Maxillary Sinus Mucosal Thickening Research Articles

Association between maxillary sinus floor perforation by dental implants and mucosal thickening: A cone-beam computed tomography study

ObjectiveTo investigate the association of perforation of the maxillary sinus floor by dental implants with mucosal thickening and to describe its characteristics in perforated cases. Study designOne-hundred and twenty-nine maxillary sinuses of 93 patients presenting 202 dental implants in the maxillary posterior region were retrospectively assessed in cone-beam computed tomography scans and classified according to maxillary sinus perforation, bone graft, mucosal thickening, and mucosal appearance. Logistic regression determined the chance of mucosal thickening in perforated maxillary sinuses. The chi-square test compared categorical variables between maxillary sinus perforated or not by implants and maxillary sinus with or without mucosal thickening. The significance level assumed was 5 % (α = 0.05). ResultsThere was perforation of 60 maxillary sinuses floor (46.5 %) by 74 dental implants. The chance of mucosal thickening was higher when the implant tip was trespassing on the maxillary sinus floor (p < 0.001). There was a significant association between maxillary sinus mucosal thickening and perforation by a dental implant with the tip trespassing the maxillary sinus floor (p < 0.05). ConclusionMaxillary sinus mucosal thickening is associated with sinus floor perforation by dental implants and does not depend on the number of implants perforating it. Clinical relevanceThere is an association between dental implants’ perforation of the maxillary sinus floor and the thickening of the maxillary sinus. In those cases, the appearance of the mucosa thickening may be irregular, local, or total opacification of the sinus cavity.

Multilevel Modeling Analysis of Odontogenic Risk Factors and Nasal Septum Deviation Associated with Maxillary Sinus Mucosal Thickening: A Cone-Beam Computed Tomography Study.

(1) Background: In this study, the impact of odontogenic risk factors with nasal septum deviation on maxillary sinus mucosal thickening was assessed using Cone-beam computed tomography CBCT. (2) Methods: A total of 328 maxillary sinus regions from 164 patients (85 males and 79 females) were examined. Images were interpreted by dental specialists and Otolaryngologists. Coronal and sagittal sections were examined to assess the proximity of the root tips of posterior maxillary teeth (RPMT) to the maxillary sinus. The periodontal bone loss for all maxillary posterior teeth was also assessed. Consequently, maxillary sinus mucosal thickening (MT) was further classified into three gradings. Multilevel modeling regression analysis was used due to the hierarchical structuring of the data. Four models were developed, a null model with no factors, a model with tooth-level factors (RPMT, PBL, tooth condition, and root length), a model with patient-level factors (gender and nasal septum deviation), and a model with combined patient- and tooth-level factors. Regression estimates (AOR) and 95% confidence intervals (CIs) of individual and tooth factors were calculated. (3) Results: Multilevel regression analysis showed that RPMT was significantly associated with MT of maxillary sinus (p < 0.001), where patients who had RPMT > 0 had higher odds of MT of maxillary sinus. Tooth condition was also found to be significantly associated with MT of maxillary sinus, where teeth with failed RCT (p < 0.001) and teeth with restorations (p < 0.008) had higher odds of MT of maxillary sinus (AOR = 2.87, 95%CI 1.65, 4.42, AOR = 1.64, 95%CI 1.14, 2.36, respectively). (4) Conclusions: In order to plan preoperative treatment for maxillary posterior teeth, it is important to assess the anatomical relationship between the sinus floor and the root tips of the maxillary posterior teeth. Additionally, we establish a better understanding of the clinician before surgical intervention is conducted.

Periodontal Lesions among Maxillary Sinus Mucosal Thickening Visiting the Department of Oral Medicine and Radiology of a Tertiary Care Centre.

