The implications of different lateral wall thicknesses on surgical access to the maxillary sinus

Abstract

The objective of this study was to measure the topographic thickness of the lateral wall of the maxillary sinus in selected Asian populations. Measurements were made on the lateral walls of maxillary sinuses recorded using CBCT in a convenient sample of patients attending an Asian teaching hospital. The points of measurement were the intersections between the axes along the apices of the canine, first premolar, and second premolar and along the mesiobuccal and distobuccal apices of the first and second molars and horizontal planes 10 mm, 20 mm, 30 mm and 40 mm beneath the orbital floor. The CBCT images of 109 patients were reviewed. The mean age of the patients was 33.0 (SD 14.8) years. Almost three quarters (71.8%) of the patients were male. The mean bone thickness decreased beginning at the 10-mm level and continuing to 40 mm below the orbital floor. Few canine regions showed encroachment of the maxillary sinus. The thickness of the buccal wall gradually increased from the canine region (where sinus encroachment of the canine region was present) to the first molar region, after which it decreased to the thickness observed at the canine region. The buccal wall of the maxillary sinus became thicker anteroposteriorly, except in the region of the second molar, and thinner superoinferiorly. These changes will affect the approach used to osteotomize the lateral sinus wall for oral surgery and for the sinus lift procedure.

The prevalence and location of the posterior superior alveolar artery in the maxillary sinus wall: A preliminary computed-cone beam study

“…Major surgeries include tumour or cancer resection, or a Le Fort I and II osteotomy as in orthognathic surgery. Additionally, the maxillary sinus forms part of the midfacial skeleton that is prone to fracture during trauma, resulting in the need for open reduction and internal fixation to realign the displaced segments ( Lim et al, 2017 ).…”

Levantamento de seio maxilar seguido de instalação imediata de implante do tipo cone morse: relato de caso

“…A perda de dentes na maxila posterior além de gerar reabsorção óssea natural, pode ocasionar a pneumatização do seio maxilar [4][5][6] . Ademais, o osso da região posterior da maxila possui baixa densidade óssea, com osso trabeculado poroso e cortical óssea delgada, constituindo fatores que inviabilizam a instalação dos implantes 7,8 . A cirurgia de levantamento de seio maxilar visa a corrigir a insuficiência óssea da maxila e viabilizar a instalação dos implantes 3,4,7 .…”

Three-dimensional CBCT based evaluation of the inferior part of the maxillary sinus: Retrospective Study

“…However, maxillary sinus floor augmentation frequently leads to complications such as perforation in the inferior part of the maxillary sinus, excessive bleeding, and hematoma 4,5 . Hence, dental radiographs have been used to analyze the anatomical structure of the inferior part of the maxillary sinus, including to predict the prognosis of implant surgery 3,[6][7][8][9][10][11][12][14][15][16] . However, it is difficult to differentiate between the maxillary sinus floor and the Schneiderian membrane on radiographs 7 .…”

“…CBCT allows the assessment of complicated anatomical structures that are difficult to observe on panoramic scans due to the presence of overlapping structures. CBCT has previously been used in the treatment of lesions, trauma, and congenital malformation surgery, but it is now also being widely used in dental clinics 3,[6][7][8][9][10][11][12][14][15][16] . Studies have used CBCT in maxillary sinus floor augmentation for measuring the height of the residual bone crest 6,8,9 , the thickness of the lateral maxillary sinus bone wall 6,10,11 , and the angle of the palatal-nasal recess (PNR) 3,11 in the inferior part of the maxillary sinus.…”

“…Therefore, the inferior part of maxillary sinus is an anatomically and clinically important structure. Nevertheless, studies reported so far measured CBCT in two-dimensional (2-D) without visualizing it in three-dimensional (3-D) 3,[6][7][8][9][10][11][12][14][15][16] . CBCT does not suffer from panoramic overlap, analyses might not be accurate without utilizing 3-D visualization 7 .…”