Research Article
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Evaluation of Maxillary Sinus Septa and Mucosal Thickening with CBCT in Adults

Year 2022, Volume , Issue 16, 63 - 74, 30.04.2022
https://doi.org/10.38079/igusabder.949252

Abstract

Aim: The aim of this study was to investigate the different anatomical and pathological variations of maxillary sinus septa and membrane thickness in adults, and identify the most helpful orthogonal plane for surgical intervention to prevent possible complications.
Method: We retrospectively analysed 50 Cone Beam Computed Tomography (CBCT) images (25 females, 25 males) to determine maxillary sinus septa localization and mucosal thickening in adults. The SPSS 22.0 program was used to analyze all the data. Normally distributed data were evaluated using Shapiro-Wilk test. Since the data hasn’t shown normal distribution, Kruskal-Wallis test were used. Mann-Whitney U test or independent-sample t test were used in order to compare the continuous variables. Statistical significance was assumed when p<0.05.
Results: The prevalence of septa in the maxillary sinus was 77% (74% females, 80% males). In the analysis of the anatomic location of the septa within the sinus, it was revealed that 105 (70.4%) septa were located in the medial region. We found that 44% of female and 16% of male presented healthy maxillary sinus mucosa. It was observed that the prevalence of mucosal thickening was statistically significantly higher in men compared to women (p=0.027).
Conclusion: Detailed preoperative analysis with CBCT before any surgical procedure in the posterior maxilla is highly beneficial for planning and success rate of the surgery. It should be considered that males may have higher prevalence of septa and membrane thickening compared with females, and that antral septa can be located mostly in the medial region of the maxillary sinus.

