Septal Height Research Articles

Three-Dimensional Evaluation of Alveolar Cleft Volume and Nasomaxillary Form in Patients with Unilateral Cleft Lip and Palate.

To evaluate the alveolar cleft volume (ACV) and to study its correlation with the nasomaxillary form in patients with unilateral cleft lip and palate (UCLP). Retrospective study. University Academic Hospital. 30 patients with UCLP and 30 non-cleft patients. Cone beam computed tomography (CBCT) scans. The Maxillary sinus volume (MSV) and Nasal cavity volume (NCV) were significantly reduced on the affected side in patients with UCLP (P < .001) and also in the cleft group when compared to the noncleft group (P < .01). The septal deviation measured at anterior, mid and posterior nasal spine were increased in the UCLP group significantly when compared to the non-cleft group (P < .01) and maximum deviation was seen at the mid-level. The mean ACV was found to be 0.587 + 0.396 cm3.The nasomaxillary complex was affected in UCLP patients irrespective of cleft size and a statistically significant correlation of ACV was found with septal height only (r value = -0.508). Parameters like septal height, anterior and middle maxillary width were significantly reduced (P < .01) in the cleft group when compared to the non-cleft group. The patients with UCLP showed significant differences among various parameters within the nasomaxillary complex when compared to the control group. Within the cleft group, the MSV and NCV were significantly decreased on the cleft side and also a significant negative correlation of ACV was found with septal height only.

A novel concept of adjustable three-layer collimator in a pixelated photon-counting detector for gamma-ray imaging: Monte Carlo simulation study

In gamma-ray imaging, a collimator plays a crucial role in determining the sensitivity of the system and the spatial resolution of the acquired image. Herein, we presented a novel concept for a variable collimator in a pixelated photon-counting detector. The gamma-ray imaging system was modeled using the Monte Carlo simulation tool Geant4 Application for Tomographic Emission program. A detector using cadmium telluride and a 99mTc point source was used. The collimators comprised three tungsten layers, and the septal height the beam finally penetrated from the incident gamma ray was adjusted differently. The first collimator layer constituted a hole with four times the pixel size, and the second and third layers comprised a hole with twice the pixel size, overlapping asymmetrically. Finally, the emitted gamma ray equaled the pixel. The spatial resolution showed different results depending on the source-to-collimator distance for each collimator configuration. Additionally, we determined that the sensitivity improved as the collimator height where gamma rays are incident and initially interact increased. We have proposed a novel collimator concept in a gamma-ray imaging system using a pixelated photon-counting detector, which may be applied in various fields in the future.

Assessment of Maxillary Molars Interradicular Septum Morphological Characteristics as Criteria for Ideal Immediate Implant Placement-The Advantages of Cone Beam Computed Tomography Analysis.

The aim of this study was to evaluate the interradicular septum bone morphometric characteristics using cone beam computed tomography (CBCT) images, as well as to establish quantitative shortcuts to allow clinicians to make a faster and more reliable plan for immediate implant placement in the maxillary molars area. This retrospective quantitative study was conducted on CBCT images obtained from 100 patients. The morphometric analysis of the maxillary molars region was based on the parameters obtained on the sagittal and axial slices. The analysis performed on sagittal slices showed that the first maxillary molars had a wider interradicular septum when compared to the second molars, but the septum height in the first molars was significantly below the height in the second maxillary molars. The axial CBCT slices analysis showed that both interradicular septum perimeter and surface area were significantly more pronounced in the first than in the second maxillary molars. The interradicular furcation angle significantly correlated with the surface area (positively) and septum height (negatively) for both molars. The results of this study may recommend CBCT image analysis as a useful tool in predefining the circumstances that can allow for substantially better planning of immediate implant placement procedures in the region of maxillary molars.

Morphological Characteristics of Maxillary Molars Interradicular Septum and Clinical Implications -What Do We Know So Far?

