Schneiderian Membrane Thickness Research Articles

Schneiderian membrane thickness variation following endodontic procedures: a retrospective cone beam computed tomography study

BackgroundTo assess the change of the Schneider membrane thickness measured by CBCT before and after root canal treatment, retreatment and pulp capping procedures.MethodsThis retrospective study was conducted on CBCT scans of a patient population of Guy’s Hospital NHS Foundation Trust, London. Three groups of patients were studied: Group 1 consisted of patients referred for primary endodontic treatment; Group 2 for endodontic retreatment; Group 3 for indirect pulp capping procedures (serving as a control group). Follow up scans were carried out 1 year after treatment. Measurements were carried out on CBCT scans and data were analysed statistically by Wilcoxon Signed Rank Test. Linear regression was used to assess predictive parameters for membrane thickness.ResultsA statistically significant reduction of the Schneider membrane thickness was observed one year after endodontic treatment and retreatment (P < 0.05) but no significant reduction was observed after pulp capping procedures. Linear regression showed that age and gender were significant predictors influencing the Schneider membrane thickness.ConclusionsWithin the limitations of this retrospective study, following root canal treatment and re-treatment a Schneiderian membrane thickness reduction occurred at 1-year follow-up.The removal of odontogenic infection following endodontic treatment may help reducing the thickness of the Schneider membrane.

Effect of Medical-Grade Polyurethane Sponges on Sinus Membrane Perforation With a Lateral Window Approach.

The most commonly reported complication during the sinus elevation surgical procedure is the perforation of the Schneiderian membrane. The aim of this retrospective study was to compare the rate of sinus membrane perforation during lateral window augmentation using either conventional sinus curettes or medical-grade polyurethane sponges. This retrospective study included patients who received a lateral window approach for sinus floor elevation. The sinus elevation procedures using medical-grade polyurethane sponges (test) or conventional curettes (control) were recorded and analyzed. All subjects' demographic data and preexisting conditions were evaluated. A total of 38 procedures met inclusion criteria, and those data were evaluated for analysis. There were no statistically significant differences in demographic data or preexisting conditions including age, sex, treatment location, presence and absence of septum, Schneiderian membrane thickness, and residual bone height between test and control groups. The membrane perforation rate was 7% in the test group and 43% in the control group; however, this difference did not reach statistical significance (P = .064). Within the limitations of this study, although there was no statistically significant reduction of sinus membrane perforation with the use of medical-grade polyurethane sponges, the decreased incidence of perforation might be of clinical significance.

Evaluation of the Relationship Between Schneiderian Membrane Thickness and Sinus Floor Cortication Using Cone Beam Computed Tomography

Aim: In this study, we aimed to investigate the relationship between sinus floor cortication (SFC) and Schneiderian membrane thickness (SMT) through cone-beam computed tomography (CBCT) images. Materials and Methods: A total of 292 maxillary sinuses of 146 patients (61 males, 85 females) who underwent a CBCT scan for dental implant treatment were evaluated. SFC was classified as follows: type-1: sinus floor exhibiting similar or higher density than the surrounding cortical areas, type-2: sinus floor exhibiting lower density than the surrounding cortical areas, type-3: sinus floor exhibiting no cortical bone, and type-4: sinus floor exhibiting fusion of sinus floor bone and native crestal bone. We also investigated the relationship between the SFC types and SMTs measured from the highest border of the membrane to the sinus floor on cross-sectional images.Results: Type-1, type-2, type-3, and type-4 SFC were seen in 114, 102, 48, and 28 cases, respectively. The Schneiderian membrane was found to be thinner in type-1 SFC than in type-2 SFC. No significant difference was found between type-3 and type-4 SFC in terms of SMT. Discussion and Conclusion: Evaluation of SFC and SMT using CBCT can provide information about implant stability and survival in treatment after sinus grafting. Although type-1 SFC is favorable for implant placement, it may also be associated with an increased risk of membrane perforation.

Thickening of Schneiderian membrane secondary to periapical lesions: A retrospective radiographic analysis.

