
- Majid Nemati
- Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazilla Khodaverdi
- Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samir Aboul Hosn Centenero
- Oral and Maxillofacial Surgery Department, Hospital Clinic de Barcelona, International University of Catalunya, Barcelona, Spain
| | - Reza Tabrizi
- Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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S Balakrishnan R, Rohinikumar S, Rajendra Prabhu A, Veeraraghavan VP, Nesappan T, Easwaramoorthy R. Efficacy of mucolytics and steam therapy in the management of sinusitis among Indians. Bioinformation 2023; 19:479-483. [PMID: 37831735 PMCID: PMC10563563 DOI: 10.6026/97320630019479] [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: 04/01/2023] [Revised: 04/30/2023] [Accepted: 04/30/2023] [Indexed: 10/15/2023] Open
Abstract
It is of interest to compare the treatment modalities of sinus membrane thickening, by analyzing the difference in pre and post-intervention radiographic measurement of sinus membrane thickness. Results showed that combination therapy of steam and mucolytics decreased the sinus thickening in a statistically significant manner compared to mucolytics alone. Thus, there is a correlation between maxillary sinus membrane thickening and patency of maxillary ostium radiographically.
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Affiliation(s)
- Rajalakshmi S Balakrishnan
- Department of Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Science, Chennai- 600077, India
| | - Subhashree Rohinikumar
- Department of Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Science, Chennai- 600077, India
| | - Abhinav Rajendra Prabhu
- Department of Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Science, Chennai- 600077, India
| | - Vishnu Priya Veeraraghavan
- Department of Biomaterials, Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Medical and Technical Sciences, Saveetha University,
Chennai 600077, India
| | - Thiyaneswaran Nesappan
- Department of Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Science, Chennai- 600077, India
| | - Rajalakshmanan Easwaramoorthy
- Department of Biomaterials, Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Medical and Technical Sciences, Saveetha University,
Chennai 600077, India
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Clinical, radiographic characterizations and complications of maxillary molar in a periodontitis population: a retrospective study based on CBCT radiography. Clin Oral Investig 2023; 27:2335-2346. [PMID: 36607492 DOI: 10.1007/s00784-022-04845-8] [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: 07/07/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study was aimed to delineate the clinical, CBCT radiographic characteristics, and complications of maxillary molar in a periodontitis population. MATERIALS AND METHODS Medical records and CBCT images were utilized to identify adult patients with periodontitis in a tertiary referral dental hospital between June 2019 and December 2020. CBCT scan images were used to characterize the detailed bone thickness, absorbing height, and position of maxillary molar as well as their associated conditions. All relevant descriptive epidemiological data, clinical information, radiographic details, and associated complications were recorded and statistically analyzed. RESULTS According to the above criteria, 577 eligible periodontitis patients were enrolled and defined as research cohort here with mean age 45 ± 4.8 years. Male patients outnumbered females with a gender ratio of 1.23:1. Our results demonstrated that the bone loss of maxillary first molar was more serious than that of second molar with tooth position symmetry. The occurrence of various complications (periodontal abscess, pulp lesions, furcation lesion, and mucosal thickening) was significantly correlated to periodontal-related clinical parameters of maxillary molar. CONCLUSIONS Our results demonstrated the more serious bone loss of maxillary first molar with tooth position symmetry. The occurrence of various complications was significantly correlated to periodontal-related clinical parameters. Our findings offer valuable information concerning the clinical, radiographic characteristics, and complications of maxillary molar in a periodontitis population. CLINICAL RELEVANCE These findings are beneficial for clinicians to comprehensively understand the bone status, pathogenesis, and clinical management of maxillary molar in periodontitis.