Abstract The interradicular septum describes area in the root furcation that separate alveoli of multi-rooted teeth. The shape and dimension depend of the topography of the extraction socket, the geometry of residual root and anatomy of molars alveoli. The clinical implications of this anatomic structure may be used in oral surgery resection procedures, periodontology and implantology. There is an opinion from the surgical and prosthodontic side that center of interradicular septum may be adequate place for immediate implantation. The aim of this study was to investigate morphological characteristics and clinical implications of upper molars interradicular septum. The studies showed that interradicular septum is important for success of resection surgery procedures: hemi-section, bisection and root amputation. It’s reported that furcation involvement in periodontal disease is clinical sign for severe bone loss. By reviewing the available literature for immediate implantation, it’s reported the clinical implications for diagnostical plan (pre-intervention), presurgical (pre-instrumentation) and intraoperative evaluation of interradicular septum for immediate implantation. The cone beam computed tomography analyze study presented mean values of septum height and wide for hypothetical plan of immediate implant placement. The presurgical studies evaluate how to assure preservation of septum and safe implant position in center of septum. The research showed varies therapy modalities that can be used, and how to choose right therapy according the socket type and initial septum width classification. According to observation of studies results, other researches should be considered for CBCT anatomical structure analyze and measures of interradicular septum for immediate implantation planning.

The effect of orthodontic extrusion on alveolar bone - a prospective clinical study

Introduction/Objective. Orthodontic extrusion is the procedure for moving the teeth in a vertical, coronal direction. This movement induces changes in the periodontal ligament and the production of new alveolar bone. The objective of the study was to determine the changes on buccal, palatal and interdental alveolar bone as a result of orthodontic extrusion. Methods. Experimental group included six patients who received orthodontic treatment with the fixed appliances; the control group included four patients without orthodontic treatment. Two cone-beam computed tomography scans (initial and final) were obtained for each patient in both groups. Length of a tooth, shortest distance from tooth?s center of resistance to the referent plane, distance from buccal or palatal plate tip to the enamel-cement junction, the height of interdental septum, buccal and palatal plate vertical gain, buccal and palatal plate thicknesses were measured on initial and final scan in the experimental and control group. Results. The reduced length of the extruded tooth was observed in the experimental group. The distance from buccal and palatal plate tip to the enamel-cement junction, mesial interproximal bone septum and buccal plate gain significantly increased in the experimental group. No significant difference was found in the distal interproximal bone septum, palatal plate gain and buccal/palatal plate thickness between groups. Conclusion. Orthodontic extrusion affects alveolar bone level by gaining the hard tissue buccal and mesial of extruded teeth, while buccal and palatal plate thickness insignificantly changed.

Prevalence and anatomical variations of maxillary sinus septa: A cone-beam computed tomography analysis.

BackgroundDetailed understanding the anatomy and variations of maxillary sinus septa is necessary. We aimed to investigate prevalence and various anatomical variations of maxillary sinus septa using cone-beam computed tomography (CBCT) images. Material and MethodsIn this retrospective cross-sectional study, CBCT scans of 809 patients referred to a specialist dental and maxillofacial radiology clinic in Babol, northern Iran, during 2014-2020 were evaluated. Location, morphology, height, and direction of septa in different planes were recorded. ResultsSinus septa were observed in 37.9% (n=307) of the participants. There were 117 cases with septa only in left sinus, 83 cases with septa only in right sinus, and 107 cases with septa in both sinuses. Totally, 414 septa were seen in the subjects. Prevalence of partial septa was considerably higher than complete septa (77.5% versus 22.5%). Regarding septa location, middle area with a prevalence rate of 58.7% was found more prevalent than other sinus areas. The mean septum height on the left and right sinuses was 6.0±3.1 mm 5.7±3.9, respectively (p<0.001). Regarding left sinus, directions of vertical (63.8%), oblique (30.8%), and straight (63.8%) were the most prevalent compared with other directions in sagittal, frontal, and axial planes, respectively. In relation to right maxillary sinus, direction of vertical in sagittal and frontal planes (72.6% and 24.2%, respectively), and direction of straight in axial plane (58.4%) were the most prevalent directions compared with others in the same planes. ConclusionsSepta prevalence in maxillary sinus was relatively high, with various directions, locations, heights, and shapes. It is recommended to use CBCT for a careful evaluation of toothless area prior to surgeries on the sinus (especially sinus lift) in three plans, in order to take careful measures and prevent postoperative complications in case septa exist. Key words:Maxillary sinus septa, anatomical variation, cone-beam computed tomography, dental implant.