Maxillary sinus due to its proximity to posterior maxillary teeth could be affected by their pathology. Since cone beam computed tomography is the go-to for 3-D imaging in dental set-up. This study aimed to find out the prevalence of periodontal lesions among maxillary sinus mucosal thickening visiting the Department of Oral Medicine and Radiology of a tertiary care centre. This descriptive cross-sectional study was conducted in the Department of Oral Medicine and Radiology of a tertiary care centre from 01 February 2021 to 30 June 2021 after obtaining ethical approval from the Institutional Review Committee. The medical records from 01 January 2019 to 31 December 2019 were retrieved. The identification of maxillary sinus mucosal thickening of more than 3 mm, in cone beam computed tomography images, was registered separately for the right and left sinuses of each patient. The presence of periodontal lesions of posterior teeth was recorded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 195 maxillary sinus mucosal thickening, periodontal lesions were found in 74 (37.95%) (31.14-44.76, 95% Confidence Interval) maxillary sinuses of 46 patients. The mean age was 53.67±12.72 years and 30 (65.21%) were males. The prevalence of periodontal lesions among maxillary sinus mucosal thickening in CBCT images was similar to other studies done in similar settings. cone beam computed tomography; maxillary sinus; periodontal disease; prevalence.

Pathogenic factors of maxillary sinus mucosal thickening observed by cone-beam computed tomography (CBCT)

ObjectiveTo explore the pathogenic factors associated with maxillary sinus mucosal thickening with Cone-beam computed Tomography (CBCT). MethodsFrom 2016 through 2020, 93 patients with periapical periodontitis or periodontitis in the maxillary posterior dental region were selected. ResultsThe preoperative thickness of the periodontitis group was significantly higher than that of the periapical periodontitis group (P < 0.05). The difference achieves statistical significance for the comparison of the thickness change with various severity of inflammation (F = 54.824, P = 0.000), the change with time (F = 312.741, P = 0.000). and the change with the interaction severity of inflammation and time（F = 86.132, P = 0.000). ConclusionsPatients with maxillary sinus mucosa thickening caused by periodontitis and periapical periodontitis should be extracted their infectious teeth and get thoroughly debridement. Maxillary sinus augmentation can perform favorable efforts 3–6 months after extracting teeth.

Utilizing a Novel AI Tool to Detect the Posterior Superior Alveolar Artery's Location's Impact on Maxillary Sinus Mucosal Thickening in the Presence of Periapical Lesions.

Periapical lesions have been implicated in sinus-related complications, but the precise influence of anatomical variations in the posterior superior alveolar artery (PSAA) on mucosal thickening remains an uncharted aspect. The new AI tool employed in this research utilizes advanced image processing algorithms to enhance image visualization. Background and Objectives: This study examines the accuracy of a new cone beam computed tomography (CBCT) software (eVol DXS, version 1.0.1.0) employing AI to detect the PSAA's location and the effect of that on maxillary sinus thickening in the presence of periapical lesions. Materials and Methods: This retrospective study included 120 CBCT cases with posterior maxillary periapical lesions and 120 without odontogenic infections. Teeth with proximity (<2 mm) to the sinus were excluded in both groups to eliminate the sinus floor's perforation effect. Both the PSAA locations and maxillary sinus thickening were classified and compared. Results: The mucosal thickening differs significantly (p < 0.001) between the study group and the control group. The study showed that an increased sinus thickness occurred when the PSAA was beneath the sinus membrane in the study group (62.5% compared to 8.6%; p < 0.001 *). The AI tool helped to achieve a 100% identification rate in determining the PSAA locations. Conclusions: AI algorithms for PSAA localization, which affects mucosal thickness in response to periapical lesions, yield excellent results.

Inflammatory Modifications in Paranasal Sinuses and Ostiomeatal Complex Anatomical Variations in Jet Aircraft Pilots: A Computed Tomography Study.

Introduction Jet aircraft pilots are exposed to huge pressure variation during flight, which affect physiological functions as systems, such as the respiratory system. Objectives The objective of the present investigation was to evaluate inflammatory changes of paranasal sinuses of jet aircraft pilots before and after a jet aircraft training program, using multislice computed tomography (CT), in comparison with a group of nonairborne individuals with the same age, sex, and physical health conditions. A second objective of the present study was to assess the association between the ostiomeatal complex obstruction and its anatomical variations. Methods The study group consisted of 15 jet aircraft pilots participating in the training program. The control group consisted of 41 nonairborne young adults. The 15 fighter pilots were evaluated before initiating the training program and after their final approval for the presence of inflammatory paranasal sinus disease. The ostiomeatal complex anatomical variations and obstructions were analyzed in pilots after the training program. Results Jet aircraft pilots presented higher incidence of mucosal thickening in maxillary sinus and anterior ethmoid cells than controls. Prominent ethmoidal bulla showed significant association with obstruction of the osteomeatal complex. Conclusions Jet aircraft pilots present increased inflammatory disease when compared with nonairborne individuals. The presence of a prominent ethmoidal bulla is associated with ostiomeatal complex obstruction.