ABSTRACTAim:The aim of this study was to investigate the possible correlation between adjacent periapical lesions of maxillary teeth and Schneiderian membrane thickness (SMT).Materials and Methods:An analytical study of case-control study design was conducted. From the archives, cone beam computed tomography (CBCT) images of 83 patients with periapical lesion in any of the maxillary posterior teeth were randomly selected as the case group. The normal, contralateral teeth in the same patient were considered in the control group. Eighty-eight teeth were considered in each group, comprising a total sample of 176. For each sample in case group, the distance from the border of the periapical lesion to the cortical bone of the bony floor of the maxillary sinus and SMT were measured. SMT on the contralateral side adjacent to the healthy (control) teeth was also measured. Data were presented in mean ± standard deviation and inferential statistics was performed using independent t test and analysis of variance (ANOVA). Later Pearson correlation and multiple linear logistic regression were carried out using Statistical Package for the Social Sciences software program, version 21.0 at 95% confidence interval.Results:Teeth with periapical lesion were found to have significantly (P < 0.001) increased SMT when compared with that of adjacent to healthy teeth. On the contrary, nonsignificant differences were found in SMT when genders and age groups were compared (P = 0.295 and 0.060, respectively). A strong negative correlation was observed between distance of the lesion to the sinus and SMT (P = 0.003).Conclusion:Neighboring periapical lesions of maxillary teeth are associated with SMT that is worsened when the lesion is close to the sinus.

Relationship between maxillary sinus findings, Schneiderian membrane thickness, and various skeletal malocclusions in a selected sample of ethnic Kashmiri population: A retrospective cone-beam computed tomography study

Objective: There are very limited studies which have investigated the relationship between maxillary sinus findings and skeletal malocclusion based on cone-beam computed tomography (CBCT). The objectives of this study were to determine the relationship between the patients' skeletal malocclusion and the maxillary sinus findings in ethnic Kashmiri population. Materials and Methods: A total of 45 CBCT scans were examined and divided into three groups according to skeletal classification. Two experienced observers reviewed the CBCT images and recorded all maxillary sinus findings. The patients' skeletal malocclusion, the thickness of the Schneiderian membrane, and the pathologic maxillary sinus findings were evaluated. Results: The maxillary sinus findings were classified into five groups: 0 = no finding, 1 = mucosal thickening, 2 = polypoidal thickening, 3 = partial opacification, and 4 = total opacification. The statistical analysis showed that there was no correlation between the skeletal malocclusion and pathological maxillary sinus findings. However, there were significant differences in the Schneiderian membrane thicknesses between the groups. Conclusion: The Schneiderian membrane thickness was significantly different for Class II and Class III patients (P = 0.002). It was lowest for Class II and highest for Class III group. The relationship between pathological maxillary sinus findings and skeletal malocclusions was statistically insignificant (P > 0.05).

Schneiderian Membrane Thickness Is Increased in Patients With Cleft Lip and Palate.

Patients with cleft lip and palate (CLP) are more likely to have sinusitis. The purpose of this study is to determine whether patients with CLP have thickening of the Schneiderian membrane. Specific aims were to (1) compare Schneiderian membrane thickness in patients with CLP to noncleft controls, (2) evaluate whether membrane thickening is associated with cleft side in patients with unilateral cleft lip and palate (UCLP), and (3) evaluate if age and sex are predictors of mucosal thickening. Case-control study. Tertiary care center. Patients with CLP and controls. The primary outcome variable was maximum Schneiderian membrane thickness measured on cone beam computed tomography. The primary predictor variable was the presence of a cleft. Additional variables were cleft phenotype, age, and sex. There were 225 patients with CLP and 93 controls. Median mucosal thickness was 2.4 mm in cleft group and 0.0 mm in controls (P = .006). In cleft group, 56.7% of sinuses had mucosal thickness >2.0 mm compared to 38.2% in controls (P = < .004). Pathologic membrane thickening (>4.0 mm) was significantly higher in cleft group (P = .005). No statistically significant difference in mucosal thickness between cleft and noncleft sides in patients with UCLP. Linear regression showed no association between age or sex and Schneiderian membrane thickness. Schneiderian membrane thickening is more common in patients with CLP and is not associated with the side of the cleft in patients with UCLP.