Evaluation of Maxillary Alveolar Ridge Morphology and Residual Bone for Implant Placement by Cone Beam Computed Tomography (CBCT)

The aim of this study was to assess the morphology and dimension of maxillary alveolar ridge at anterior and posterior regions using cone beam computed tomography (CBCT) prior to the placement of immediate implants. CBCT scans of 192 patients were evaluated. Measurements were taken at the cross sectional views in the maxillary central incisor, lateral incisor, canine incisor, first and second premolars and first and second molars regions. Alveolar ridge width and height, buccal plate thickness, buccal undercut, inter-root septum height, and root penetration to sinus floor were measured. Independent T-test was used for statistical analysis. The mean value of alveolar height in the maxillary incisors were higher than the posterior teeth with central incisors having the highest value of 19.23 ± 8.74 mm. At anterior maxilla, the lateral incisor with the mean value of 1.07 ± 0.64 mm exhibits the highest buccal undercut and the thinnest ridge width. At the site of posterior regions premolars had higher buccal undercut than molars. Canine with the mean value of 0.19 ± 0.31 mm thickness at the mid-alveolar of buccal plate, had the thinnest plate among other maxillary incisors. Sinus penetration and inter-root septum height were higher in premolar teeth than molars. The mean value of ridge width at all levels was significantly different between men and women, except at the level of crest in central incisor. CBCT evaluation presents accurate measurements for ridge assessment prior to immediate implant insertion. The recommended appropriate size of implant platform would be 5 mm in the incisor and almost 6 mm in premolar region.

Comparative flower morphology of Agapanthus africanus and A. praecox (Amaryllidaceae)

The structure of Agapanthus africanus and A. praecox flowers was studied on permanent cross-sectional and longitudinal sections using a light microscope. The genus Agapanthus belongs to the subfamily Agapanthoideae, the family Amaryllidaceae, which is characterized by the presence of the upper ovary, septal nectaries and fruit – fleshy capsule. Micromorphological studies of the flower are considered as a way for detection of unknown plant features, adjustment of plants to specialized ways of pollination and determining the first stages of morphogenesis of fruit, and further use these features in taxonomy. 10 flowers of A. africanus and A. praecox were sectioned using standard methods of Paraplast embedding and serial sectioning at 20 micron thickness. Sections were stained with Safranin and Astra Blau and mounted in Eukitt. It was found that in the studied species the tepals have single-bundle traces. The vascular system of the superior ovary consists of a three bundle dorsal vein, of the ventral roots complex, which are reorganized into paired ventral bundles of the carpel, which form traces to ovules. For the first time, the following gynoecium zones were detected in A. africanus: a synascidiate structural zone with a height of about 560 μm and a fertile symplicate structural zone with a height of about 380 μm and a hemisymplicate zone of 2580 μm. In A. praecox gynoecium, there is a synascidiate structural zone with a height of 200 μm and a symplicate structural zone of 600 μm and a hemisymplicate zone of 620 μm. Septal nectaries appear in the hemisymplicate zone and open with nectar fissures at the base of the column, with a total septal nectar height of 2880 μm in A. africanus and 820 μm in A. praecox. The ovary roof is 300 µm in A. africanus and 200 µm in A. praecox. Triple dorsal bundles of carpels in A. africanus have been identified, which could be considered as adaptation of different stages of morphogenesis of fruit to dehiscence. The new data obtained by the vascular anatomy of the flower and the presence of different ovary zones significantly add to the information about anatomical and morphological features of the studied species, which can be further used in the taxonomy of the family Amaryllidaceae.

Subdorsal Z-flap: a modification of the Cottle technique in dorsal preservation rhinoplasty.

To present the novel technique of subdorsal Z-flap in dorsal preservation rhinoplasty and give an overview on current available dorsal preservation techniques in the literature. The subdorsal Z-flap combines the advantages of the high and low septal strip techniques in dorsal preservation rhinoplasty and ensures well tolerated treatment of the dorsal hump and structural stability. The technique and concept of Dorsal Preservation Rhinoplasty (DPR) has been used for more than a century but only recently gained significant popularity along with specific technical refinements. The advantage of DPR lies in the preservation of the delicate triangular cartilaginous unity of the septal and upper lateral cartilages with its functional and esthetic implications in contrast to all resecting techniques. A variety of modifications of DPR have been published in recent years, each with advantages and disadvantages. The issue of hump recurrence remains a major concern in DPR. We describe the 'subdorsal Z-flap' and related techniques of DPR in detail, present two clinical case studies and discuss alternative technical modifications. The 'subdorsal Z -flap' combines the advantages of the high septal strip procedure with the advantages of the traditional 'low septal strip' or Cottle technique. By starting the incision at a high level, final septal height can be adjusted precisely. By creating a triangular shape with a vertical cut below the K-Area, which is usually the highest point of the hump, significant leverage can be applied from below the hump and the septal overlap may be sutured securely for a stable correction. In combination with Piezo osteotomy and full open approach, great precision and predictability can be achieved. In a recent publication, we presented more than 100 consecutive cases of subdorsal Z-flap DPR with good functional and esthetic outcomes. The subdorsal Z-flap modification is a combination of two popular DPR techniques, fusing their advantages while minimizing risk profile. A slightly higher degree of technical difficulty and necessary tissue dissection provides the benefits of better predictability and reduction of adverse outcomes.

