The maxillary sinus floor in the oral implantology

Clinical and Topographical Anatomy Department, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie (Impact Factor: 0.66). 02/2008; 49(4):485-9.
Source: PubMed


The aim of this study was to establish the mean distances between the maxillary sinus floor and the roots of the lateral maxillary teeth in dentate subjects, respectively the mean height of the available bone for oral implant placement in the corresponding area, in edentulous ones.
We determined the maxillary sinus floor position in relation to morphoclinical alveolodental benchmarks on 50 dry skulls, dentate 30 and edentulous 20, and correlations were performed by use of 40 CT-scans of the targeted area. In addition, 20 human adult cadavers were bilaterally dissected in order to bring topographical evidence at that level.
The data we obtained lead us to define three dentosinusal relations: tangent (close) relation 60.8%; distanced relation 25.6%; penetrating relation: 13.6%; three subantral classes in edentulous patients, emphasizing the direct relation of the age of the edentulism and the degree of bone resorption. We discuss the results we obtained from the viewpoint of their application in the field of oral implantology.
The maxillary sinus floor represents the danger zone for the oral implantology.

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Available from: Nicoleta Măru, Mar 28, 2014
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    • "Although the current study did not calculate the amount of bone remaining between sinus floor and root apices, yet it is obvious that the maximum amount of sinus pneumatization around the 2nd molar obtained in our study goes in agreement with the least amount of bone remaining above the 2nd molar in different studies [6] [17] [29] [35]. The inverse relation between sinus pneumatization and remaining alveolar bone is well known and is further strengthened by Nimigean et al. [35]. Their study inferred that the antral floor depends upon the dental scaffold that constitutes the main factor during development and will transform in relation with the normal/pathological status of the dentoperiodontal apparatus, for which they concluded that the available bone is lost from the inferior expansion of the sinus after teeth loss. "
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    ABSTRACT: Objective The purpose of this study was to assess whether and how the information obtained by means of cone beam computed tomography (CBCT) on maxillary posterior teeth differs from that obtained by panoramic radiography. Materials and method From 157 subjects (mean age 48 years, range 19–84 years; 89 females) referred to the oral imaging center, a pair of panoramic and CBCT images was selected for further analysis. Both imaging modalities were analyzed to determine the topographic relationship of maxillary teeth to the sinus floor. Pathologic conditions, apical periodontitis, and presence of soft tissue thickening were also examined with both techniques. Results CBCT showed an intimate relationship of the first and second molar with the maxillary sinus in 54 and 38 %, respectively. Thirty-nine apical periodontitis lesions causing reactive changes in the maxillary sinus were detected by CBCT, while just six of them were diagnosed with panoramic imaging. A total of 26 teeth with apical extension to the maxillary sinus were detected with CBCT, from which two could be identified with panoramic radiography. Conclusion This study emphasizes that anatomical and pathological involvement of the maxillary sinus in relation to posterior teeth is considerably high. It is of clinical importance that the 3D nature of CBCT imaging allowed a better assessment of the relationship between the maxillary sinus and posterior root apices compared to the low detection on panoramic radiographs. Clinical relevance CBCT imaging can be a valuable adjunct in radioanatomical and radiodiagnostic observations in the posterior maxilla. It may better visualize maxillary sinus involvement for posterior upper teeth than panoramic radiography.
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