Prevalence and Correlation of Concha Bullosa and Nasal Septal Deviation with Maxillary Sinus Mucosal Thickening Using Cone-Beam Computed Tomography

Background: This study aimed to assess the prevalence and correlation of Concha Bullosa (CB) and Nasal Septal Deviation (NSD) with maxillary sinus Mucosal Thickening (MT) using Cone-Beam Computed Tomography (CBCT).&#x0D; Methods: This descriptive, cross-sectional study was conducted on CBCT scans of 228 females and 157 males (mean age of 44.82±15.10 years) retrieved from the archives of the Radiology Department of Shahid Beheshti Dental School. The images were evaluated by one oral and maxillofacial radiologist for presence/absence of NSD, CB, and maxillary sinus MT, and their correlations. Statistical analyses were performed by independent t-test, Chi-square test, and binomial test (alpha=0.05).&#x0D; Results: The prevalence of CB, NSD, and MT was 61.6, 80, and 70.6%, respectively. NSD (p=0.131) and CB (p=0.211) had no significant correlation with MT. However, CB and NSD were significantly correlated (p=0.006). NSD had a significant correlation with contralateral presence of CB as well (p=0.000). The prevalence of CB was significantly higher in females (p&lt;0.05), while the prevalence of NSD and MT was significantly higher in males (p&lt;0.05).&#x0D; Conclusion: The present study revealed no significant correlation between CB and NSD with maxillary sinus MT. Thus, in absence of clinical symptoms, patients with CB or NSD should not be necessarily referred for treatment of sinus abnormalities. However, considering the significant correlation of CB and NSD, in case of presence of one entity, the other one should be suspected.

Evaluation of Association between Maxillary Posterior Teeth Periapical Pathologies and Maxillary Sinus Mucosal Changes—A Cone-Beam Computed Tomography (CBCT) Study

Abstract Introduction Odontogenic infections are one of the common causes of maxillary sinusitis. With the close proximity of the roots of maxillary posterior teeth to the sinus floor, the infection may spread into the sinus causing sinus mucosal thickening. This study aims to evaluate the association between maxillary posterior teeth periapical pathologies and maxillary sinus mucosal changes using cone-beam computed tomography (CBCT) images. Methods One-hundred six maxillary posterior teeth with periapical lesions were included in this study and were assessed using CBCT images by two maxillofacial radiologists. The proximity of the roots to the sinus floor, the proximity of the top edge of the periapical lesion to the sinus floor, and the sinus mucosal changes associated with the periapical lesions were studied. The size of the periapical lesion was measured and scored using CBCT periapical index. Mucosal thickening more than 2 mm was considered pathological and the type, pattern, and severity of mucosal thickening were assessed. Data were analyzed using chi-squared tests at a level of significance set at p-value less than 0.05. Results Among the 106 teeth with periapical lesions, 99 teeth (93.4%) revealed the presence of maxillary sinus mucosal thickening. The prevalence of mucosal thickening increased significantly with the presence of cortical bone destruction, the close proximity of the root, and the periapical lesion to the sinus floor. The generalized type of mucosal thickening was more prevalent with larger periapical lesions and a significant increase in the severity of the thickening was observed closer spatial relationship of the root to the sinus floor. Conclusion Periapical pathologies of maxillary posterior teeth often cause sinus mucosal thickening. The early diagnosis and management of these pathologies will be helpful in preventing the spread of infection into the maxillary sinus.