Bone changes in the mandibular incisors after orthodontic correction of dental crowding without extraction: A cone-beam computed tomographic evaluation.

PurposeThis study aimed to evaluate changes of the alveolar bone and interdental bone septum of the mandibular incisors through cone-beam computed tomography (CBCT) after orthodontic treatment of mandibular dental crowding without dental extraction.Materials and MethodsThe sample consisted of 64 CBCT images (32 pre-treatment and 32 post-treatment) from 32 adult patients with class I malocclusion and an average age of 23.0±3.9 years. The width and height of the alveolar bone and interdental septum, the distance between the cementoenamel junction (CEJ) and the facial and lingual bone crests, and the inclination of the mandibular incisors were measured.ResultsThe distance between the CEJ and the marginal bone crest on the facial side increased significantly (P<0.05). An increased distance between the CEJ and the bone crest on the facial and lingual sides showed a correlation with the irregularity index (P<0.05); however, no significant association was observed with increasing mandibular incisor inclination (P>0.05). The change in the distance between the CEJ and the marginal bone crest on the facial side was correlated significantly with bone septum height (P<0.05).ConclusionBone dehiscence developed during the treatment of crowding without extraction only on the incisors' facial side. Increasing proclination of the mandibular incisor was not correlated with bone dehiscence. The degree of dental crowding assessed through the irregularity index was associated with the risk of developing bone dehiscence. The interdental septum reflected facial marginal bone loss in the mandibular incisors.

Retrospective analysis of maxillary sinus septa – A cone beam computed tomography study

BackgroundSinus lift procedures have become a routine and reliable way to gain bone volume in the posterior maxilla for implant placement. The presence of an antral septum in the maxillary sinus increases the risk of complications and subsequent implant failure. This study was designed to estimate the prevalence of maxillary sinus septa and its correlation with age, sex, dentition status and the risk of perforating the Schneiderian membrane using cone beam computed tomography (CBCT). MethodsThis retrospective, cross-sectional study consisted of a total of 178 CBCT images (100 male, 78 female), 63.0% were dentate, 36.0% partially dentate and 1.1% edentate subjects with a mean age of 35 ± 45 years was analyzed to determine the prevalence, height, location, and orientation of maxillary sinus septa. The septa were classified according to the modified Al-Faraje’s classification into VII septal patterns, and the risk of perforation of the Schneiderian membrane was estimated. The chi-square test was used to compare categorical variables, and Student’s t-test and the Kruskal-Wallis test were used to compare continuous variables. ResultsSepta were present in 25.6% of the sinus segments (37.64% of the subjects). The mean septum height was 5.22 mm ± 2.06 in males and 6.27 mm ± 3.55 in females. The majority of septa were located in the middle 76.92%, while 4.40% were anterior, and 18.68% were posterior; 76.92% were in a buccopalatal direction, whereas 23.08% were in an anteroposterior direction. Class III was the most prevalent type. Overall, 60.4% had a moderate risk of membrane perforation, 30.8% had a low risk, and only 8.8% had a high risk. ConclusionThree-dimensional CBCT image analyses can be used as a diagnostic tool to provide accurate information that can help avoid unnecessary intra- and postoperative complications during sinus augmentation procedures by identifying the anatomic structures inherent to the maxillary sinus.

