Cone beam computed tomographic evaluation of the maxillary sinus septa and location of blood vessels at the lateral maxillary sinus wall in a sample of the Singaporean population

Abstract

ObjectivesThe purpose of the study was to retrospectively investigate the prevalence, location, orientation, origin and height of the maxillary sinus septa as well as the location of anastomosis (of the infra-orbital artery and posterior superior alveolar artery) from the alveolar crest in a sample population of Singapore. MethodsThe study was done through the retrospective analysis of cone beam computed tomography (CBCT) images of 224 maxillary sinuses in 139 patients. ResultsThe prevalence of septa was 38.3% in this study. Septa formation was most commonly seen at the anterior region (i.e. first and second premolar), followed by the posterior (third molar) and middle region (first and second molar). 93% of the septa demonstrated a bucco-lingual orientation. 61.6% of septa were found to be primary septa i.e. located above root apices of maxillary teeth whereas 38.4% of septa were secondary septa i.e. located above an edentulous span. The mean height of the septa was 5.95mm.The intra-osseous anastomosis between the infra-orbital artery and posterior superior alveolar artery was visible on the coronal view of 100 (45%) maxillary sinuses and the mean height of the intra-osseous anastomosis from the alveolar crest was 17.8mm. ConclusionTo prevent the occurrence of complications, it is vital to have sufficient pre-operative knowledge of the possible anatomic structures present in the maxillary sinus. Having pre-operative CBCT imaging prior to sinus augmentation is advantageous as it allows for accurate assessment for the presence of septa or other anatomic irregularities that may complicate the surgery.