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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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Weng Y, Wang H, Wu D, Xu S, Chen X, Huang J, Feng Y, Li L, Wang Z. A novel lineage of osteoprogenitor cells with dual epithelial and mesenchymal properties govern maxillofacial bone homeostasis and regeneration after MSFL. Cell Res 2022; 32:814-830. [PMID: 35821090 PMCID: PMC9436969 DOI: 10.1038/s41422-022-00687-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/10/2022] [Indexed: 12/12/2022] Open
Abstract
Bone regeneration originates from proliferation and differentiation of osteoprogenitors via either endochondral or intramembranous ossification; and the regeneration capacities decline with age and estrogen loss. Maxillary sinus floor lifting (MSFL) is a commonly used surgical procedure for guiding bone regeneration in maxilla. Radiographic analysis of 1210 clinical cases of maxilla bone regeneration after MSFL revealed that the intrasinus osteogenic efficacy was independent of age and gender, however; and this might be related to the Schneiderian membrane that lines the sinus cavity. In view of the particularity of this biological process, our present study aimed to elucidate the underlying mechanism of MSFL-induced bone regeneration. We first established a murine model to simulate the clinical MSFL. By single-cell RNA-sequencing and flow cytometry-based bulk RNA-sequencing, we identified a novel Krt14+Ctsk+ subset of cells that display both epithelial and mesenchymal properties and the transcriptomic feature of osteoprogenitors. Dual recombinases-mediated lineage tracing and loss-of-function analyses showed that these Krt14+Ctsk+ progenitors contribute to both MSFL-induced osteogenesis and physiological bone homeostasis by differentiating into Krt14-Ctsk+ descendants which show robust osteogenic capacity. In addition, we detected a similar population of Krt14+Ctsk+ cells in human samples of Schneiderian membrane, which show a highly similar osteogenic potential and transcriptomic feature to the corresponding cells in mice. The identification of this Krt14+Ctsk+ population, featured by osteoprogenitor characteristics and dual epithelial-mesenchymal properties, provides new insight into the understanding of bone regeneration and may open more possibilities for clinical applications.
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Affiliation(s)
- Yuteng Weng
- Department of Oral Implantology & Department of Oral and Maxillofacial Surgery, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Haicheng Wang
- Department of Oral Implantology & Department of Oral and Maxillofacial Surgery, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Di Wu
- Department of Oral Implantology & Department of Oral and Maxillofacial Surgery, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Shuyu Xu
- Department of Oral Implantology & Department of Oral and Maxillofacial Surgery, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Xiaofan Chen
- Department of Oral Implantology & Department of Oral and Maxillofacial Surgery, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Jie Huang
- Department of Oral Implantology & Department of Oral and Maxillofacial Surgery, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Yanhuizhi Feng
- Department of Oral Implantology & Department of Oral and Maxillofacial Surgery, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Lin Li
- Department of Oral Implantology & Department of Oral and Maxillofacial Surgery, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Zuolin Wang
- Department of Oral Implantology & Department of Oral and Maxillofacial Surgery, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China.
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BULUT A, ÖZER AM. Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.949252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Shetty SR, Arya S, Kamath V, Al-Bayatti S, Marei H, Abdelmagyd H, El-Kishawi M, Al Shehadat S, Al Kawas S, Shetty R. Application of a Cone-Beam Computed Tomography-Based Index for Evaluating Surgical Sites Prior to Sinus Lift Procedures-A Pilot Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9601968. [PMID: 35005022 PMCID: PMC8741360 DOI: 10.1155/2021/9601968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/30/2021] [Accepted: 12/17/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Radiography-based indices can help surgeons perform detailed examinations of the surgical site and predict the surgical difficulty of cases. We aimed to develop and validate a novel CBCT-based index that can predict the surgical difficulty of sinus-augmentation procedures. MATERIALS AND METHODS In the first stage, five experienced dental specialists performed a review of the literature and closed group discussions and designed the novel index. In the next stage, the index was validated. CBCT scans of 30 patients scheduled for sinus-augmentation procedures were evaluated and assigned presurgical CBCT evaluation scores (PSCESs) by five examiners. Subsequently, one oral surgeon performed sinus augmentation using the lateral antrostomy technique and assigned surgical difficulty scores (SDSs) to each of the 30 cases along with 2 observers. The PSCESs and SDSs were statistically analysed to determine the interrater reliability and validity of the index. RESULTS The interrater agreement of the PSCES among the five presurgical evaluators was 0.85. The PSCES of the five evaluators had highly significant correlation (P < 0.001, r = 0.68 to 0.76) with the SDS. Regression analysis revealed that for every unit increase in the PSCES, there is 0.46 to 0.57 increase in the SDS value. CONCLUSION The results of this pilot study revealed that a novel CBCT-based index can be used as a reliable tool for predicting the surgical difficulty of sinus-augmentation procedures. However, the novel index needs to be tested on a larger sample of patients and evaluators for a more concrete validity and reliability.