Dorsal preservation septorhinoplasty

Nasal dorsum deprojection is avery important tool in functional and aesthetic rhinoplasty. In classic techniques, resection of dorsal bone and cartilage renders dorsal reconstruction necessary. The concept of dorsal preservation rhinoplasty has been known for more than acentury but has experienced arenaissance in recent years, with many critical technical modifications. We present the latest technique of piezo-assisted dorsal preservation rhinoplasty with subdorsal triangular resection and subdorsal Cottle modification based on clinical experience of 205cases. Furthermore, the advantages and disadvantages of this technique are discussed and several other current variations are presented. Piezo-assisted osteotomy enables avery precise fracture line and sparing of periosteum, with bone sculpting possible even after mobilization. Subdorsal septal height reduction always precedes completion of the osteotomy and nasal bone mobilization, to ensure patient safety with regard to skull base injury. Using the presented technical modifications, the risk of step deformities in the radix is minimized. In selected patients, dorsal preservation septorhinoplasty enables the surgeon to perform very conservative and precise deprojection of the nose with excellent outcomes, although the spectrum of possible complications is shifted in comparison to classic techniques. The preliminary experience of 205cases with arevision rate of less than 10% is promising. Afinal evaluation of the technique will only be possible after further studies and evaluation of long-term results.

Maxillary sinus septa and anatomical correlation with the dentition type of sinus region: a cone beam computed tomographic study

Maxillary sinus septa increase the risk of membrane perforation during sinus floor elevation and grafting operations. This study was designed to evaluate the prevalence, morphology, localisation, aetiology, and orientation of maxillary sinus septa in dentate, completely edentulous, and partially edentulous sinus regions using cone beam computed tomography (CBCT), and possible patient-related factors were also assessed. Data from 300 patients (600 sinuses), 160 women and 140 men, with a mean (SD) age of 50.72 (13.99) years (range 20–83), who were undergoing treatment planning for implant-supported restorations in posterior maxillae, were analysed from reformatted CBCT scans. Sinus septa were detected in 132 (44%) patients. A total of 208 septa were found, and 187 (31.17%) single maxillary sinuses presented septa in 600 sinuses. Unilateral septa were found in 77 patients (58.3%) and bilateral septa in 55 patients (41.7%). Out of the 208 septa, 42 (20.19%) were in the anterior third, 124 (59.62%) were in the middle third, and 42 (20.19%) were in the posterior third. Further, 106 (50.96%) septa were in completely edentulous regions, 64 (30.77%) were in partially edentulous regions, and 38 (18.27%) were in dentate regions. The prevalence of septa was significantly higher in the middle third area of the completely edentulous sinus regions. The mean (SD) height of septa was 6.34 (3.05) mm, and the mean orientation was buccopalatal in 204 patients (98.08%). Maxillary sinus septa are common anatomical structures. To avoid possible complications during sinus augmentation, a detailed radiographic identification of anatomical structures in maxillary sinuses is needed.

A comparative evaluation of iliac crest bone graft with and without injectable and advanced platelet rich fibrin in secondary alveolar bone grafting for cleft alveolus in unilateral cleft lip and palate patients: A randomized prospective study

PurposePlatelet rich fibrin enhances bone healing and results in better graft intake and helps in faster periodontal healing. In this study we have used a combination of two newly developed forms of platelet rich fibrin: injectable and advanced along with iliac bone graft for secondary alveolar bone grafting and compared it with cases in which only iliac bone graft was used. Methods30 patients with alveolar cleft, with age group of ≥7 years, having complete unilateral cleft alveolus were included and divided into 2 groups of 15 patients each randomly. In Group A, secondary alveolar bone grafting was done using iliac bone graft along with injectable and advanced palate rich fibrin and in Group B, secondary alveolar bone grafting was done only with iliac bone graft. Success of the treatment was assessed using radiographic and clinical methods which included: The bone resorption of the interalveolar septum height of the teeth adjacent to the cleft, evaluated as per Bergland classification, assessment of periodontal status of the teeth adjacent to cleft alveolus. ResultsAfter 3 months and 6 months postoperatively: study group had better overall scores as per Bergland criteria. Periodontal status improved in both groups but was more in study group compared to control group. For both evaluations the data was clinically favorable in the study group. ConclusionOn preliminary investigations it shows that combination of injectable and advanced platelet rich fibrin seems to enhance bone formation in alveolar clefts when admixed with autologous cancellous bone harvested from the iliac crest than using iliac bone graft alone. It also reduces the chances of bone resorption and show higher percentage of bone volume. Secondary alveolar grafting improves periodontal health around the cleft alveolus.

