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Journal of Periodontology Jun 2021The 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...
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.
Topics: Arteries; Cone-Beam Computed Tomography; Humans; Maxilla; Maxillary Sinus; Molar; Sinus Floor Augmentation
PubMed: 33107598
DOI: 10.1002/JPER.20-0560 -
Indian Journal of Otolaryngology and... Oct 2022In our study, we aimed to evaluate the risk of skull base perforation during endoscopic sinus surgery in individuals with hypoplasic maxillary sinuses using Cone Beam...
In our study, we aimed to evaluate the risk of skull base perforation during endoscopic sinus surgery in individuals with hypoplasic maxillary sinuses using Cone Beam Computed Tomography (CBCT). We included 52 patients with bilateral maxillary sinus hypoplasia and 52 patients with normal maxillary sinus in the study. Reviewing paranasal CBCT scans, we noted the olfactory fossa depths and lateral lamella lengths of all the groups and compared between the hypoplasia groups and the control group. Compared the maxillary hypoplasia sinus individuals with the control group, both the olfactory fossa depths and the lateral lamina length were different in the maxillary hypoplasic individuals. In individuals with hypoplasic maxillary sinus, the olfactory fossa depth and the lateral lamina length values are higher, which increases the risk of complications in endoscopic sinus surgery.
PubMed: 36452797
DOI: 10.1007/s12070-021-02700-y -
BMJ Case Reports Apr 2021A sinus pneumocele is a rare entity caused by obstruction of a paranasal sinus ostium. It is characterised by dilation and expansion of the sinus, with subsequent bony...
A sinus pneumocele is a rare entity caused by obstruction of a paranasal sinus ostium. It is characterised by dilation and expansion of the sinus, with subsequent bony erosion. The most probable mechanism is air trapping in the paranasal sinus, via a one-way valve mechanism. The case presented concerns a 68-year-old Caucasian man, with recurrent episodes of acute rhinosinusitis. Clinical examination and subsequent imaging of the face, revealed a large pneumocele of the right frontal sinus that significantly eroded the posterior sinus wall. A large mucocele of the right maxillary sinus was also noted, extending to the middle meatus, causing full obstruction of the ostiomeatal complex. Endoscopic sinus surgery was performed, the mucocele was removed and the pneumatisation pathway of the frontal sinus was restored. The patient reports full resolution of symptoms and shows no evidence of recurrence, 6 months postoperatively.
Topics: Aged; Frontal Sinus; Humans; Male; Maxillary Sinus; Mucocele; Neoplasm Recurrence, Local; Paranasal Sinus Diseases
PubMed: 33893136
DOI: 10.1136/bcr-2021-242477 -
Clinical and Experimental Dental... Jun 2022The present study aims to describe the relationship between upper first molar roots and maxillary sinus, for the first time with a truly three-dimensional approach.
OBJECTIVES
The present study aims to describe the relationship between upper first molar roots and maxillary sinus, for the first time with a truly three-dimensional approach.
METHODS
From a retrospective cone-beam computed tomography (CBCT) sample of the upper jaw, a total of 105 upper first molars in contact with maxillary sinus from 74 patients (male 24, female 50, mean age 42) were included in the present study. Segmentation of the upper first molar and maxillary sinus in CBCT was performed utilizing a semiautomatic livewire segmentation tool in MeVisLab v.3.1. The segmentations were analyzed in 3-matic Medical 20.0 for root volume and the contact area between upper first molar roots and maxillary sinus. Analysis of variance test was applied to detect statistically significant differences between the roots.
RESULTS
The palatal root had the largest contact area with maxillary sinus 27.8 ± 21.4 mm (20% of the root area) followed by the mesiobuccal 20.5 ± 17.9 mm (17% of the root area) and distobuccal root 13.7 ± 12 mm (14% of the root area). A significant difference in the contact area of the different roots of the upper first molar was seen.
CONCLUSIONS
This study showed that 70% of the upper first molars were in contact with the maxillary sinus. The palatal root had on average a fifth of its root surface in contact with the sinus, while for mesiobuccal this was a sixth of its root surface and distobuccal roots this was somewhat less. The true 3D relationship could help to better understand maxillary anatomy in relation to occurring pathologies and treatment planning in this area.
Topics: Adult; Cone-Beam Computed Tomography; Female; Humans; Male; Maxillary Sinus; Molar; Retrospective Studies; Tooth Root
PubMed: 35332695
DOI: 10.1002/cre2.561 -
International Journal of Oral Science Jul 2023This study aimed to introduce a minimally invasive technique for maxillary sinus floor elevation using the lateral approach (lSFE) and to determine the factors that...
