Maxillary sinus septa: prevalence, morphology, diagnostics and implantological implications. Systematic review

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 frequent 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.

Shape, Septa and Scalloping of the Maxillary Sinus

“…This study illustrated that they are present in all age groups and that they were most prevalent from thirteen to fifteen years of age. This may correlate with pneumatization of the sinus (Scuderi et al) and may confirm Vinter's theory that the "septa remains were the margin of two post pneumatization regression zones allowing for transfer of masticatory pressure" (Malec et al, 2014).…”

“…Most authors classify the septa as according to Underwood (1910), who had suggested that they arise due to tooth development. The current study noted the highest prevalence of septa in the anterior region (27.9 % right; 28.5 % left) as with previous studies such as Malec et al (2014). It is not certain as to how the maxillary septa may develop, but according to Malec et al (2014), they may occur during craniofacial development in relation to the sutures found along the alveolar process and maxillary sinus, or they may be due to tooth development and masticatory forces.…”

“…The current study noted the highest prevalence of septa in the anterior region (27.9 % right; 28.5 % left) as with previous studies such as Malec et al (2014). It is not certain as to how the maxillary septa may develop, but according to Malec et al (2014), they may occur during craniofacial development in relation to the sutures found along the alveolar process and maxillary sinus, or they may be due to tooth development and masticatory forces. Other authors such as Nievert et al (1930, cited by Malec et al, 2014 suggest that they are embryonic outpouchings of the ethmoid infundibulum.…”

“…The author noted their location in the anterior, middle and posterior regions of the sinus, and they appeared to have a relation to tooth development (Malec et al, 2014). Most studies confirm this and noted that maxillary septa are of importance during dental implantations and sinus lifts as their presence may complicate these procedures (Malec et al, 2015).…”

“…These structures were more common in the anterior region, and in females. The maxillary morphology is important during planning of dental procedures such as dental implantation and sinus augmentation (Malec et al, 2014), as well as anthropologically in forensic identification such as age or population affinity. …”