What does the normal fetal face look like? MR imaging of the developing mandible and nasal cavity

PurposeAnalyze fetal facial structures using MR imaging scans in an aim to establish normal biometrical measures of fetal nasal and mandibular structures for multiple gestational weeks, comprise nomograms and compare female and male fetuses. MethodsA Historic cohort study of 255 fetal facial MR imaging scans was performed at a tertiary medical center during a 4-year period. Clinical data was collected from electronic medical charts. Length of septal height (SH), septal length (SL), Interocular Distance(IOD), maximal nasal length(MNL), mandibular vertebral length(MVL), antero-posterior diameter(APD), inferior facial angle(IFA) and biparietal diameter(BPD) were measured and compared with gender and gestational age (GA). Interrater and intrarater reliability was investigated. ResultsNormal measures were established for each gestational age. We found that all parameters but IFA correlated with GA. Males had a longer SL, BPD and MNL while females had a wider IFA. ConclusionsNovel facial biometric parameters that correlate with GA hold cardinal information for the prenatal evaluation of facial development and thus surface the need for additional research in order to asses these findings as radiologic markers for facial structural pathologies.

Morphometric Measurements of the Maxillary Sinus Based on Cone Beam Computed Tomography in a Selected Kenyan Population

Objective : To assess the maxillary antrum (sinus) volume, dimensions, and to establish the sinus floor relation ship to posterior maxillary teeth roots and the prevalence of septation using Cone beam Computed Tomogram (CBCT) scans in a selected Kenyan population. Study design: A descriptive, cross-sectional retrospective study. Study Area : The study was carried out in Nairobi, the capital city of Kenya, a cosmopolitan city that has the largest referral hospital in Kenya. Study material: Cone beam Computed Tomogram (CBCT) scans of the midface region obtained with permission from a private maxillofacial imaging centre in Nairobi. The study population was determined using convenient sampling method, obtaining 55 scans of the Maxillary sinus. Results: Fifty-five scans were analyzed with 20(36.4%) belonging to males and 35(63.6%) being scans of females. The mean septum height was 4.5mm±1.9mm and the mean exostosis height was 4.2mm±2.2mm. The closest root apex to the antral floor was the mesiobuccal root apex of the second permanent molar: 2.2mm±1.5mm. There was a statistically significant difference between gender and the anteroposterior dimension of the sinusp=0.02, The mean sinus volume was larger in males, 13980.4±5024.4mm 3 (13.9ml±5.0ml) than in females, 10,885±3305.6 mm 3 (10.8ml±3.3ml). The difference was not statistically significant. Conclusion : There is variation of the maxillary sinus size, within the same individual and among different individuals, thereby emphasizing the need for a complete imaging in treatment planning in the para-antral region. Due to the increased use of implants in dentistry, CBCT imaging as part of the diagnostic pre-implant workup and sinus analysis is crucial so as to avoid complications during surgery in the para-antral region

The effects of posterior alveolar bone height on the height of maxillary sinus septa.

The purpose of this study was to evaluate whether posterior alveolar bone height affects maxillary sinus septa (MSS) height in dentate and edentulous patients, as determined by cone-beam computed tomography (CBCT). This retrospective analysis enrolled 166 patients (91 men and 75 women) with a mean age of 43.12 ± 15.26years (range 18-74years), who had at least one MSS on CBCT images. MSS were categorized into three regions: anterior, middle, and posterior. Patients were categorized as complete or partial posterior edentulous or fully posterior dentate. The maximum vertical diameter of the sinus septa and alveolar bone height was analyzed in sagittal CBCT sections; P < 0.05 was regarded as statistically significant. We found 210 MSS among the patients in this study. Of the 166 patients, 36 had bilateral septa and 4 had three septa. The septa were mainly located in the middle region in the dentate (n = 70; 33.3%) and edentulous (n = 59; 28.1%) patients. The mean septal height was significantly higher in men than in women (P = 0.024). In dentate patients, the mean MSS height was similar among the three regions. In edentulous patients, the anterior mean MSS height (4.96 ± 2.77mm) was lower than that of the other two regions. There was no statistically significant association between septa and alveolar bone height in any anatomic region, in either group (r = 0.022; P = 0.748). These results suggest that MSS height is not influenced by alveolar bone height.

A radiologic evaluation of the incidence and morphology of maxillary sinus septa in Japanese dentate maxillae.

