Abstract
BackgroundDuring implant treatment in the maxillary molar area, maxillary sinus floor augmentation is often performed to ameliorate the reduced alveolar bone height attributable to bone remodeling and pneumatization-induced expansion of the maxillary sinus. However, this augmentation may cause complications such as misplaced implants, artery damage, and maxillary sinus mucosal perforation; infections like maxillary sinusitis; and postsurgical complications such as bone graft leakage and postoperative nasal hemorrhaging. To reduce the complications during maxillary sinus floor augmentation and postoperative infections, we performed retrospective investigations of various systemic and local factors that influence pre-operative sinus mucosal thickness (SMT) by using cone-beam computed tomography (CBCT). Subjects included patients who underwent maxillary sinus floor augmentation in an edentulous maxillary molar area with a lateral approach. Pre-operative SMT, existing bone mass, and nasal septum deviation were measured using CBCT images. Relationships between SMT and the following influencing factors were investigated: (1) age, (2) sex, (3) systemic disease, (4) smoking, (5) period after tooth extraction, (6) reason for tooth extraction, (7) residual alveolar bone height (RBH), (8) sinus septa, and (9) nasal septum deviation. Correlations were also investigated for age and RBH (p < 0.05).ResultsWe assessed 35 patients (40 sinuses; 11 male, 24 female). The average patient age was 58.90 ± 9.0 years (males, 57.9 ± 7.7 years; females, 59.9 ± 9.4 years; age range, 41–79 years). The average SMT was 1.09 ± 1.30 mm, incidence of SMT > 2 mm was 25.0%, incidence of SMT < 0.8 mm was 50.0%, and the average RBH was 2.14 ± 1.02 mm. The factors that influenced SMT included sex (p = 0.0078), period after tooth extraction (p = 0.0075), reason for tooth extraction (p = 0.020), sinus septa (p = 0.0076), and nasal septum deviation (p = 0.038).ConclusionsFactors associated with higher SMT included male sex, interval following tooth extraction < 6 months, periapical lesions, sinus septa, and nasal septum deviation. Factors associated with SMT > 2 mm were sex and reason for tooth extraction, while factors associated with SMT < 0.8 mm were time following tooth extraction and nasal septum deviation. Despite the limitations of this study, these preoperative evaluations may be of utmost importance for safely conducting maxillary sinus floor augmentation.
Highlights
During implant treatment in the maxillary molar area, maxillary sinus floor augmentation is often performed to ameliorate the reduced alveolar bone height attributable to bone remodeling and pneumatizationinduced expansion of the maxillary sinus
Nasal septum deviation measurements (Fig. 2) Nasal septal deviation (NSD) was defined as any bending of the nasal septal contour observed on coronal cone-beam computed tomography (CBCT) images, in accordance with the definition proposed by Bhandary and Kamath [18]
In maxillary sinusitis accompanying implant treatment, local inflammation accompanying maxillary sinus floor augmentation procedures may result in interactions among infection, caused by decreased mucociliary functions that conduct maxillary sinus ventilation/discharge, as well as microbes, bacteria, and viruses; and ostium/ ostiomeatal complex occlusion due to nasal/paranasal sinus morphology, all of which result in the onset of acute sinusitis [21]
Summary
During implant treatment in the maxillary molar area, maxillary sinus floor augmentation is often performed to ameliorate the reduced alveolar bone height attributable to bone remodeling and pneumatizationinduced expansion of the maxillary sinus This augmentation may cause complications such as misplaced implants, artery damage, and maxillary sinus mucosal perforation; infections like maxillary sinusitis; and postsurgical complications such as bone graft leakage and postoperative nasal hemorrhaging. Maxillary sinus floor augmentation has often been reported to cause complications during surgery, such as misplaced implants, artery damage, and maxillary sinus mucosal perforation; infections like maxillary sinusitis; and postoperative complications such as bone graft leakage and nasal hemorrhage [5,6,7]. Sinus mucosal perforation was the most frequent complication during surgery, with an incidence of 0–58.3%, whereas maxillary sinusitis was a frequent postoperative complication, with an incidence of 3–20%, and both of these complications were related to a medical history of chronic sinusitis, smoking, and sinus septa, as well as stenosis of the ostiomeatal complex (OMC) due to a deviated nasal septum or concha bullosa [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