Maxillary sinus volume and adenoid tissue size in children: computed tomographic evaluation

Abstract OBJECTIVES. Adenoid hypertrophy is related to obstructive sleep apnea syndrome (OSAS). In this study, we investigated the relationship between adenoid tissue size and maxillary sinus volumes by examining the paranasal sinus computed tomography (PNSCT) images. MATERIAL AND METHODS. PNSCT images of 41 children were included in this study. According to the adenoid/nasopharynx (A/NP) ratio, two groups were identified. Group 1 (n=19, 9 males and 10 females): A/NP≤0.50 and Group 2 (n=22, 16 males and 6 females): A/NP&gt;0.50. The following measurements were performed: adenoid width, NP width, A/NP ratio, air column, soft palate, maxillary sinus volume and mucosal thickening. RESULTS. Adenoid width of group 2 (16.11±2.26 mm) was higher than that of group 1 (10.97±2.26 mm). In group 2, with an A/NP ratio of 0.61±0.07, the air column value (6.30±2.27 mm) was lower than that of group 1 with an A/NP ratio of 0.40±0.07 (air column value: 10.06±3.78 mm). NP width, soft palate and maxillary sinus volumes were not different between groups 1 and 2. As the adenoid width increased, the A/NP ratio increased, and the air column decreased. CONCLUSION. The increase of the A/NP ratio was related to the decreased air column. In older children, air column and bilateral maxillary sinus volumes increased. In males, the adenoid width value was larger than that in females. There was no significant relationship between A/NP ratio and maxillary sinus volume or NP width values. However, higher A/NP ratio values were related to lower air column measurements.

Change in Maxillary Sinus Mucosal Thickness in Patients with Preoperative Maxillary Sinus Mucosal Thickening as Assessed by Otolaryngologists: A Retrospective Study.

Background and Objectives: Maxillary sinus pathologic conditions may increase the risk of complications during posterior maxillary sinus augmentation surgery. The purpose of this study was to evaluate the changes in participants with preoperative maxillary sinus mucosal thickening and to assess this factor as a preoperative risk indicator for sinusitis after maxillary dental implantation. Materials and Methods: We compared the preoperative and postoperative maxillary sinus mucosal thickness (MSMT), the distance between the maxillary sinus ostium and sinus floor (MOD), and the MSMT/MOD ratio. The participants were divided into three groups (sinus augmentation, bone grafting, and no grafting). Results: The mean preoperative MSMT was 4.3 ± 2.0 mm, and the mean MSMT/MOD ratio was 0.13 ± 0.05. No postoperative sinusitis was observed in these patients, including cases caused by anatomical variations. The mean postoperative MSMT was 4.5 ± 2.3 mm, and the mean postoperative MSMT/MOD ratio was 0.15 ± 0.06. There was no statistically significant difference between the groups at each time point (p > 0.05). Conclusions: The study found no significant change in MSMT at post-treatment evaluation, even when considering different subgroups. It underscores the importance of preoperative maxillary sinus radiographic assessments and collaboration between dentists and otolaryngologists for better outcomes in patients with preoperative maxillary sinus mucosal thickening.

Prevalence of Incidental Maxillary Sinus Anomalies on CBCT Scans: A Radiographic Study.

CBCT significantly impacts dental procedures and has brought significant reforms to our approach to diagnosis and treatment planning despite its limitations in differentiating soft tissues. It is an excellent imaging modality and quickly identifies sinus opacification and provides valuable insight into paranasal sinus pathologies, with considerably lower radiation exposure. The present study aimed to investigate the occurrence of maxillary sinus abnormalities in CBCT scans, identify the frequency, type, and location of these findings, and find the correlation between the distance of periapical lesions and radiographic changes in the maxillary sinus. Two examiners independently evaluated 117 patients to diagnose and classify the cases into different abnormality subtypes. The periapical lesions most closely related to the sinus were recorded. The diameters of the left and right maxillary sinus ostium and the distance of the ostium's lower border to the sinus's osseous floor were recorded. The findings were correlated with the age and gender of these patients. The present study reveals that sixty-one patients were diagnosed with mucosal thickening (52.1%). The sinus wall most affected by mucosal thickening was the maxillary sinus floor, followed by the medial and lateral walls. Of 19 patients with periapical lesions, 15 had maxillary sinus mucosal thickening, which is statistically significant (p = 0.004). The high occurrence of abnormalities in the maxillary sinus emphasizes the importance for the radiologist to comprehensively interpret the whole volume acquired in CBCT images, including the entire sinus. Incidental findings may be considered in the individual clinical context of signs and symptoms, reducing the risk of overestimating the real impact of radiographic findings.