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Affiliation(s)
- Shishir Ram Shetty
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, UAE
| | | | - Vinayak Kamath
- Department of Public Health Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Saad Al-Bayatti
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, UAE
| | - Hesham Marei
- College of Dentistry, Gulf Medical University, Ajman, UAE
| | | | - Mohamed El-Kishawi
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, UAE
| | - Saaid Al Shehadat
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, UAE
| | - Sausan Al Kawas
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, UAE
| | - Raghavendra Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, UAE
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Díaz-Olivares LA, Cortés-Bretón Brinkmann J, Martínez-Rodríguez N, Martínez-González JM, López-Quiles J, Leco-Berrocal I, Meniz-García C. Management of Schneiderian membrane perforations during maxillary sinus floor augmentation with lateral approach in relation to subsequent implant survival rates: a systematic review and meta-analysis. Int J Implant Dent 2021; 7:91. [PMID: 34250560 PMCID: PMC8273047 DOI: 10.1186/s40729-021-00346-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/22/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This systematic review aimed to propose a treatment protocol for repairing intraoperative perforation of the Schneiderian membrane during maxillary sinus floor augmentation (MSFA) procedures with lateral window technique. In turn, to assess subsequent implant survival rates placed below repaired membranes compared with intact membranes and therefore determine whether membrane perforation constitutes a risk factor for implant survival. MATERIAL AND METHODS This review was conducted according to PRISMA guidelines. Two independent reviewers conducted an electronic search for articles published between 2008 and April 30, 2020, in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL); also, a complementary handsearch was carried out. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of evidence in the studies reviewed. RESULTS Seven articles fulfilled the inclusion criteria and were analyzed. A total of 1598 sinus lift surgeries were included, allowing the placement of 3604 implants. A total of 1115 implants were placed under previously perforated and repaired membranes, obtaining a survival rate of 97.68%, while 2495 implants were placed below sinus membranes that were not damaged during surgery, obtaining a survival rate of 98.88%. The rate of Schneiderian membrane perforation shown in the systematic review was 30.6%. In the articles reviewed, the most widely used technique for repairing perforated membranes was collagen membrane repair. CONCLUSIONS Schneiderian membrane perforation during MFSA procedures with lateral approach is not a risk factor for dental implant survival (p=0.229; RR 0.977; 95% CI 0.941-1.015). The knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.
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Affiliation(s)
- Luis Alfredo Díaz-Olivares
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Pza Ramon y Cajal s/n, 28040, Madrid, Spain
| | - Jorge Cortés-Bretón Brinkmann
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Pza Ramon y Cajal s/n, 28040, Madrid, Spain.