References

  • Kalyvas D, Kapsalas A, Paikou S, Tsiklakis K. Thickness of the Schneiderian membrane and its correlation with anatomical structures and demographic parameters using CBCT tomography: a retrospective study. International Journal of Implant Dentistry. 2018;4:32-9.
  • Krennmair G, Ulm CW, Lugmayr H, Solar P. The incidence, location, and height of maxillary sinus septa in the edentulous and dentate maxilla. J Oral Maxillofac Surg. 1999;57:667-71.
  • Genç T. Dental İmplant Tedavisi Öncesi Maksilla Ve Mandibuladaki Anatomik Yapıların ve Varyasyonlarının Radyolojik Olarak Değerlendirilmesi [doktora tezi]. Ankara: Hacettepe Üniversitesi; 2014.
  • Naitoh M, Suenaga Y, Kondo S, Gotoh K, Ariji E. Assessment of maxillary sinus septa using cone-beam computed tomography: etiological consideration. Clin Implant Dent Relat Res. 2009;11:52-8.
  • Lee WJ, Lee SJ, Kim HS. Analysis of location and prevalence of maxillary sinus septa. J Periodontal Implant Sci. 2010;40(2):56-60.
  • Mehra P, Murad H. Maxillary sinus disease of odontogenic origin. Otolaryngol Clin North Am. 2004;37:347-364.
  • Zimmo N, Insua A, Sinjab K, Chan HL, Shaikh L, Wang HL. Impact of sex, age, and season on sinus membrane thickness. Int J Oral Maxillofac Implants. 2018;33(1):175-180.
  • Monje A, Diaz KT, Aranda L, Insua A, Garcia-Nogales A, Wang HL. Schneiderian membrane thickness and clinical implications for sinus augmentation: a systematic review and meta-regression analyses. J Periodontol. 2016;87:888-99.
  • Koymen R, Gocmen-Mas N, Karacayli U, Ortakoglu K, Ozen T, Yazici AC. Anatomic evaluation of maxillary sinus septa: Surgery and radiology. Clin Anat. 2009;22:563-70.
  • Visconti MAPG, Ferreira LM, Prado RF, Melo SLS, Verner FS, Haiter-Neto F. Evaluation of maxillary sinus septa prior to dental implant therapy: a cone beam computed tomography study. Int J Odontostomat. 2018;12(2):97-102.
  • Neugebauer J, Ritter L, Mischkowski RA, et al. Evaluation of maxillary sinus anatomy by cone– beam CT prior to sinus floor elevation. Int J Oral Maxillofac Implants. 2010;25(2):258-65.
  • Monje A, Catena A, Monje F, et al. Maxillary sinus lateral wall thickness and morphologic patterns in the atrophic posterior maxilla. J Periodontol. 2014;85(5):676-82.
  • Shoaleh S, Barbad Z, Shahla MD, Setareh S, Shahram H. 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.
  • Lana JP, Carneiro PM, Machado Vde C, de Souza PE, Manzi FR, Horta MC. Anatomic variations and lesions of the maxillary sinus detected in cone beam computed tomography for dental implants. Clin Oral Implants Res. 2012;23(12):1398-403.
  • Orhan K, Seker BK, Aksoy S, Bayindir H, Berberoğlu A, Seker E. Cone beam CT evaluation of maxillary sinus septa prevalence, height, location and morphology in children and an adult population. Med Princ Pract. 2013;22:47-53.
  • Van Zyl AW, Van Heerden WFA. Retrospective analysis of maxillary sinus septa on reformatted computerised tomography scans. Clin Oral Implants Res. 2009;20(12):1398-401.
  • Vogiatzi T, Kloukos D, Scarfe WC, Bornstein MM. Incidence of anatomical variations and disease of the maxillary sinuses as identified by cone beam computed tomography: A systematic review. Int J Oral Maxillofac Implants. 2014;29(6):1301-14.
  • Santos Junior O, Pinheiro LR, Umetsubo OS, Cavalcanti MG. CBCT-based evaluation of integrity of cortical sinus close to periapical lesions. Braz Oral Res. 2015;29(1):1-7.
  • Min-Jung K, Ui-Won J, Chang-Sung K, et al. Maxillary sinus septa: Prevalence, height, location, and morphology. A reformatted computed tomography scan analysis. J Periodontol. 2006;77(5):903-8.
  • Maestre-Ferrín L, Galán-Gil S, Rubio-Serrano M, PeñarrochaDiago M, Peñarrocha-Oltra D. Maxillary sinus septa: a systematic review. Med Oral Pato. Oral Cir Bucal. 2010;15(2):383-6.
  • Özeç İ, Kiliç E, Müderris S. Maksiller sinüs septa: Bilgisayarli tomografi ve panoramik radyografi ile değerlendirme. Cumhuriyet Dental Journal. 2018;11(2):82-6.
  • Van den Bergh JP, ten Bruggenkate CM, Disch FJ, Tuinzing DB. Anatomical aspects of sinus floor elevations. Clin Oral Implants Res. 2000;11:256-65.
  • Kader Aydin K, Sayar G. Evaluation of maxillary sinus pathologies using cone beam computed tomography. Yeditepe Dental Journal. 2018;14(2):7-12.
  • Amine K, Slaoui S, Kanice F, Kissa J. Evaluation of maxillary sinus anatomical variations and lesions: a retrospective analysis using cone beam computed tomography. Journal of Stomatology Oral and Maxillofacial Surgery. 2020;121(5):484-89.
  • Dragan E, Odri GA, Melian G, Haba D, Olszewski R. Three-dimensional evaluation of maxillary sinus septa for implant placement. Med Sci Monit. 2017;23:1394-1400.
  • Jung J, Hwang BY, Kim BS, Lee JW. Floating septum technique: Easy and safe method maxillary sinus septa in sinüs lifting procedure. Maxillofacial Plastic and Reconstructive Surgery. 2019;41:54-6.
  • Lee JE, Jin SH, Ko Y, Park JB. Evaluation of anatomical considerations in the posterior maxillae for sinus augmentation. World J Clin Cases. 2014;2(11):683-8.
  • Rege IC, Sousa TO, Leles CR, Mendonça EF. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health. 2012;12:30-36.
  • 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.
  • Raghav M, Karjodkar FR, Sontakke S, Sansare K. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent. 2014;5:361-65.
  • Dobele I, Kise L, Apse P, Kragis G, Bigestans A. Radiographic assessment of findings in the maxillary sinus using cone-beam computed tomography. Stomatologija. 2013;15(4):119-22.
  • Block MS, Dastoury K. Prevalence of sinus membrane thickening and association with unhealthy teeth: A retrospective review of 831 consecutive patients with 1,662 cone-beam scans. J Oral Maxillofac Surg. 2014;72(12):2454-60.
  • Schneider AC, Brager U, Sendi P, Caversacio MD, Busre D, Bornstein MM. Characteristics and dimensions of the sinus membrane in patients referred for single– implant treatment in the posterior maxilla: a cone beam computed tomographic analysis. Int J Oral Maxillofac Implants. 2013;28:587-96.
  • Janner SFM, Caversaccio M, 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. Clinical Oral Implants Research. 2011;22:1446-53.

Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi

Year 2022, Volume , Issue 16, 63 - 74, 30.04.2022
https://doi.org/10.38079/igusabder.949252

Abstract

Amaç: Bu çalışmanın amacı, erişkinlerde maksiller sinüsün septa ve mukozal kalınlaşma gibi farklı anatomik ve patolojik varyasyonlarını araştırmak ve cerrahi girişim öncesinde olası komplikasyonları önleyebilmek amacıyla en uygun ortogonal düzlemin belirlenmesine yardımcı olmaktır.
Yöntem: Konik Işınlı Bilgisayarlı Tomografi (KIBT) görüntülemesi yapılmış 50 erişkin hastanın (25 kadın ve 25 erkek) maksiller sinüsündeki septa varlığı ve mukozal kalınlaşma retrospektif olarak değerlendirildi. Tüm veriler Statistical Package for the Social Sciences (SPSS) versiyon 22.0 programı kullanılarak analiz edildi. Verilerin normal dağılıma uygunluğu Shapiro Wilk testi, normal dağılıma uygun olmayan verilerin karşılaştırılması Kruskal Wallis testi ile incelendi. Sürekli değişkenlerin karşılaştırılması Mann-Whitney U veya bağımsız-örneklem t testi kullanılarak yapıldı. Sonuçlar p<0.05 için istatistiksel olarak anlamlı kabul edildi.
Bulgular: Maksiller sinüs içerisinde septa varlığı %77 oranında (kadınlarda %74, erkeklerde %80) bulundu. Antral septaların %70.4 oranında medialde yerleşim gösterdiği saptandı. Kadınlarda sağlıklı maksiller sinüs mukozası oranı %44, erkeklerde %16 olarak tespit edildi. Mukozal kalınlaşma oranının, kadınlara oranla erkeklerde istatistiksel anlamlı olarak daha yüksek olduğu görüldü (p = 0.027).
Sonuç: Cerrahi girişim öncesi KIBT’lerin titizlikle değerlendirilmesi, tedavi planı ve başarısı açısından büyük önem taşımaktadır. Özellikle erkeklerde mukozal kalınlaşma ve septa varlığının daha sık karşılaşılabileceği ve antral septaların çoğunlukla maksiller sinüsün medial bölgesinde yerleşim gösterebileceği dikkate alınmalıdır.