Evaluation of the inner aspect of the maxillary sinus is important for the success of a sinus lift procedure. The most common surgical complication is perforation of the Schneiderian membrane, which is thought to occur because of the presence of maxillary sinus septa. Therefore, we retrospectively investigated the incidence and morphology of maxillary sinus septa using multiplanar reformatted computed tomographic (CT) images from dentate Japanese patients. A total of 276 patients and 552 maxillary sinus segments were evaluated. The maxillary sinus septa were divided into four locations: forefront, anterior, middle, and posterior. The heights of the septa were measured at three sites from the deepest point of the sinus floor: lateral, mid-point, and medial. Sinus septa were identified in 191 of 552 (34.6%) maxillary sinus segments obtained from 111 of 276 (40.2%) patients. One unilateral septum was most commonly detected, and the sinus septa were most often located in the middle of the maxillary sinus. The average height of the identified septa was 8.69 ± 4.68mm (mean ± standard deviation). Multiplanar reformatted CT images can identify maxillary sinus septa in any plane. The height of maxillary sinus septa in the dentate maxillae was higher than detected in previous studies. Appropriate treatment planning using CT images should be considered to prevent surgical complications.

Modified nasal floor and inferior meatus flap for septal perforation repair. Extension and limits.

The nasal floor and inferior meatus (NFIM) flap represents an available option for the reconstruction of a septal perforation (SP). This study explores the feasibility of repairing SPs using a modified simple and extended (including inferior turbinate) NFIM flap. An anatomic study was achieved in fresh frozen cadaveric specimens to measure the area and lengths of NFIM flap. The repair of SP with simple and extended NIFM flaps was performed in some of these cadaveric specimens. Preoperative radiological evaluation of CT scans allowed studying the reconstruction limits of the simple or extended NFIM flap. A cohort of patients with SP who underwent reconstruction with an NFIM flap was also included. Complete SP repair with NFIM was achieved in all specimens (n=10). In 38 fresh cadaveric specimens, coronal and sagittal lengths and area of simple NFIM flaps were smaller than in extended NFIM flaps. The radiological analysis of 75 CT scans revealed that the septal height could be reconstructed with a simple and extended NFIM flap. Complete SP repair wasachieved in 5 patients (4 male, mean age 57.4 years) using modified NFIM flaps. The simple or expanded NFIM flap represents a feasible option to repair small or medium-sized perforations located at the lower 1/3 or 3/4 of the nasal septum.

Autologous dental pulp mesenchymal stem cells for inferior third molar post-extraction socket healing: A split-mouth randomised clinical trial.

BackgroundSince the discovery of adult mesenchymal stem cells extensive research has been conducted to determine their mechanisms of differentiation and effectiveness in cell therapy and regenerative medicine.Material and MethodsTo assess the efficacy of autologous dental pulp mesenchymal stem cells delivered in a collagen matrix for post-extraction socket healing, a single-centre, double-blind, randomised, split-mouth, controlled clinical trial was performed. Both impacted mandibular third molars were extracted from 32 patients. Dental pulp was collected and dissociated; the resulting cell suspension, obtained by centrifugation, was incorporated into a resorbable collagen matrix and implanted in 32 experimental post-extraction sockets. Collagen matrices alone were implanted in 32 contralateral, control post-extraction sockets. Two neuroradiologists independently assessed the extent of bone repair at 6 months after the extractions. Computed tomography (CT, Philips Brilliance) and an advanced display platform (IntelliSpace Portal) was used to record extraction socket density, expressed as Hounsfield units (HU) and height (mm) of the distal interdental bone septum of the second molar. Measurements at 6 months post-extraction were compared with measurements obtained immediately after extraction. Data were analysed with the statistical program STATA 14.ResultsTwo patients dropped out of the study. The final sample consisted of 22 women and 8 men (mean age, 23 years; range: 18–30 years). Clinical, radiological, and surgical characteristics of impacted third molars of the control and experimental groups were homogeneous. Measurements obtained by the two neuroradiologists showed agreement. No significant differences were found in the extent of bone repair during analyses of density (p=0.4203 neuroradiologist 1; p=0.2525 neuroradiologist 2) or interdental septum height (p=0.2280 neuroradiologist 1; p=0.4784 neuroradiologist 2).ConclusionsIn our clinical trial, we were unable to demonstrate that autologous dental pulp mesenchymal stem cells reduce socket bone resorption after inferior third molar extraction. Key words:Clinical trial, autologous, pulpal stem cells, extraction socket healing.