Dental implant placement in participants with maxillary sinus mucosal thickening

Dental implant placement in participants with maxillary sinus mucosal thickening

Increased risks of maxillary sinus mucosal thickening in Chinese patients with periapical lesions

ObjectivesThis study aimed to evaluate the effects of factors related to periapical lesions (PALs) on sinus membrane thickening (SMT) in the Chinese population using cone-beam computed tomography (CBCT). MethodsIn this retrospective study, CBCT images (n = 512) of maxillary sinuses of 446 patients were evaluated by two examiners for SMT and PALs, PAL size, and the distance between the maxillary sinus floor (MSF), and the PAL’s edge/root apex. The data were analyzed using analysis of variance, the Kruskal-Wallis test, χ2-test, and logistic regression. ResultsA binary logistic regression model showed that the prevalence and severity of SMT > 2 mm were significantly associated with older age (>60 years) (odds ratio [OR]: 4.03, 95% confidence interval [CI]): 2.24–7.72, P < 0.001], male sex (OR: 2.08, 95% CI: 1.21–3.56, P < 0.006), and PALs (OR: 6.89, 95% CI: 3.93–12.08, P < 0.001). The type of contact and penetration between the MSF and PALs or root apex showed a more significant relation with SMT > 2 mm than did distance after adjusting for confounding factors, including age and sex (PALs: OR = 10.17 and 14.57, P < 0.001; root apex: OR = 3.49 and 5.86, P < 0.001). ConclusionsThe prevalence and severity of SMT were significantly associated with older age, male sex, PALs, PAL size, and the distance between the MSF and PALs/root apex. Therefore, communication between dental surgeons and an otolaryngology specialist is important for the timely diagnosis and treatment of SMT of dental origin.

CBCT Evaluation of Periapical Pathologies in Maxillary Posterior Teeth and Their Relationship with Maxillary Sinus Mucosal Thickening.

In modern dentistry, radiographic imaging is crucial for examining the connection between the maxillary sinus floor and the root apices of the maxillary posterior teeth, particularly when the periapical region is affected by pathology that could result in infectious, inflammatory, or traumatic changes in the maxillary sinus. This study aimed to investigate the prevalence of periapical pathologies in the maxillary posterior teeth and their relationship with maxillary sinus mucosal thickening by using cone-beam computed tomography scans. This retrospective study was conducted on 420 digitized CBCT images which were scanned in sagittal, axial, and coronal views. Out of 420 total images, 223 (53.1%) were of males and 197 (44.9%) were of females. The data were analyzed using SPSS version 28. A total of 2936 posterior maxillary teeth were tested for periapical pathology (PP), 1477 on the right side and 1459 on the left side. In terms of gender, there was no significant relationship between PP in maxillary posterior teeth on both sides and mucosal thickness of the maxillary sinus (p > 0.05). A significant relationship was found between PP in maxillary posterior teeth on both sides and maxillary sinus mucosal thickening (p < 0.05). This study concluded that the prevalence of periapical pathology in the maxillary posterior teeth was significantly associated with a rise in the incidence of maxillary sinus mucosal thickening. Moreover, the primary causative factor for the pathophysiology of the odontogenic maxillary sinus was the periapical pathology in both maxillary first molars.

Maxillary sinus volume and mucosal thickening according to the septal deviation angle and age of the children.

We examined the relationship between nasal septal deviation (SD) angle and maxillary sinus volumes by examining the paranasal sinus computed tomography (PNSCT) images in children. In this retrospective study, PNSCT images of 106 children with one-sided nasal SD were included. According to the SD angle, two groups were identified: Group 1 (n = 54): SD angle ≤ 11°, Group 2 (n = 52): SD angle > 11°. There were 23 children between 9 and 14 years and 83 children between 15 and 17 years. Maxillary sinus volume and mucosal thickening were evaluated. In 15- to 17-year age group, maxillary sinus volumes of males were higher than females bilaterally. For each of the males and females, ipsilateral maxillary sinus volume was significantly lower than the contralateral side in all children and in 15- to 17-year age group. In each of the SD angle values (≤11 or >11) separately, ipsilateral maxillary sinus volume was lower; and in the SD angle > 11° group, maxillary sinus mucosal thickening values were higher than those of the contralateral side. In young children in 9- to 14-year age group, bilateral maxillary sinus volumes decreased, in this group maxillary sinus volume was not affected according to the SD. However, in 15- to 17-year age groups, maxillary sinus volume was lower on the ipsilateral SD side; and ipsilateral and contralateral maxillary sinus volumes of the males were significantly higher than those in the females. SD should be treated at an appropriate time to prevent SD-related maxillary sinus volume shrinkage and rhinosinusitis.