This study aimed to introduce a minimally invasive technique for maxillary sinus floor elevation using the lateral approach (lSFE) and to determine the factors that influence the stability of the grafted area in the sinus cavity. Thirty patients (30 implants) treated with lSFE using minimally invasive techniques from 2015 to 2019 were included in the study. Five aspects of the implant (central, mesial, distal, buccal, and palatal bone heights [BHs]) were measured using cone-beam computed tomography (CBCT) before implant surgery, immediately after surgery (T0), 6 months after surgery (T1), and at the last follow-up visit (T2). Patients' characteristics were collected. A small bone window (height, (4.40 ± 0.74) mm; length, (6.26 ± 1.03) mm) was prepared. No implant failed during the follow-up period (3.67 ± 1.75) years. Three of the 30 implants exhibited perforations. Changes in BH of the five aspects of implants showed strong correlations with each other and BH decreased dramatically before second-stage surgery. Residual bone height (RBH) did not significantly influence BH changes, whereas smoking status and type of bone graft materials were the potentially influential factors. During the approximate three-year observation period, lSFE with a minimally invasive technique demonstrated high implant survival rate and limited bone reduction in grafted area. In conclusion, lSFE using minimally invasive techniques was a viable treatment option. Patients who were nonsmokers and whose sinus cavity was filled with deproteinized bovine bone mineral (DBBM) had significantly limited bone resorption in grafted area.
Topics: Humans; Animals; Cattle; Maxillary Sinus; Retrospective Studies; Sinus Floor Augmentation; Bone Resorption; Cone-Beam Computed Tomography
PubMed: 37433766
DOI: 10.1038/s41368-023-00233-4 -
Clinical Oral Implants Research Sep 2023To describe the histological events that occur after maxillary sinus floor elevation when the elevated and undetached sinus mucosa are in close proximity or in contact...
AIM
To describe the histological events that occur after maxillary sinus floor elevation when the elevated and undetached sinus mucosa are in close proximity or in contact with each other.
MATERIALS AND METHODS
From 76 rabbits, 152 elevated maxillary sinuses were analyzed histologically. Sites without adhesions were classified as "No proximity," whereas the adhesion stages were divided into "Proximity," "Fusion," and "Synechia stages." The width of the pseudostratified columnar epithelium and the distance between the two layers of the elevated and undetached sinus mucosae were measured at various standardized positions.
RESULTS
Thirty-one sites presenting with adhesions were found. Twelve sites were in the proximity stage," presenting cilia of the two epithelial layers that were shortened and interlinked within the mucous context. Hyperactivity of the goblet cells was also observed. In the other cases, the hyperplastic epithelium showed attempts to reach the contralateral mucosa. The 15 "fusion stage" sites presented regions with epithelial cells of the two mucosal layers that penetrated each other. Four sites presented "synechiae stages," represented by bridges of connective tissue connecting the two lamina propria.
CONCLUSIONS
Close proximity or tight contact between the elevated and undetached mucosa adhering to the bone walls might occur after maxillary sinus floor elevation. This induced hyperplasia of the epithelial cells and adhesion of the two layers until synechiae formation.
Topics: Animals; Rabbits; Maxillary Sinus; Sinus Floor Augmentation; Mucous Membrane; Connective Tissue
PubMed: 37403596
DOI: 10.1111/clr.14123 -
Ear, Nose, & Throat Journal May 2022Antrochoanal polyp is usually a benign solitary mass lesion originated from maxillary sinus mucosa and emerging through maxillary ostium. We report a rare case of...
Antrochoanal polyp is usually a benign solitary mass lesion originated from maxillary sinus mucosa and emerging through maxillary ostium. We report a rare case of antrochoanal polyp and migrated dental implant in the ipsilateral maxillary sinus. Clinicians should be aware that ACP may have other concomitant conditions such as migrated dental implants.
PubMed: 35634654
DOI: 10.1177/01455613221106205 -
International Journal of Implant... Aug 2022This systematic review aimed at assessing the effect of the repositioned bone lid on bone augmentation in lateral sinus lift in pre-clinical in vivo and clinical... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review aimed at assessing the effect of the repositioned bone lid on bone augmentation in lateral sinus lift in pre-clinical in vivo and clinical studies. Secondary aims were to report on the healing of the bone window and to assess the implant survival rate.
MATERIAL AND METHODS
Animal and human studies comparing lateral maxillary sinus floor elevation in combination or not with the repositioned bone lid were retrieved from MEDLINE (PubMed), Web of Science and Cochrane online library. Studies published in English up to April 2022 and reporting on histological and/or radiographic outcomes were considered. Case reports, case series and reviews were excluded. A hand search was also conducted. Risk of bias was assessed and meta-analysis performed to investigate the effect of the bone lid on new bone formation.
RESULTS
After screening, 5 animal studies (4 in rabbits, 1 in sheep) and 2 clinical studies (1 RCT, 1 case-control) were included. Meta-analysis confirmed a higher new bone formation in rabbits at 2 and 8 weeks using the bone lid. The two clinical studies investigated lateral sinus lift with concomitant implant placement and reported similar results and high short-term implant success rate in both test and control groups.