| | - Natalia Martínez-Rodríguez
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Pza Ramon y Cajal s/n, 28040, Madrid, Spain
| | - José María Martínez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Pza Ramon y Cajal s/n, 28040, Madrid, Spain
| | - Juan López-Quiles
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Pza Ramon y Cajal s/n, 28040, Madrid, Spain
| | - Isabel Leco-Berrocal
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Pza Ramon y Cajal s/n, 28040, Madrid, Spain
| | - Cristina Meniz-García
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Pza Ramon y Cajal s/n, 28040, Madrid, Spain
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ÖZER AM, BULUT A. Posterior Superior Alveoler Arter Konumunun Cinsiyet ile İlişkisi: Retrospektif Analiz. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.38079/igusabder.894404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Wei Y, Zhang B, Yang G, Xu T, Hu W, Chung KH. Effect of ridge preservation at molar extraction sites with severe periodontitis on the Schneiderian membrane thickness changes: a pilot study. BMC Oral Health 2021; 21:184. [PMID: 33845803 PMCID: PMC8040225 DOI: 10.1186/s12903-021-01546-8] [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: 10/31/2020] [Accepted: 03/30/2021] [Indexed: 11/15/2022] Open
Abstract
Background Information regarding the reaction of bone augmentation in terms to sinus mucosa thickness of periodontally compromised molar extraction sites is limited. This retrospective study aimed to analyze the effect of ridge preservation procedures following the extraction of molars with severe periodontitis on the healing pattern of adjacent maxillary sinus mucosal membranes. Methods Thirty-one periodontally compromised maxillary molar teeth either receiving ridge preservation (test group, n = 20) or undergoing spontaneous healing (control group, n = 11) were investigated. Cone-beam computed tomography (CBCT) scanning was performed before the extraction procedure and repeated 6 months later. The mucosa thickness (MT) of the adjacent periodontally compromised molar tooth was measured from CBCT images before tooth extraction and after 6 months of healing at nine assigned measurement points. The data were analyzed at α = 0.05. Results The prevalence of pre-extraction maxillary sinus mucosal thickening was 60.0% and 63.6% in the test and control groups, respectively. The average MT of the thickened sinus mucosa before tooth extraction was 3.78 ± 2.36 mm in the test group and 4.63 ± 3.20 mm in the control group (P = 0.063). The mean mucosal thickening reductions in the thickened MT subjects after 6 months of healing were 2.20 ± 2.05 mm (test group) and 2.64 ± 2.70 mm (control group), P = 0.289. The differences of MT between the time prior to extraction and after 6 months of healing were statistically significant within both groups (P < 0.05). Conclusions Following extraction of molars with severe periodontitis, a reduction in swelling of the Schneiderian membrane has been observed regardless of the addition of a DBBM socket graft. However, a mucosal thickness > 2 mm was still frequently observed.
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Affiliation(s)
- Yiping Wei
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Bo Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China.,Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Gang Yang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Tao Xu
- Department of Emergency, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Wenjie Hu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China.
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, University of Washington, Seattle, WA, USA
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Takalkar S, Girotra C, Kini Y, Padhye M, Tomar G, Acharya S, Gite M. Evaluation of Sexual Dimorphism in Schneider Membrane Thickness Using Cone-Beam Computed Tomography (CBCT) for its Clinical and Forensic Implications. J Maxillofac Oral Surg 2021. [DOI: 10.1007/s12663-021-01531-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Sghaireen MG. Thickening of Schneiderian membrane secondary to periapical lesions: A retrospective radiographic analysis. J Int Soc Prev Community Dent 2020; 10:316-322. [PMID: 32802778 PMCID: PMC7402264 DOI: 10.4103/jispcd.jispcd_101_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 12/18/2022] Open
Abstract
Aim: The aim of this study was to investigate the possible correlation between adjacent periapical lesions of maxillary teeth and Schneiderian membrane thickness (SMT). Materials and Methods: An analytical study of case-control study design was conducted. From the archives, cone beam computed tomography (CBCT) images of 83 patients with periapical lesion in any of the maxillary posterior teeth were randomly selected as the case group. The normal, contralateral teeth in the same patient were considered in the control group. Eighty-eight teeth were considered in each group, comprising a total sample of 176. For each sample in case group, the distance from the border of the periapical lesion to the cortical bone of the bony floor of the maxillary sinus and SMT were measured. SMT on the contralateral side adjacent to the healthy (control) teeth was also measured. Data were presented in mean ± standard deviation and inferential statistics was performed using independent t test and analysis of variance (ANOVA). Later Pearson correlation and multiple linear logistic regression were carried out using Statistical Package for the Social Sciences software program, version 21.0 at 95% confidence interval. Results: Teeth with periapical lesion were found to have significantly (P < 0.001) increased SMT when compared with that of adjacent to healthy teeth. On the contrary, nonsignificant differences were found in SMT when genders and age groups were compared (P = 0.295 and 0.060, respectively). A strong negative correlation was observed between distance of the lesion to the sinus and SMT (P = 0.003). Conclusion: Neighboring periapical lesions of maxillary teeth are associated with SMT that is worsened when the lesion is close to the sinus.