Prevalence and pattern of proximity of maxillary posterior teeth to maxillary sinus with mucosal thickening: A cone beam computed tomography based retrospective study.

Odontogenic sinusitis is a prevalent but frequently unrecognized condition, and periapical pathologies of maxillary posterior teeth are accused as one of the main causative factors. This study aimed to evaluate the relationship between the periapical status of maxillary posterior teeth and its proximity to the maxillary sinus floor in the occurrence of incidental sinus pathologies using cone-beam computed tomography (CBCT). CBCT scans of 118 patients of age range 18-77 years were evaluated retrospectively to determine the relationship of maxillary posterior teeth to sinus floor in which vertical relationship was assessed using modified Kwak's classification and periapical status using CBCT periapical index. Statistical analysis was performed using SPSS statistics software. Of all 227 sinuses examined, 56.8% showed pathological changes, with mucosal thickening being the most common. More than 50% (50.2%) of sinuses were associated with periapical lesions of at least one maxillary posterior tooth based on evidence of pathological mucosal thickening. The presence of pathologic mucosal thickening was also significantly related (P < 0.05) to the presence of periapical pathologies. There was a significant association between tooth position and pathological sinus mucosal thickening, especially with second molars, first molars, and second premolars, respectively (P < 0.05). Second molar involvement was the most significant (P < 0.05). The present study established a positive association between periapical disease status of maxillary posteriors and maxillary sinus mucosal thickening. Maxillary second premolar and first and second molars pathologies can significantly affect the maxillary sinus compared to other maxillary posterior tooth. CBCT proved to be an efficient imaging modality in detecting these changes.

Proximity of healthy posterior teeth to the maxillary sinus floor in relation to mucosal thickening: a CBCT study.

To evaluate the relationship between proximity of the root apices of healthy maxillary posterior teeth to the maxillary sinus floor (MSF) and mucosal thickening (MT) of the MSF using cone beam computed tomography (CBCT). Eighty-four CBCT images obtained from the patients, aged between 20 and 70years with healthy and fully dentate maxillary posterior sextants, were included. The anatomical relationship between root apices of maxillary posterior teeth and MSF, was evaluated: (Type 1: no contact, Type 2: at least one root apex in contact, Type 3: at least one root apex protruding into MSF). Besides, MT of the MSF was measured from the thickest region. The patients were categorized into two groups based on the absence (≤ 2mm) or the presence (2 < mm) of MT. Statistical significance was accepted at p < 0.05. Intraexaminer consistency demonstrated an excellent agreement (p < 0.05). The prevalence of Type 1, 2, and 3 proximity were found as 26 (15.5%), 61 (36.3%), and 81 (48.2%); respectively. Overall, 62 (36.9%) maxillary sinuses demonstrated MT (2 < mm, mean: 8.6 ± 7.5mm). The prevalence and mean values of MT (2 < mm) were not found to be statistically significantly different in terms of sex and proximity types (p > 0.05). Logistic regression analysis results were not found to be statistically significant (p > 0.05). The proximity of healthy maxillary posterior teeth to the MSF was not found to be a contributing factor for the MT of the MSF. Further studies with larger samples, taking the other factors causing MT into consideration, are needed.

