Three-Dimensional Evaluation of Maxillary Sinus Septa for Implant Placement

Research trends on maxillary sinus septa in 2019-2021: a scoping review with scientometric analysis

PURPOSE

This study aimed to conduct a bibliometric analysis of trends in the description items within the literature published from 2019 to 2021 with "maxillary sinus septum" in the title or subtitle.

METHODS

Electronic data from PubMed (MEDLINE), Google Scholar, and ScienceDirect were searched from 2019 to 2021. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) to select 21 of 243 articles and examined their studies. Statistical calculations from data recorded by the authors were performed using the Chi-square, Mann-Whitney, and independent tests. Significance was set at P < 0.05.

RESULTS

The number of articles decreased annually. The highest number of publications was from Asia (64.3%), accounting for 71.4% of publications. The features of the septum were described for eight items, with one septum (70.14%) mentioned significantly more frequently, followed by on one side (65.89%) or the right side (62.22%). Location was mentioned significantly more frequently in the middle (55.22%) and for those aged 45 years and older (50.38%). No significant differences were observed in prevalence, age, height, or width between sexes; the patients' ages ranged from 18 to 90 years. Septa were significantly more prevalent in dentulous (45.38%) and partially edentulous (48.58%) patients, with significantly more patients exhibiting buccopalatal orientation (82.39%).

CONCLUSIONS

This study focused primarily on anatomical features using CBCT examination, and analyses of male-female differences and the origin of the sinus septum are necessary for the future.

Le Fort I Osteotomy Complicated by Presence of Maxillary Sinus Septa

ABSTRACT

Presence of maxillary sinus septa, an anatomical variant, has never been documented as a possible complication of Le Fort I orthognathic surgery procedure. This case report describes the difficulty faced by an experienced surgeon during Le Fort I down-fracture procedure. The osteotomized maxilla remained firm despite confirmation that all osteotomy cuts have been performed adequately. The presence of a bilateral sagittally oriented maxillary sinus septa extending from the floor to the roof of the sinus in this case had prevented separation of the lower maxilla during down-fracture maneuver. Such normal anatomical variant must be identified during orthognathic surgery treatment planning session to avoid grave complications.

Prevalence and characterization of maxillary sinus septa in a brazilian population

Background

The aim of this study was to assess the anatomic aspects of the maxillary sinus septa, by means of computed tomography images, in a Brazilian population. The results might be of clinical significance in sinus lift surgery planning.

Material and Methods

In the study, 123 computed tomographs obtained from a private radiology clinic were used. They were analyzed by a single, trained and calibrated observer in order to evaluate the presence, quantity, localizations, dimensions, orientations and different characteristics in dentate, partially edentulous and completely edentulous individuals of the sinus septa.

Results

Of the individuals analyzed, 26% had a septum in the maxillary sinus, with 59.6% being classified as complete, 44.2% showed prevalence for the middle region of the maxillary sinus. There was no statistically significant difference between the right and left sides (p>0.05).

Conclusions

The majority of patients in the sample analyzed presented to septa in the maxillary sinuses, and when septa were present, a higher number of occurrence was noted in the middle region of the maxillary sinus. (This region is normally the choice of sinus lift surgery). There was no predilection relative to age, sex and type of dentition.

Key words:Multislice computed tomography, maxillary antrum, anatomic variation.

[Topography of maxillary sinus septa according to cone beam computed tomography data]

The aim of the study was to establish the location, orientation and height of the maxillary sinus primary septa. The data of 100 cone-beam computed tomography scans of patients with a mean age of 37.6±15.4 years from dental outpatient hospitals of Minsk, Belarus taken from 2012 to 2019 were analyzed. The prevalence of sinus septa was 45.6% for sinuses and 37.2% for patients. As a rule, septa were symmetric bilaterally. The heights of septa varied from 2-3 mm to 8-14 mm in the majority of cases. Orientation of septa was coronal in 94.7%, sagittal in 3.9%, and horizontal in 1.4% of cases. The location of the septa must be considered when planning for dental implants. In addition, septa in the upper and posterior regions of the maxillary sinus may interfere with mucociliary clearance.

Evaluation of maxillary sinus anatomical variations and lesions: A retrospective analysis using cone beam computed tomography

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.

Anatomical characteristics of maxillary sinus septa visualized by cone beam computed tomography

Proper implant positioning in the posterior region of the edentulous maxilla commonly requires sinus floor elevation. Maxillary sinus septa increase the risk of membrane perforation during sinus floor elevation. The purpose of this retrospective, cone beam computed tomography (CBCT)-based study was to examine the frequency, number, location, and orientation of antral septa in the maxillary sinus. Further, possible associated factors were assessed. Measurements were performed on CBCT scans of 301 patients (602 sinuses). The data were analysed statistically with respect to patient age, sex, and dentition type. One or more septa were detected in 117 patients (38.9%). A total of 188 septa were found in the 602 sinuses (31.2%). Septa were most often coronally oriented (53.2%), followed by sagittal (24.5%) and transverse (22.3%) orientations. Septa were most often found in the region of the first and second molar (37.2%), followed by the posterior region of the third molar (33.0%) and the anterior region of the premolars and canines (29.8%). A significant association was found between edentulism and the presence of septa. For edentulous patients, the septa were most often transversally oriented. Maxillary sinus septa are encountered in every third patient. This may have an influence on the performance of sinus floor elevation.

Three-dimensional CAD/CAM imaging of the maxillary sinus in ageing process

OBJECTIVES

During the physiological ageing process atrophy of the alveolar bone appears in vertical direction. This bone resorption causes pushing the limits of the maxillary sinus at the expense of a degraded bone. The sinus volume increases due to the facial development in children and adolescents or during the ageing process due to the loss of teeth and bone mass. The main aim of this study is to determine the sinus shape and sinus floor morphology related to age.

MATERIALS AND METHODS

Human adult male and female cadaveric heads (aged 37 to 83 years) with different dental status were used. The three-dimensional CAD/CAM software was used to scan the solid impressions of the maxillary sinus to visualize the real sinus shape and sinus floor. Subsequently, other findings are shown in tables and evaluated graphically.

RESULTS

The maxillary sinus morphology, its relationship to the nasal cavity, the sub sinus alveolar bone height, displacement of the lowest and highest points of sinus, and the sinus relationship to the roots of the upper teeth were studied and evaluated. Some septa, crests, and the prominent infraorbital canal were also found in the area of the sinus floor.

CONCLUSIONS

This paper provides a unique view on the maxillary sinus and its changes during the ageing process with preserved topographical relations in a representative sample of the Slovak population. The visualization of the maxillary sinus anatomy is necessary in the diagnosis and treatment plans for dental implants and during current surgical procedures.