A Replicable and Reproducible Digital Method for Quantifying Maxillary Sinus Airway Changes after Sinus Lifts Using the Lateral Window Approach Technique-A Retrospective Study.

Héctor González Menéndez,Pilar Velasco Bohórquez,Paulina Rodríguez Torres,Agustín Galparsoro Catalán,Blanca Muñoz Jiménez,Sofía Hernández Montero,Álvaro Zubizarreta Macho,Lara San Hipólito Marín,Georgia Tzironi

doi:10.3390/jpm11111093

Héctor González Menéndez, Pilar Velasco Bohórquez + Show 7 more

Open Access

https://doi.org/10.3390/jpm11111093

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Abstract

In the present retrospective study, we aimed to assess the replicability and reproducibility of a novel digital measurement technique for analyzing the volumes of the left and right maxillary sinuses and the nasal and maxillary sinus airway complex after a sinus lift procedure using the lateral window approach, to provide an accurate measurement technique for easily applying in clinical practice and to allow pre-operative assessment of maxillary sinus lift surgery, avoiding complications and making surgery more predictable. Material and Methods: Thirty patients with partially edentulous posterior maxilla were selected and submitted to bilateral sinus lift using the lateral window approach technique, with grafting materials selected and submitted to cone beam computed tomography (CBCT) scans, both pre- and postoperatively. Then, datasets were uploaded to therapeutic digital planning software to measure the volume of the right and left maxillary sinuses and the nasal and maxillary sinus airway complex. Gage R&R statistical analysis was performed to assess the replicability and reproducibility of the digital measurement technique. Results: The variability attributable to the novel digital measurement technique was 3.4% for replicability and 3.4% for reproducibility of the total variability of the samples. Conclusion: The novel digital method proposed is a replicable and reproducible technique for analyzing the volume of the right and left maxillary sinuses and the nasal and maxillary sinus airway complex after a sinus lift using the lateral window approach technique, allowing an accurate pre-operative assessment of maxillary sinus lift surgery, avoiding complications and making surgery more predictable.

Highlights

The first upper molar has the highest rates of cavities and periodontal disease, followed by the third upper molar and upper premolars
Dental extractions can cause the bone tissues to undergo volumetric changes characterized by the resorption of the alveolar process and the pneumatization of the maxillary sinus— in the upper jaw, due to the centripetal bone resorption pattern—decreasing bone availability and complicating the rehabilitation of edentulous patients using dental implants [2]
The results showed a volume reduction in both maxillary sinuses, as well as in the nasal and maxillary sinus airway complex, after a sinus lift using the lateral window approach technique and a novel digital measurement method to quantify the maxillary sinus volume changes with an accurate, replicable, and reproducible approach

Summary

Introduction

The first upper molar has the highest rates of cavities and periodontal disease, followed by the third upper molar and upper premolars. These conditions can lead to premature tooth loss [1]. The presence of the maxillary sinus in the posterior upper maxilla limits bone availability and inhibits dental implant placement for rehabilitation of posterior edentulism [3]. Bone augmentation procedures are an option for increasing bone availability and enabling the placement of dental implants, including grafting procedures, apposition grafts (with or without Le Fort I osteotomies), short dental implants, and sinus lifts. Sinus lifts involve a bone augmentation procedure that necessitates a maxillary sinus approach, which is the largest cavity of the paranasal sinuses with average measurements of 40 mm height, 20 mm length, 30 mm depth [4], and a mean volume of 11.3 ± 4.60 cm3 [5]

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