Analysis of the anatomy of the maxillary sinus septum using 3-dimensional computed tomography

Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, South Korea.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons (Impact Factor: 1.28). 04/2011; 69(4):1070-8. DOI: 10.1016/j.joms.2010.07.020
Source: PubMed

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.

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    • "A CT scan can determine sinus pathology that panaromic radiography cannot detect. CT imaging provides proper surgical planing and helps to prevent complications [8]. In our cases, both septas were not observed with panoramic radiograph so a preoperative CT examination was necessary. "
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    ABSTRACT: Maxillary sinus septas are barriers of cortical bone that arise from the floor or from the walls of sinus and may even divide the sinus into two or more cavities. Morphologically maxillary sinus septa are generally oriented in buccopalatinal orientation horizontal or sagittal orientation of the sinus septa is a rare condition. This report presents two sinus lift case, in which observed septa in a horizontal orientation was presented. Both cases were fixed by an implant supported prosthethic restoration. Surgeons must know detailed knowledge about maxillary sinus anatomy for successful sinus augmentation. Computed tomography (CT) is useful for examining the maxillary sinus. Horizontal-type sinus septa are rarely seen. Surgeons must be aware of septa types and orientations. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
    05/2015; 44. DOI:10.1016/j.ijscr.2015.05.001
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    • "Prompt evaluation of the maxillary sinus volume can be useful in procedures of sinus floor elevation in placement of implants (Kuhl et al., 2010) or to establish the optimal volume of implant in this procedure (Gray et al., 2000); it is also useful to determine the percentage of pneumatization in this cavity (Park et al., 2011). "
    International Journal of Morphology 12/2011; 29(4):1375-1378. DOI:10.4067/S0717-95022011000400051 · 0.20 Impact Factor
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    ABSTRACT: Antral pathoses and anatomical variations increase the risk of surgical complications during a lateral window sinus augmentation procedure. Therefore, an understanding of maxillary sinus diseases and anatomies is imperative. In the first part of this article, common sinus diseases will be reviewed, which include acute/chronic rhinosinusitis, mucoceles, pseudocysts, retention cysts, and odontogenic diseases of the maxillary sinus. In addition, a treatment strategy will be proposed toward the management of these antral diseases. In the second part, anatomical variations of the maxillary sinus, for example, the septum and artery that is in approximation to the osteotomy site will be discussed. Knowledge of diagnosing and managing sinus pathoses and anatomies could assist surgeons in reducing the incidence of sinus augmentation complications.
    Implant dentistry 12/2011; 20(6):406-12. DOI:10.1097/ID.0b013e3182341f79 · 1.11 Impact Factor
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