Schneiderian Membran Kalınlığı ile Sinüs Taban Kortikasyonu Arasındaki İlişkinin Konik Işınlı Bilgisayarlı Tomografi ile Değerlendirilmesi

Year 2020, , 1 - 6, 15.01.2020

Seval Bayrak , Gülbahar Ustaoğlu , Gözde Serindere , Hüsniye Demirtürk Kocasaraç

https://doi.org/10.21673/anadoluklin.466703

Abstract

Amaç: Bu
çalışmada sinüs tabanı kortikasyonu (STK) ve Schneiderian membran kalınlığı
(SMK) arasındaki ilişkiyi konik ışınlı bilgisayarlı tomografi (KIBT)
görüntüleri üzerinden incelemek amaçlanmıştır.

Gereç ve Yöntemler: Dental implant tedavisi için KIBT çektirmiş 146 hastaya ait (61 erkek, 85
kadın) toplam 292 maksiller sinüs değerlendirildi. STK şu şekilde sınıflandırıldı:
tip 1: çevre kortikal alanla benzer ya da daha yüksek dansite gösteren sinüs tabanı,
tip 2: çevre kortikal alandan daha düşük dansite gösteren sinüs tabanı, tip 3:
kortikal kemik içermeyen sinüs tabanı, tip 4: krestal kemikle kaynaşmış sinüs
tabanı. Kesitsel görüntülerde membranın en üst noktası ile tabanı arasında ölçülen
SMK ile STK tipleri arasındaki ilişki de incelendi.

Bulgular: Tip 1, tip 2, tip 3 ve tip 4 STK sırasıyla 114, 102, 48 ve 28 vakada görüldü.
Schneiderian membran tip 1 STK’de tip 2 STK’ye kıyasla daha ince bulundu. Tip 3
STK ile tip 4 STK arasında SMK açısından anlamlı fark görülmedi.

Tartışma ve Sonuç: STK ve SMK’nin KIBT ile değerlendirilmesi sinüs greftleme sonrası tedavide
implant stabilitesi ve sağkalımı hakkında bilgi sağlayabilir. Tip 1 STK,
implant yerleştirme için elverişli iken, daha yüksek bir membran perforasyonu riski
ile ilişkili olabilir.

Keywords

Kortikasyon, Schneiderian Membran, Sinus Taban Ogmentasyonu, Konik Işınlı Bilgisayarlı Tomografi, Dental İmplantasyon

Evaluation of the Relationship Between Schneiderian Membrane Thickness and Sinus Floor Cortication Using Cone Beam Computed Tomography

Abstract

Aim: In this study, we aimed to investigate the
relationship between sinus floor cortication (SFC)
and Schneiderian membrane thickness (SMT) through cone-beam computed tomography
(CBCT) images.

Materials and Methods: A total of 292 maxillary
sinuses of 146 patients (61 males, 85 females) who underwent a CBCT scan for dental implant
treatment were evaluated. SFC was classified as follows: type-1: sinus floor
exhibiting similar or higher density than the surrounding cortical areas, type-2:
sinus floor exhibiting lower density than the surrounding cortical areas, type-3:
sinus floor exhibiting no cortical bone, and type-4: sinus floor exhibiting
fusion of sinus floor bone and native crestal bone. We also investigated the relationship
between the SFC types and SMTs measured from the highest border of the membrane
to the sinus floor on cross-sectional images.

Results: Type-1, type-2, type-3, and type-4 SFC were seen in
114, 102, 48, and 28 cases, respectively. The Schneiderian membrane was found
to be thinner in type-1 SFC than in type-2 SFC. No significant difference was
found between type-3 and type-4 SFC in terms of SMT.

Discussion and Conclusion: Evaluation of SFC and SMT
using CBCT can provide information about implant stability and survival in treatment after sinus grafting. Although
type-1 SFC is favorable for implant placement, it may also be associated with
an increased risk of membrane perforation.

Keywords

Cortication, Schneiderian Membrane, Sinus Floor Augmentation, Cone-Beam Computed Tomography, Dental Implantation