The prevalence of nasal septum deviation and its association with maxillary sinus mucosal thickening using cone-beam computed tomography

Introduction: Maxillary sinus mucosal thickening is a very common disease that is attributed to several reasons including environmental and anatomical. The aim of this study was to investigate the prevalence and relationship between nasal septum deviation and maxillary sinus mucosal thickening using cone-beam computed tomography imaging. Methods: The nasal cavities and maxillary sinuses of 226 patients (169 women and 57 men) were retrospectively examined using cone beam computed tomography. Statistical analysis was done to determine the prevalence and relationship between the nasal septum deviation and maxillary sinus mucosal thickening regarding gender and age. The level of significance was set at 0.05 and statistical analysis was done using the SPSS version 26. Results: The average age of the participants was 43.7 ± 13.3 years. The prevalence of deviated nasal septum was 87.6% (95% CI, 82.6-91.3%), and no significant relationship between nasal septum deviation and age and gender was observed. The highest frequency of nasal septum deviation according to the Meladina classification modified by Rao et al. was assigned to type 7 (36%). Mucosal thickness &gt; 2 mm was found in the right and left maxillary sinuses, 36.7%, and 34.5%, respectively.

Cone beam computed tomographic evaluation of infraorbital canal protrusion into the maxillary sinus and its importance for endoscopic surgery

ObjectiveThe aim of this retrospective study is to investigate the prevalence of Infraorbital Canal Protrusion (ICP) degree into the maxillary sinus and its relationship with variations in adjacent structures on Cone Beam Computed Tomography (CBCT) images. Methods350 CBCT images (700 Infraorbital Canal [IC]) were evaluated retrospectively. ICP was divided into 3 subtypes according to the protrusion degree. The correlation between IC types and variations in adjacent anatomical structures (Haller cell, middle nasal concha pneumatization, maxillary sinus mucosal thickening and septa) was evaluated. The distance between Infraorbital Canal and Cnine Root (IC-CR) was also measured. For type 3, measurements were performed on IC as the length of the bony septum from the IC to the Mxillary Sinus Wall (IC-MSW), the distance from the inferior orbital rim, where the IC begins to protrude into the maxillary sinus (IOR-ICP), the vertical distance from the IC to the Maxillary Sinus Roof (IC-MSR) and Floor (IC-MSF). ResultsThe prevalence of type 1, 2 and 3 was 62.9%, 29.1%, and 8% respectively. IC-CR was 10.2, 10.7 and 11.4 mm in type 1, 2 and 3, respectively. IC-MSW, IOR-ICP, IC-MSR and floor IC-MSF was 3.8, 10.9, 7.4 and 27.7 mm, respectively. On the right and left side, statistically significant correlation was found between IC types and the presence of the Haller cell and sinus septa. But there was no significant correlation between IC types and middle concha pneumatization. ConclusionAccurate diagnosis of ICP is very important in preventing infraorbital nerve damage in surgical procedures to be performed in the maxillary region. The results of this study could be a guide for surgical planning in this region. Level of evidenceRetrospective study.

Relationship of Maxillary Sinus Mucosal Thickening and Residual Alveolar Ridge Height: A CBCT Analysis

Objectives: Maxillary sinus pathological conditions, like thickening of the Schneiderian membrane, can influence the outcomes of augmentation procedures and implant treatment. The present study aimed to evaluate the relationship between the residual ridge height and maxillary sinus membrane thickening. Materials and Methods: A total of 240 cone-beam computed tomography (CBCT) images of the maxillary sinus of 141 patients (62.1% males and 37.9% females, bilateral in 99 patients and unilateral in 42 patients) who were candidates for implant placement were evaluated. The CBCT scans were subsequently assessed for the following variables: residual ridge height, sinus membrane thickening at future implant(s) site(s), the ostium patency, and presence of periapical lesion adjacent to the edentulous area. Results: The total prevalence of sinus membrane thickening (66.2%) was sub-classified as follows: flat in 53.7%, polypoid in 12.1%, and complete opacification in 0.4%. The prevalence of sinus membrane thickening was higher in male participants. It was revealed that age had no significant relationship with presence of a periapical lesion or sinus membrane thickening (P>0.05). Membrane thickening was detected in all sinuses with obstructed ostium. Reduced residual ridge height was significantly associated with higher sinus membrane thickening at the second premolar and first molar sites (P<0.05). Conclusion: Maxillary sinus membrane thickening (mostly with flat appearance) is frequently observed on CBCT scans taken prior to augmentation and implant placement. This, in return, may trigger a reduction in ridge height.