Cone-beam computed tomography assessment of Schneiderian membranes: Non-infected and infected membranes, and membrane resolution following tooth extraction: A retrospective clinical trial

BackgroundCone-beam computed tomography (CBCT) presurgical assessment on the maxillary sinus can reduce the possibility of Schneiderian membrane perforation. This study examined Schneiderian membrane thickness (SMT) and its relationship with neighboring hard tissues for patients with and without membrane thickening. For patients with sinus infections, we evaluated dimensional changes of the SMT post-extraction relative to pre-extraction SMT and residual bone height (RBH). MethodsCBCT images from 93 patients needing single-tooth implant reconstruction without (n = 83) and with (n = 14) odontogenic infected maxillary sinuses were assessed. SMT, RBH, and lateral wall thickness (LWT) were measured. Causes of extraction, RBH in the infection site, and retrospective post-extraction record of SMT were recorded for the thickened SMT group. ResultsMean SMT for normal SMT group was 1.13 ± 0.43 mm, RBH was 6.26 ± 2.38 mm; upper and lower LWT was 1.85 ± 0.95 mm, and 3.07 ± 2.26 mm, respectively. RBH and LWT had no significant relationships with SMT. For thickened SMT group, mean values for SMT and RBH prior to extraction were 4.53 ± 2.46 mm and 1.97 ± 1.43 mm, respectively. Pre-extraction SMT had a moderately negative correlation with pre-extraction RBH. SMT resolution in thickened SMT group was observed by 2.80 ± 1.37 months post-extraction; post-extraction SMT was not significantly different from normal SMT group (p = .187). ConclusionsWithin the limitation of the sample size, thickened SMT induced by odontogenic infection subsides about 3 months following tooth extraction, and further sinus lifting implant surgery may be considered.

Effects of clinical local factors on thickness and morphology of Schneiderian membrane: A retrospective clinical study.

It was informed that the thickness of maxillary sinus membrane may be affected by the local and patient-related factors in the literature. The aim of this retrospective study is to evaluate factors that may have an influence of the thickness and morphology of the maxillary sinus membrane. A total of 414 cone beam computed tomography images of 207 patients were evaluated. Radiographic parameters were evaluated at each maxillary premolar and molar tooth regions. Statistical analysis was performed to assess the association between the maxillary sinus mucosa thickness and morphology. The following factors including gender, periodontal bone loss (PBL), bone density, amount of residual alveolar bone at the edentulous space, vitality of the teeth present, and anatomical relationship between the sinus floor and posterior teeth were evaluated. The mean thickness of maxillary sinus membrane ranged between 1.47 to 2.92 mm and was significantly thicker in male subjects (P < .05). Positive correlation was detected between the sinus membrane thickness values in each posterior tooth region (P < .05). Thickening of the membrane was noted in 53% of the scans. The most commonly observed morphological change was flat thickening of the membrane (21%). No correlation was found between the evaluated local factors on the thickness and morphology of the maxillary sinus membrane (P > .05). Tooth vitality, residual alveolar bone height, and PBL seem to have no effect on the thickness and morphology of the maxillary sinus membrane.

Schneiderian membrane thickness in patients with cleft lip/palate: a case control study

Schneiderian membrane thickness in patients with cleft lip/palate: a case control study

The clinical and radiographic outcomes of Schneiderian membrane perforation without repair in sinus elevation surgery.

The aim of this comparative study was to evaluate the clinical outcome of nonrepair of the perforated maxillary sinus membrane compared to the nonperforated cases. A retrospective comparative study was performed by identifying all lateral window sinus augmentation procedures, which were done during a defined period. Demographic data, systemic diseases, and smoking habits of patients were recorded. Thickness of the Schneiderian membrane and the amount of residual bone before surgery were measured by cone-beam computed tomography (CBCT). In case of perforation, no attempt was made to repair the membrane. Alloplast was used for bone augmentation. The thickness of the Schneiderian membrane and gained bone height were recorded using CBCT at the time of prosthesis delivery. Sixty-three patients with 65 sinuses were included in this retrospective study. The rate of sinus perforation was 39%. There was a significant association between the presence of sinus pathoses before surgery and the occurrence of Schneiderian membrane perforation (P = 0.03). The Schneiderian membrane was significantly thicker in patients with perforation compared to the patients without perforation (P < 0.001). There was no correlation between the size of the perforation and the thickness of the Schneiderian membrane. Most of the perforations (83%) occurred at the mesial and middle part of the lateral window. The Schneiderian membrane thickness was decreased significantly in both groups after the sinus elevation procedure (P < 0.05). The bone graft height was stable over the follow-up period in both groups (P > 0.05). There was no implant failure in any of the groups. Nonrepair of the Schneiderian membrane perforation did not adversely affect the clinical and radiographical outcomes. There were higher intraoperative and postoperative complications in the nonrepair group.