References

• REFERENCES1. Arman C, Ergur I, Atabey A, Guvencer M, Kiray A, Korman E, et al. [The thickness and the lengths of the anterior wall of adult maxilla of the West Anatolian Turkish people]. Surg Radiol Anat. 2006;28(6):553-8.
• 2. Sharan A, Madjar D. [Maxillary sinus pneumatization following extractions: a radiographic study]. International Journal of Oral and Maxillofacial Implants. 2008;23(1):48-55.
• 3. Tan WL, Wong TL, Wong M, Lang NP. [A systematic review of post‐extractional alveolar hard and soft tissue dimensional changes in humans]. Clin Oral Implants Res. 2012;23(s5):1-21.
• 4. Aghaloo TL, Moy PK. [Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement?]. Int J Oral Maxillofac Implants. 2007;22 Suppl:49-70.
• 5. Del Fabbro M, Testori T, Francetti L, Weinstein R. [Systematic review of survival rates for implants placed in the grafted maxillary sinus]. Int J Periodontics Restorative Dent. 2004;24(6):565-77.
• 6. Wallace SS FS. [Effect of maxillary sinus augmentationon the survival of endosseous dental implants. A systematic review.]. Ann Periodontol. 2003;8:328-43.7. Choucroun G, Mourlaas J, Kamar Affendi NH, Froum SJ, Cho SC. [Sinus Floor Cortication: Classification and Prevalence]. Clin Implant Dent Relat Res. 2017;19(1):69-73.
• 8. Cakur B, Sumbullu MA, Durna D. [Relationship among Schneiderian membrane, Underwood's septa, and the maxillary sinus inferior border]. Clin Implant Dent Relat Res. 2013;15(1):83-7.
• 9. Hernandez-Alfaro F, Torradeflot MM, Marti C. [Prevalence and management of Schneiderian membrane perforations during sinus-lift procedures]. Clin Oral Implants Res. 2008;19(1):91-8.
• 10. Pommer B, Unger E, Suto D, Hack N, Watzek G. [Mechanical properties of the Schneiderian membrane in vitro]. Clin Oral Implants Res. 2009;20(6):633-7.
• 11. Oh E, Kraut RA. [Effect of sinus membrane perforation on dental implant integration: a retrospective study on 128 patients]. Implant Dent. 2011;20(1):13-9.
• 12. Wen SC, Lin YH, Yang YC, Wang HL. [The influence of sinus membrane thickness upon membrane perforation during transcrestal sinus lift procedure]. Clin Oral Implants Res. 2015;26(10):1158-64.
• 13. Schatzker J, Horne JG, Sumner-Smith G. [The effect of movement on the holding power of screws in bone]. Clin Orthop Relat Res. 1975(111):257-62.
• 14. Bidez MW, Misch CE. [Force transfer in implant dentistry: basic concepts and principles]. J Oral Implantol. 1992;18(3):264-74.
• 15. White SC, Pharoah MJ. [The evolution and application of dental maxillofacial imaging modalities]. Dent Clin North Am. 2008;52(4):689-705, v.
• 16. Janner SF, Caversaccio MD, Dubach P, Sendi P, Buser D, Bornstein MM. [Characteristics and dimensions of the Schneiderian membrane: a radiographic analysis using cone beam computed tomography in patients referred for dental implant surgery in the posterior maxilla]. Clin Oral Implants Res. 2011;22(12):1446-53.
• 17. Guo ZZ, Liu Y, Qin L, Song YL, Xie C, Li DH. [Longitudinal response of membrane thickness and ostium patency following sinus floor elevation: a prospective cohort study]. Clin Oral Implants Res. 2016;27(6):724-9.
• 18. Ren S, Zhao H, Liu J, Wang Q, Pan Y. [Significance of maxillary sinus mucosal thickening in patients with periodontal disease]. Int Dent J. 2015;65(6):303-10.
• 19. Insua A, Monje A, Chan HL, Zimmo N, Shaikh L, Wang HL. [Accuracy of Schneiderian membrane thickness: a cone-beam computed tomography analysis with histological validation]. Clin Oral Implants Res. 2016.
• 20. Rapani M, Rapani C, Ricci L. [Schneider membrane thickness classification evaluated by cone-beam computed tomography and its importance in the predictability of perforation. Retrospective analysis of 200 patients]. Br J Oral Maxillofac Surg. 2016;54(10):1106-10.
• 21. Bornstein MM, Wasmer J, Sendi P, Janner SF, Buser D, von Arx T. [Characteristics and dimensions of the Schneiderian membrane and apical bone in maxillary molars referred for apical surgery: a comparative radiographic analysis using limited cone beam computed tomography]. J Endod. 2012;38(1):51-7.
• 22. Shahidi S, Zamiri B, Momeni Danaei S, Salehi S, Hamedani S. [Evaluation of Anatomic Variations in Maxillary Sinus with the Aid of Cone Beam Computed Tomography (CBCT) in a Population in South of Iran]. J Dent (Shiraz). 2016;17(1):7-15.
• 23. Yoo J-Y, Pi S-H, Kim Y-S, Jeong S-N, You H-K. [Healing pattern of the mucous membrane after tooth extraction in the maxillary sinus]. Journal of periodontal & implant science. 2011;41(1):23-9.
• 24. Shanbhag S, Karnik P, Shirke P, Shanbhag V. [Cone‐beam computed tomographic analysis of sinus membrane thickness, ostium patency, and residual ridge heights in the posterior maxilla: implications for sinus floor elevation]. Clin Oral Implants Res. 2014;25(6):755-60.
• 25. Engström H, Chamberlain D, Kiger R, Egelberg J. [Radiographic evaluation of the effect of initial periodontal therapy on thickness of the maxillary sinus mucosa]. J Periodontol. 1988;59(9):604-8.
• 26. Phothikhun S, Suphanantachat S, Chuenchompoonut V, Nisapakultorn K. [Cone-beam computed tomographic evidence of the association between periodontal bone loss and mucosal thickening of the maxillary sinus]. J Periodontol. 2012;83(5):557-64.