Analysis of the anatomy of the maxillary sinus septum using 3-dimensional computed tomography.
ABSTRACT Maxillary posterior teeth exhibit a high incidence of periodontal bone and tooth loss. After tooth loss, the edentulous alveolar process of the posterior maxilla is often affected by resorption, which results in loss of vertical bone volume. Moreover, progressive sinus pneumatization leads to a decrease in the alveolar process from the cranial side. The sinus elevation and augmentation surgical technique opened a new way of anchoring endosseous implants despite discernible bone reduction. However, the surgical interventions require in-depth knowledge of maxillary sinus anatomy such as sinus septum and potential variations. The purpose of this study was to investigate the prevalence, location, height, morphology, and orientation of maxillary sinus septa by use of computed tomography (CT) and 3-dimensional imaging.
Two hundred patients undergoing implant treatment at the Yonsei University College of Dentistry, Seoul, South Korea, were randomly selected for analysis of maxillary sinus septa. CT and DentaScan (GE Medical Systems, Milwaukee, WI)-reformatted data from 400 sinuses were analyzed with the Preview program (Infinitt, Seoul, South Korea). Three-dimensional images were rendered for measurement by use of the Accurex program (CyberMed, Seoul, South Korea).
We found 111 septa in 400 maxillary sinuses (27.7%). This corresponded to 37% of the patients. Among total septa, 25 sinus septa (22.5%) were located in the anterior, 51 (45.9%) in the middle, and 35 (31.5%) in the posterior regions. The directional orientation analyses showed that 106 septa were buccopalatal, 4 were sagittal, and 1 was transverse type. The mean septal heights were 7.78 ± 2.99 and 7.89 ± 3.09 mm in the right and left sinuses, respectively.
Three-dimensional CT image analyses may provide useful information that can avoid unnecessary complications during sinus augmentation procedures by facilitating adequate, timely identification of the anatomic structures inherent to the maxillary sinus.
- SourceAvailable from: Tomasz Smektała[Show abstract] [Hide abstract]
ABSTRACT: Background: The purpose of this review is to indicate the prevalence of septa, illustrate the most adequate diagnostic method and further discuss pre-operative considerations and implantological implications. Materials and methods: On June 30 th , 2013, a comprehensive database search was executed using PubMed (Medline) and Google Scholar. No time frames were applied. Only publications in English, Polish and German in peer-reviewed journals were considered. Results: The final number of articles was 55: 7 articles were found to describe the possible aetiology of sinus septa, 34 articles describing the prevalence, 21 including information on classification, 19 showed methods of diagnosis and 24 articles included practical information about the influence of the septa in pre-and implantation surgery. One article could be found in more than one category. Conclusions: Septa can be found in 9% to 70% patients (mean prevalence: about 36%) in every age group — young dentate patients as primary septa and old edentate or edentulous patients as primary or secondary septa more frequ-ent in edentate or edentulous patients. When planning any surgical procedures, septa incidence should be taken into consideration. Precise information about the septa can be obtained from computed tomography (CT) or cone-beam CT. With development of the knowledge and surgical technique, septa appearance has simply become another option for treatment as any form of disadvantage.Folia morphologica 12/2013; 73(3):259-266. · 0.47 Impact Factor
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ABSTRACT: Purpose: The purpose of this study was to evaluate the feasibility of the outfracture osteotomy sinus graft technique with the evaluation of 8.5 year survival rate of the implants placed in the atrophic edentulous posterior maxillary area. Methods: One hundred and seventy-six cases of 145 patients who visited our center from August 2004 to February 2013 and were diagnosed as atrophic edentulous maxillary alveolar ridge, were selected and underwent sinus graft with outfracture osteotomy sinus graft technique. Feasibility of the outfracture osteotomy sinus graft technique was investigated with clinical and radiographic evaluation to assess the survival rate of the total dental implants in augmentation sinus surgery. Total fixture number available in follow-up period was 320, in which the lost 15 patients were excluded out of 160 patients. Results: Eight point five year cumulative survival rate was 95.6% with 14 failures of total 320 fixtures. The average follow-up period was 28 months 16 days with the minimum and maximum follow-up periods of 4 months 5 days and 94 months 10 days, respectively. Conclusion: Traditional infracture technique is a popular method for an augmentation sinus surgery. The authors modified this classical method by outfracturing and readapting the bony window after sinus graft, with excellent treatment results evidenced by high survival rate, which proves the feasibility of the newly-designed outfracture osteotomy sinus graft technique.Maxillofacial Plastic and Reconstructive Surgery. 01/2013; 35(2).
- Clinical Maxillary Sinus Elevation Surgery,, First Edition. edited by Daniel Kao, 04/2014: chapter 3: pages 31-56; Wiley-Blackwell., ISBN: 978-0-470-96073-8