CBCT analysis of schneiderian membrane thickness and its relationship with gingival biotype and arch form.

The purpose of this study was to investigate a relationship between gingival tissue biotypes and arch form with Schneiderian membrane thickness, using limited cone beam computed tomography. A total of 90 subjects were selected. For each subject three parameters were assessed - gingival biotype - clinically by Probe transparency method as thin or thick and coded as 0 and 1, respectively, gingival thickness and Schneiderian membrane thickness in mm, arch form as square, oval, or tapered (radiographically by cone beam computed tomography images). Central incisors and first molars were assessed for gingival biotype and gingival thickness and Schneiderian membrane thickness was determined at 16. Numerical data were estimated for normal distribution. Analysis of Variance test was followed by Tukey honestly significant difference test and Pearson's correlation coefficient test for analysis. Thin gingival biotype was found associated with the central incisors and thick gingival biotype with molars. Limited cone beam computed tomography scans evaluation revealed highest prevalence of square arch form followed by oval, and tapered. The average thickness of the Schneiderian membrane was 1.18 ± 0.43 mm on left side and 1.09 ± 0.41 mm on right side with a range of 0.50 - 2.00 mm. Mean Schneiderian membrane thickness was more in case of thick gingival biotype and with square arc form both on right and left sides. The Schneiderian membrane thickness was positively and highly associated with gingival biotype. The gingival biotype and arch form had significant effect on Schneiderian membrane thickness and can provide valuable clinical information on Schneiderian membrane thickness preoperatively for implant placement and sinus lift procedures.

Changes in the thickness of schneiderian membrane and sinus pathology after implant placement with a transalveolar approach for sinus floor elevation

Changes in the thickness of schneiderian membrane and sinus pathology after implant placement with a transalveolar approach for sinus floor elevation

The relation of schneiderian membrane thickness and membrane perforation in sinus lift procedure: a systematic review

The relation of schneiderian membrane thickness and membrane perforation in sinus lift procedure: a systematic review

Long-term Schneiderian membrane thickness changes following zygomatic implant placement: A retrospective radiographic analysis using cone beam computed tomography.

The purpose of this retrospective study was to evaluate the long-term changes in the thickness of Schneiderian membranes after zygomatic implant placement using cone beam computed tomography (CBCT). Twenty-five consecutive patients were included in this study. All the patients underwent bilateral zygomatic implant placement. Schneiderian membrane thickness (SMT) in 49 maxillary sinuses (one sinus was not included because of early loss of the zygomatic implants) was measured using CBCT before and at least 1year after zygomatic implant placement. Ostium patency of each sinus was also evaluated and recorded. In total, 84 zygomatic implants and 30 regular implants were placed in included patients. Two unilateral maxillary zygomatic implants in one patient were removed 2months after implant placement. The SMT increased from 1.03mm (inter-quartile range: 1.57mm) to 1.33mm (inter-quartile range: 1.98mm) after a median follow-up time of 23.00months (inter-quartile range: 14months), and the difference was statistically significant. Before zygomatic implant insertion, 24.5% (12/49) of sinuses had SMT greater than 2mm, whereas this value was 28.6% (14/49) after zygomatic implant placement. The percentage of sinuses observed with ostium patency also increased from 2.0% (1/49) to 12.2% (6/49). Chronic Schneiderian membrane thickening could result from zygomatic implant insertion. Intensive postoperative care and clinical and radiographic monitoring are recommended after zygomatic implant placement.