CONCLUSIONS
The meta-analysis provided moderate evidence that the repositioned bone lid favored the formation of new bone to a higher extent as compared to resorbable membranes in animal studies. Implant success seems not to be influenced by the technique in the short term.
Topics: Animals; Dental Implantation, Endosseous; Humans; Maxilla; Maxillary Sinus; Rabbits; Sheep; Sinus Floor Augmentation; Transverse Sinuses
PubMed: 36036281
DOI: 10.1186/s40729-022-00433-3 -
Diagnostics (Basel, Switzerland) Sep 2023CBCT significantly impacts dental procedures and has brought significant reforms to our approach to diagnosis and treatment planning despite its limitations in...
CBCT significantly impacts dental procedures and has brought significant reforms to our approach to diagnosis and treatment planning despite its limitations in differentiating soft tissues. It is an excellent imaging modality and quickly identifies sinus opacification and provides valuable insight into paranasal sinus pathologies, with considerably lower radiation exposure. The present study aimed to investigate the occurrence of maxillary sinus abnormalities in CBCT scans, identify the frequency, type, and location of these findings, and find the correlation between the distance of periapical lesions and radiographic changes in the maxillary sinus. Two examiners independently evaluated 117 patients to diagnose and classify the cases into different abnormality subtypes. The periapical lesions most closely related to the sinus were recorded. The diameters of the left and right maxillary sinus ostium and the distance of the ostium's lower border to the sinus's osseous floor were recorded. The findings were correlated with the age and gender of these patients. The present study reveals that sixty-one patients were diagnosed with mucosal thickening (52.1%). The sinus wall most affected by mucosal thickening was the maxillary sinus floor, followed by the medial and lateral walls. Of 19 patients with periapical lesions, 15 had maxillary sinus mucosal thickening, which is statistically significant ( = 0.004). The high occurrence of abnormalities in the maxillary sinus emphasizes the importance for the radiologist to comprehensively interpret the whole volume acquired in CBCT images, including the entire sinus. Incidental findings may be considered in the individual clinical context of signs and symptoms, reducing the risk of overestimating the real impact of radiographic findings.
PubMed: 37761284
DOI: 10.3390/diagnostics13182918 -
International Journal of Implant... Apr 2022Tooth extraction and the projection of the tooth roots into the maxillary sinus are reported to greatly reduce the bone height from the alveolar ridge to the maxillary...
PURPOSE
Tooth extraction and the projection of the tooth roots into the maxillary sinus are reported to greatly reduce the bone height from the alveolar ridge to the maxillary sinus floor, while missing teeth are reported to lead to the expansion of the maxillary sinus, all of which are important considerations during dental implant treatment for the maxillary molar region. Therefore, assessing the anatomical characteristics of the maxillary sinus acting as complicating factors is crucial before sinus augmentation. We conducted a three-dimensional examination of the effects of missing teeth and nasal septal deviation (NSD) on maxillary sinus volume (MSV).
METHODS
We selected participants with two or more missing teeth from patients who underwent maxillary sinus augmentation for a unilateral free-end saddle between April 2019 and December 2020. We calculated the MSV and NSD using cone-beam computed tomography (CBCT). We compared the relationships of the presence/absence of teeth and NSD with MSV bilaterally in each patient using the Wilcoxon t-test. p-values < 0.05 denoted statistical significance.
RESULTS
This study included 30 patients (30 sinuses; 12 men, 18 women). The average patient age was 58.2 ± 10.2 years (men, 60.4 ± 3.7 years; women, 59.2 ± 4.5 years; range, 40-77 years). The mean number of missing teeth was 2.98 ± 1.01: 13 patients had two missing teeth and 17 had three or more missing teeth. Nine patients (30%) had NSD. The mean MSV on the ipsilateral and contralateral sides of the NSD was 21.50 ± 3.84 cm and 22.10 ± 3.56 cm, respectively; thus, NSD did not affect MSV (p = 0.150). The mean MSV on the edentulous and non-edentulous sides was 21.58 ± 3.89 cm and 21.77 ± 4.30 cm, respectively; thus, the MSV was significantly smaller on the edentulous side (p = 0.00036).
CONCLUSION
Although this study was a limited preoperative study, three-dimensional measurement of the maxillary sinus with CBCT in partially edentulous patients revealed that missing teeth lead to substantial reductions in MSV, while NSD was not associated with MSV.
Topics: Adult; Aged; Anodontia; Cone-Beam Computed Tomography; Female; Humans; Male; Maxillary Sinus; Middle Aged; Mouth, Edentulous; Pilot Projects; Sinus Floor Augmentation; Tooth Loss
PubMed: 35428947
DOI: 10.1186/s40729-022-00415-5