The potential clinical relevance of anatomical structures and variations of the maxillary sinus for planned sinus floor elevation procedures: A retrospective cone beam computed tomography study

Clin Implant Dent Relat Res. 2019 Feb;21(1):114-121. doi: 10.1111/cid.12703. Epub 2018 Dec 17.

Abstract

Background: Complications arising from sinus floor elevation (SFE) with lateral approach surgery can be avoided by means of maxillary sinus examination in the preoperative period.

Purpose: To investigate anatomical variations in the maxillary sinus by making use of cone beam computed tomography (CBCT) in terms of SFE with a lateral approach.

Materials and methods: Two hundred twenty eight maxillary sinuses in 114 patients were included. Parameters such as the position and diameter of the posterior superior alveolar artery (PSAA) canal, the frequency and localization of the septa or accessory maxillary ostium (AMO), and lateral wall thickness values were subjected to statistical analysis.

Results: Septa were observed in 35.1% of sinuses. The majority of septa were determined in the middle region (48.8%). Additionally, 71.1% of PSAA canals were intraosseous, generally exceeding 1 mm in diameter (68.9%). The shortest mean perpendicular distance between the sinus floor and the PSAA canal was determined in the first molar region (9.22 ± 5.66 mm). Similarly, the highest mean sinus lateral wall thickness was determined in the first molar region, in the area 3 mm distant from the sinus floor (2.42 mm ± 0.88 mm). AMO was detected in 40.8% of sinuses.

Conclusion: CBCT-guided treatment planning may be beneficial prior to SFE procedures in order to avoid surgical complications.

Keywords: maxillary sinus; maxillary sinus floor elevation; sinus augmentation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cone-Beam Computed Tomography
  • Female
  • Humans
  • Male
  • Maxillary Sinus / anatomy & histology*
  • Maxillary Sinus / blood supply
  • Maxillary Sinus / diagnostic imaging
  • Middle Aged
  • Retrospective Studies
  • Sinus Floor Augmentation* / methods
  • Treatment Outcome
  • Young Adult