Factors influencing the sinus membrane thickness in edentulous regions: a cone-beam computed tomography study

Abstract

Background During implant treatment in the maxillary molar area, maxillary sinus floor augmentation is often performed to ameliorate the reduced alveolar bone height attributable to bone remodeling and pneumatization-induced expansion of the maxillary sinus. However, this augmentation may cause complications such as misplaced implants, artery damage, and maxillary sinus mucosal perforation; infections like maxillary sinusitis; and postsurgical complications such as bone graft leakage and postoperative nasal hemorrhaging. To reduce the complications during maxillary sinus floor augmentation and postoperative infections, we performed retrospective investigations of various systemic and local factors that influence pre-operative sinus mucosal thickness (SMT) by using cone-beam computed tomography (CBCT). Subjects included patients who underwent maxillary sinus floor augmentation in an edentulous maxillary molar area with a lateral approach. Pre-operative SMT, existing bone mass, and nasal septum deviation were measured using CBCT images. Relationships between SMT and the following influencing factors were investigated: (1) age, (2) sex, (3) systemic disease, (4) smoking, (5) period after tooth extraction, (6) reason for tooth extraction, (7) residual alveolar bone height (RBH), (8) sinus septa, and (9) nasal septum deviation. Correlations were also investigated for age and RBH (p < 0.05). Results We assessed 35 patients (40 sinuses; 11 male, 24 female). The average patient age was 58.90 ± 9.0 years (males, 57.9 ± 7.7 years; females, 59.9 ± 9.4 years; age range, 41–79 years). The average SMT was 1.09 ± 1.30 mm, incidence of SMT > 2 mm was 25.0%, incidence of SMT < 0.8 mm was 50.0%, and the average RBH was 2.14 ± 1.02 mm. The factors that influenced SMT included sex (p = 0.0078), period after tooth extraction (p = 0.0075), reason for tooth extraction (p = 0.020), sinus septa (p = 0.0076), and nasal septum deviation (p = 0.038). Conclusions Factors associated with higher SMT included male sex, interval following tooth extraction < 6 months, periapical lesions, sinus septa, and nasal septum deviation. Factors associated with SMT > 2 mm were sex and reason for tooth extraction, while factors associated with SMT < 0.8 mm were time following tooth extraction and nasal septum deviation. Despite the limitations of this study, these preoperative evaluations may be of utmost importance for safely conducting maxillary sinus floor augmentation.

Biomechanical analysis of the maxillary sinus floor membrane during internal sinus floor elevation with implants at different angles of the maxillary sinus angles

“…Ongoing discussion exists on a standard imaging threshold for the maxillary sinus mucosal thickness. With most studies using 1 mm as a standard [ 50 , 51 ], we simplified the maxillary sinus membrane by setting its thickness to 1 mm.…”

Efficacy of mucolytics and steam therapy in the management of sinusitis among Indians

“…However, it is most common to see sinus membrane thickening even in patients who are clinically asymptomatic and it is concluded that sinus membrane thickness of more than 4 mm is pathological in nature [ 16 ]. It is highly essential for the clinician to correlate the radiographic and clinical findings and plan the treatment accordingly [ 17 ]. The cause of the sinus membrane thickening and fluid accumulation may be due to "Acute rhinosinusitis" if the symptoms such as posterior or anterior nasal discharge, blockage of nose, congestion develops within 12 weeks of time duration [ 18 ] .Radiographic imaging reveals changes in the mucosa with hazy, fluid filled ostiomeatal complex.…”

Effects of missing teeth and nasal septal deviation on maxillary sinus volume: a pilot study

“…In accordance with our previous study [ 13 ], the presence of NSD was determined on coronal CBCT by the method described by Bhandary and Kamath [ 14 ]. A straight line was drawn from the maxillary anterior spine to the crista galli.…”