Abstract
The objective of this study was to analyze three-dimensionally the morphological characteristics of the pterygomaxillary region related to pterygoid implants. Volume, height, width and bone density were studied in relation to age, sex and dental status. This retrospective observational study analyzed the CBCT of 52 hemi-maxillas three-dimensionally (females n = 28, males n = 24; dentate = 31, edentulous = 21). Patients were exposed between September 2009 and October 2014, and data collection was performed between November 2015 and May 2016. Bone density, volume, height and width were analyzed in various locations of the maxilla and pterygoid process, and the variables age, gender and dental status patients were compared. The results show that the mean width of the pterygomaxillary joint was 7.5 mm (SD 1.00 mm), mean height was 12.51 mm (SD 1,82 mm) and mean volume was 321.7 mm3 (SD 142.02 mm3). Statistically significant differences between dentate and edentulous patients were found, showing a higher osseous density in dentate patients in the pterygoid process (758.2, SD 106.8, 95% CI 729.2 to 787.3 GSD - Gray Scale Density - compared to 689.9, SD 107.3, 95% CI 660.8 to 719.1 GSD; P = 0.022). In the maxilla, density was statistically significant lower in female subjects (571.0, SD 74.1, 95% CI 594.9 to 645.4 GSD) than in male subjects (620.2, SD 93.8, 95% CI 594.4 to 645.4 GSD, P = 0.047). In conclusion, due to the significant variation in the morphological characteristics of the pterygomaxillary region among subjects, personalized pre-surgical radiological assessment should always be performed. Gender, age and dental status are critical factors as they significantly affect bone density in this region.
Highlights
The objective of this study was to analyze three-dimensionally the morphological characteristics of the pterygomaxillary region related to pterygoid implants
One study did not found statistically significant differences when comparing genders[5], while other assures that female subjects had significantly denser bone compared with male subjects[6]
This research shows three critical factors affect osseous density locally: gender, age and dental status
Summary
The objective of this study was to analyze three-dimensionally the morphological characteristics of the pterygomaxillary region related to pterygoid implants. Height, width and bone density were studied in relation to age, sex and dental status. This retrospective observational study analyzed the CBCT of 52 hemi-maxillas three-dimensionally (females n = 28, males n = 24; dentate = 31, edentulous = 21). Volume, height and width were analyzed in various locations of the maxilla and pterygoid process, and the variables age, gender and dental status patients were compared. The placement of implants in the posterior maxilla can become a challenge due to, among other factors, the poor osseous quantity and quality of the maxillary tuberosity[2], and it has been demonstrated that implants have a higher propensity to fail under conditions of low-density bone[3]. There are other authors who believe that none important anatomical structure can be injured during the placement of these implants[12,13]
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