Abstract
BackgroundAlthough mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized that mucosal thickening would not alter the predictability for sinus floor augmentation and dental implant placement. The purpose of this retrospective study was to evaluate the outcomes of dental implant placement in sinus-augmented areas with preexisting sinus mucosal thickening.MethodsThis study involved the review of cone-beam computed tomographic (CBCT) scans taken on patients that underwent both maxillary sinus elevation with grafting and implant placement at the University of Michigan School of Dentistry from 2004 to 2014. Cases with documented radiographic and clinical follow-up were included. The data analyses revealed the following.ResultsA total of 29 CBCT scans met the inclusion criteria for evaluation, and 93.1% of them had maxillary sinus mucosal/tissue thickening. Specifically, 6.9% of cases exhibited no thickening, 6.9% had minimal thickening (1–2 mm), 20.7% of cases had moderate thickening (2–5 mm), and 65.5% had severe thickening (>5 mm). We propose these categorical measurements of tissue thickening as a new “mucosal thickening index.” The tissue thickening did not vary based on gender, age, or smoking status, nor did it relate to the underlying alveolar ridge height. However, patients with a history of periodontal diseases demonstrated a significant association with mucosal thickening (p = 0.0043). These data indicate that there is high implant and grafting success rate (100%) in the maxillary sinus despite large and varied physiologic sinus mucosal/tissue thickening.ConclusionsBased on study findings, this research will help guide dental practitioners regarding cases that exhibit mucosal thickening. These data support the concept that physiologic mucosal thickening in varied ranges is not associated with implant or grafting failure in the maxillary sinus.
Highlights
Mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited
Study design Our study hypothesis was that mucosal thickening of more than 2 mm and up to 1/3 of the volume of the sinus would not alter the predictability for sinus floor elevation (SFE) and dental implant placement
This study consisted of performing a retrospective analysis of cone-beam computed tomographic (CBCT) scans taken with a CBCT machine (i-CAT Cone-Beam Computed Tomography machine, Imaging Sciences International, Hatfield, PA) for patients that underwent both maxillary sinus elevation with grafting and implant placement at the University of Michigan School of Dentistry from 2004 to 2014
Summary
Mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized that mucosal thickening would not alter the predictability for sinus floor augmentation and dental implant placement. Despite the high survival rate of dental implants inserted in maxillary sinuses that have undergone sinus floor elevation (SFE) with bone grafting, complications still occur [1,2,3]. Postoperative maxillary sinusitis is less common (0–22%) [6, 7]; it could potentially compromise the outcome of SFE and affect the overall well-being of the patient [8]. Various cyst-like pathologies can be found in the maxillary sinus, including a pseudocyst and a surgical ciliated cyst [13]. Pseudocysts are diagnosed as dome-shaped, noncorticated soft tissue opacities with a well-defined border in the maxillary sinus [16]
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