Evaluation of the Characteristics and Association Between Schneiderian Membrane Thickness and Nasal Septum Deviation.

Nasal septum deviation (NSD) is an anomaly that disturbs normal mucus drainage in sinuses, leading to recurrent sinusitis. Sinusitis, infections, and mucosal irritations are the potential causes of Schneiderian membrane thickening (SMT). The aim of this study was to evaluate the characteristics and association between NSD and SMT along with factors such as age, gender, and tooth groups using cone-beam computed tomography (CBCT) imaging. The maxillary sinus and nasal cavity of 249 patients (136 females and 113 males) were examined retrospectively using CBCT. The statistical analysis was performed to determine the association between SMT, NSD, gender, and age. No statistically significant relation was detected between NSD and SMT. The NSD was found in 50.6% of patients without gender predilection. Age was not associated with the presence of NSD. The mean thickness of the membrane was least in the third molar region and highest in the first molar region. The average SMT was found to be higher in males for all the examined tooth areas (P ≤ 0.05). A retrospective evaluation of CBCT images emphasized the concept that NSD was not a factor that affected the thickening of maxillary sinus mucosa. The CBCT imaging could be used for evaluating the maxillary sinuses and nasal septum.

Correlation between Gingival Biotype, Marginal Bone Loss, Periapical Infection and Schneiderian Membrane Thickness in Chronic Periodontitis Patients (A Cross-Sectional

Background: Identification of factors affecting maxillary sinus membrane thickness would be of practical importance in surgical planning for both implant placement and otolaryngeal surgery. This study aimed to analyze a possible correlation be­tween Schneiderian membrane thickness (SMT) and gingival biotype (GB), marginal bone loss (MBL) and presence of periapical infection (PAI) of related teeth using Cone beam computed tomography (CBCT)Subjects and Methods: A total of fifty consecutive moderate to severe chronic periodontitis patients were included in this cross-sectional study. The patients’ sex and age were recorded. Clinical measurement of (GB) was performed in the premolar and first molar area, and then (CBCT) images of patients were examined for (SMT), (MBL) and presence of (PAI) in the same area. All measured parameters were analyzed and graded. Then correlation between these parameters and Schneiderian membrane thickness was evaluated.Results: Higher percentage of severe SMT was observed in patient with thick gingival biotype (37.3%) than those with thin biotype (33.3%) and a direct positive correlation between SMT and MBL (r= 0.595, p<0.001) was detected. Cases with PAI showed higher mean sinus membrane thickness (5.3±1.97) than normal cases (2.26±1.90) (p<0.001).Conclusion: The presence of periapical infection marginal bone loss or clinically detected thick gingival biotype in the maxilla could be associated with thicker Schneiderian membrane, so clinicians should be aware of these clinical and radiographic findings that could predict the sinus membrane thickness.

Evaluation of the effect of apical lesion on mucosal thickening and thickness of apical bone using limited cone-beam computed tomography.

The purpose of this study was to evaluate the effect of periapical lesion size on the degree of mucosal thickening of maxillary sinus and thickness of apical bone using cone-beam computed tomography. In Group 1 (teeth with apical lesions), diameter of apical lesion, width of apical bone, thickness of Schneiderian membrane; for Group 2 (teeth without apical lesions), width of apical bone in long axis of root and thickness of Schneiderian membrane were measured on coronal and sagittal images. Mann-Whitney U-test revealed no significant difference between two groups regarding mucosal thickening and apical bone measurements (P > 0.05). Wilcoxon signed-rank test showed no significant difference between the measurements in sagittal and coronal slices (P > 0.05). Results of the present study showed that Schneiderian membrane near the maxillary premolars and molars with apical lesions is not significantly thicker compared to teeth without apical lesions.

Mechanical characteristics of the maxillary sinus Schneiderian membrane ex vivo.