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Affiliation(s)
- Mohammed G Sghaireen
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
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Periapical Lesions and Their Relationship to Schneider's Membrane in Cone-Beam Computed Tomography. Int J Dent 2020; 2020:8450315. [PMID: 32211047 PMCID: PMC7085373 DOI: 10.1155/2020/8450315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/05/2020] [Accepted: 02/13/2020] [Indexed: 11/17/2022] Open
Abstract
Objective To determine the relationship between the height of the periapical lesions adjacent to the maxillary sinus and the thickness of the Schneider membrane evaluated with cone-beam tomography. Materials and Methods. The universe was made up of 2432 tomography scans and a sample of 976, by systematic random sampling, and took into account those that presented any of the variables and/or both. For the relationship analysis, the sample was distributed according to sex, maxillary side, and age; it was formed between 18 and 86 years, in age groups of 18–36 years, 37–48 years, 49–59 years, and 60–86 years. The quantitative variables of the statistic descriptive analysis, hypothesis tests, and Spearman correlation were recorded. Results A significantly low correlation (p < 0.010) was observed between the periapical lesions and the thickness of the Schneider membrane in women (rho = 0.38) and men (rho = 0.32); in the same way, a significantly low correlation was observed in the age groups of 18–36 years (rho = 0.27) and 37–48 years (rho = 0.28), while a significantly moderate correlation was observed in the age groups of 49–59 years (rho = 0.45) and 60–86 years (rho = 0.44), and with respect to the sides, a significantly low correlation (rho = 0.28) was obtained for the right side and a significantly moderate correlation (rho = 0.45) was obtained on the left side. Conclusion We found that the height of the periapical lesions and the thickness of the Schneider membrane are significantly related according to age, sex, and maxillary side, this relationship being accentuated at an older age and on the left side.
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Whyte A, Boeddinghaus R. The maxillary sinus: physiology, development and imaging anatomy. Dentomaxillofac Radiol 2019; 48:20190205. [PMID: 31386556 PMCID: PMC6951102 DOI: 10.1259/dmfr.20190205] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/27/2019] [Accepted: 07/31/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The maxillary sinus is of paramount importance for otolaryngologists, rhinologists, oral and maxillofacial surgeons, head and neck and dental and maxillofacial radiologists. A comprehensive review article concerning the physiology, development and imaging anatomy was undertaken. METHODS Relevant literature pertaining to the physiology of the sinonasal cavity, development of the paranasal sinuses and imaging anatomy of the maxilla and maxillary sinus from 2000 to 2019 was reviewed. Emphasis was placed on literature from the last 5 years. RESULTS Extensive recent research using imaging has provided new insights into the development of the maxillary sinus, the other paranasal sinuses and the midface. The fundamental physiological concept of mucociliary clearance and its role in sinus health is emphasized. The paranasal sinuses are an integral part of a common mucosal organ formed by the upper and lower airway.An in-depth understanding of the soft-tissue and neurovascular relationships of the maxillary sinus to the deep fascial spaces and branches of the trigeminal nerve and external carotid artery respectively is required to evaluate and report imaging involving the maxillary sinus.Sinusitis of rhinogenic, rather than odontogenic origin, originates from nasal inflammation followed by anterior ethmoid disease and secondary obstruction of the ostiomeatal unit. The role of anatomical variants that predispose to this pattern of disease is discussed in detail with illustrative examples.The maxillary sinus is intimately related to the roots of the posterior maxillary teeth; the high frequency of mucosal disease and sinusitis of odontogenic aetiology is now well recognized. In addition, an understanding of the anatomy of the alveolar process, morphology of the alveolar recess of the maxillary sinus and neurovascular supply are essential both for deliberate surgical intervention of the sinus and complications related to oral surgical procedures. CONCLUSIONS An understanding of the fundamental principles of the development, physiology, anatomy and relationships of the maxillary sinus as depicted by multi-modality imaging is essential for radiologists reporting imaging involving the paranasal sinuses and midface.
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