It has been speculated that certain Schneiderian membrane thickness (SMT) might be more prone to perforation. This investigation was aimed at studying the mechanical characteristics of the Schneiderian membrane under one- and two-dimensional tests and their correlation to the histological SMT in human samples. Sixteen Schneiderian membranes were collected from 11 cadaver heads treated with Thiel's embalming method. The samples were processed and analyzed clinically and histologically. One-dimensional maximum elongation until perforation and two-dimensional resistance to ball penetration were performed after the biopsy. Data was analyzed by using the Wilcoxon rank test and the Spearman's rank correlation. The histological SMT was 1.36±0.42mm, whereas the clinical thickness was 0.27±0.21mm, yielding statistical significance (p=0.000). The resistance under ball penetration was 0.59±0.43N and the mean maximum elongation in the one-dimension test 11.19±7.14mm. Expressed in percentage, the mean stretch was 241.36±227.97% (range 31.5 up to 947%). A weak positive correlation was found between the ball penetration test and the SMT (r=0.10, p=0.711), while a weak negative correlation was found between stretching test and the SMT (r=-0.021, p=0.94). Mechanical tests seem to indicate that SMT might not significantly predispose to Schneiderian membrane perforation. Hence, other anatomical and operator's factors should be considered of surpassing importance. Thinner SM might be more prone to perforation when detaching it from the maxillary sinus antrum; however, a thick membrane is not prevented to tear, as their resistance under elastic forces is not higher than thinner ones.

The effect of demographic and disease variables on Schneiderian membrane thickness and appearance

The purpose of this study was to evaluate the prevalence of sinus mucosal thickening (MT) and mucosal appearance (MA) in a patient population as detected with cone beam computed tomography (CBCT) and to determine the effects of various disease and demographic factors on MT and MA. The retrospective study consisted of CBCT images of 1000 maxillary arches in 500 patients. The arches were divided into 3 groups (atrophic, partially atrophic, and nonatrophic) according to the type of the maxillary dental crest. The CBCT scans were assessed to detect the prevalence of maxillary sinus MT and MA. χ2 analysis was used to determine the significance of association of periodontal bone loss (PBL), periapical (PA) status, alveolar crest type, age, and gender on sinus MT and MA. MT was significantly associated with PBL (P = .004), PA status (P = .001), and gender (P < .01). MA was significantly associated with PBL (P = .038), PA status (P = .009), and gender (P < .020). There were no significant associations between age or crest type and either MT or MA. Periodontal bone loss, PA lesions, and gender may have an association with MT of the maxillary sinus.

Radiological evaluation of maxillary sinus anatomy: A cross-sectional study of 300 patients

ObjectiveThe aim of the present study was to evaluate the principal anatomical characteristics of the maxillary sinus using Cone Beam Computed Tomography (CBCT) in order to facilitate prevention of intra- and post-operative complications. Materials and methodsThree hundred CBCT scans from patients undergoing implant surgery were analysed. The following anatomical structures were evaluated: (1) Residual ridge height (RRH) and width (RRW); (2) Ridge bone density (BD); (3) Maxillary sinus angle (MSA); (4) Maxillary sinus lateral wall thickness (LWT); (5) Schneiderian membrane thickness (MT); (6) Maxillary sinus septa (SS); (7) Posterior superior alveolar artery (PSAA).‘ ResultsMean patient age was 59.5±13.6. Mean RRH at upper second premolar (2PM) was 8.66±3.95mm, 4.90±2.28mm at first molar (1M), and 5.26±2.13mm at second molar (2M). Mean RRW was 6.72±2.69mm at 2PM, 6.87±2.65mm at 1M and 7.09±2.80mm at 2M. Bone density was 330.93±211.02 Hounsfield Units (HU) at first molar position and MSA was 73.39±15.23°. LWT was 1.95±0.98mm. Mean Schneider Membrane thickness (MT) was 1.82±1.59mm; MT was ≤3mm in 72.9% of patients and >3mm in 27.10%. 20.56% of patients presented bucco-palatal oriented septa with a mean height of 13.11±3.82mm. PSAA was observed in 48.60% and mean distance to the top of the ridge was 13.15±3.71mm, and was mostly observed inside the sinus (53.85%). ConclusionsCBCT scanning has been shown to be a useful tool for evaluating maxillary sinus anatomical variations. CBCT should be considered the gold standard when evaluating the maxillary sinus area.