References

  • Kalyvas D, Kapsalas A, Paikou S, Tsiklakis K. Thickness of the Schneiderian membrane and its correlation with anatomical structures and demographic parameters using CBCT tomography: a retrospective study. International Journal of Implant Dentistry. 2018;4:32-9.
  • Krennmair G, Ulm CW, Lugmayr H, Solar P. The incidence, location, and height of maxillary sinus septa in the edentulous and dentate maxilla. J Oral Maxillofac Surg. 1999;57:667-71.
  • Genç T. Dental İmplant Tedavisi Öncesi Maksilla Ve Mandibuladaki Anatomik Yapıların ve Varyasyonlarının Radyolojik Olarak Değerlendirilmesi [doktora tezi]. Ankara: Hacettepe Üniversitesi; 2014.
  • Naitoh M, Suenaga Y, Kondo S, Gotoh K, Ariji E. Assessment of maxillary sinus septa using cone-beam computed tomography: etiological consideration. Clin Implant Dent Relat Res. 2009;11:52-8.
  • Lee WJ, Lee SJ, Kim HS. Analysis of location and prevalence of maxillary sinus septa. J Periodontal Implant Sci. 2010;40(2):56-60.
  • Mehra P, Murad H. Maxillary sinus disease of odontogenic origin. Otolaryngol Clin North Am. 2004;37:347-364.
  • Zimmo N, Insua A, Sinjab K, Chan HL, Shaikh L, Wang HL. Impact of sex, age, and season on sinus membrane thickness. Int J Oral Maxillofac Implants. 2018;33(1):175-180.
  • Monje A, Diaz KT, Aranda L, Insua A, Garcia-Nogales A, Wang HL. Schneiderian membrane thickness and clinical implications for sinus augmentation: a systematic review and meta-regression analyses. J Periodontol. 2016;87:888-99.
  • Koymen R, Gocmen-Mas N, Karacayli U, Ortakoglu K, Ozen T, Yazici AC. Anatomic evaluation of maxillary sinus septa: Surgery and radiology. Clin Anat. 2009;22:563-70.
  • Visconti MAPG, Ferreira LM, Prado RF, Melo SLS, Verner FS, Haiter-Neto F. Evaluation of maxillary sinus septa prior to dental implant therapy: a cone beam computed tomography study. Int J Odontostomat. 2018;12(2):97-102.
  • Neugebauer J, Ritter L, Mischkowski RA, et al. Evaluation of maxillary sinus anatomy by cone– beam CT prior to sinus floor elevation. Int J Oral Maxillofac Implants. 2010;25(2):258-65.
  • Monje A, Catena A, Monje F, et al. Maxillary sinus lateral wall thickness and morphologic patterns in the atrophic posterior maxilla. J Periodontol. 2014;85(5):676-82.
  • Shoaleh S, Barbad Z, Shahla MD, Setareh S, Shahram H. 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.
  • Lana JP, Carneiro PM, Machado Vde C, de Souza PE, Manzi FR, Horta MC. Anatomic variations and lesions of the maxillary sinus detected in cone beam computed tomography for dental implants. Clin Oral Implants Res. 2012;23(12):1398-403.
  • Orhan K, Seker BK, Aksoy S, Bayindir H, Berberoğlu A, Seker E. Cone beam CT evaluation of maxillary sinus septa prevalence, height, location and morphology in children and an adult population. Med Princ Pract. 2013;22:47-53.
  • Van Zyl AW, Van Heerden WFA. Retrospective analysis of maxillary sinus septa on reformatted computerised tomography scans. Clin Oral Implants Res. 2009;20(12):1398-401.
  • Vogiatzi T, Kloukos D, Scarfe WC, Bornstein MM. Incidence of anatomical variations and disease of the maxillary sinuses as identified by cone beam computed tomography: A systematic review. Int J Oral Maxillofac Implants. 2014;29(6):1301-14.
  • Santos Junior O, Pinheiro LR, Umetsubo OS, Cavalcanti MG. CBCT-based evaluation of integrity of cortical sinus close to periapical lesions. Braz Oral Res. 2015;29(1):1-7.
  • Min-Jung K, Ui-Won J, Chang-Sung K, et al. Maxillary sinus septa: Prevalence, height, location, and morphology. A reformatted computed tomography scan analysis. J Periodontol. 2006;77(5):903-8.
  • Maestre-Ferrín L, Galán-Gil S, Rubio-Serrano M, PeñarrochaDiago M, Peñarrocha-Oltra D. Maxillary sinus septa: a systematic review. Med Oral Pato. Oral Cir Bucal. 2010;15(2):383-6.
  • Özeç İ, Kiliç E, Müderris S. Maksiller sinüs septa: Bilgisayarli tomografi ve panoramik radyografi ile değerlendirme. Cumhuriyet Dental Journal. 2018;11(2):82-6.
  • Van den Bergh JP, ten Bruggenkate CM, Disch FJ, Tuinzing DB. Anatomical aspects of sinus floor elevations. Clin Oral Implants Res. 2000;11:256-65.
  • Kader Aydin K, Sayar G. Evaluation of maxillary sinus pathologies using cone beam computed tomography. Yeditepe Dental Journal. 2018;14(2):7-12.
  • Amine K, Slaoui S, Kanice F, Kissa J. Evaluation of maxillary sinus anatomical variations and lesions: a retrospective analysis using cone beam computed tomography. Journal of Stomatology Oral and Maxillofacial Surgery. 2020;121(5):484-89.
  • Dragan E, Odri GA, Melian G, Haba D, Olszewski R. Three-dimensional evaluation of maxillary sinus septa for implant placement. Med Sci Monit. 2017;23:1394-1400.
  • Jung J, Hwang BY, Kim BS, Lee JW. Floating septum technique: Easy and safe method maxillary sinus septa in sinüs lifting procedure. Maxillofacial Plastic and Reconstructive Surgery. 2019;41:54-6.
  • Lee JE, Jin SH, Ko Y, Park JB. Evaluation of anatomical considerations in the posterior maxillae for sinus augmentation. World J Clin Cases. 2014;2(11):683-8.
  • Rege IC, Sousa TO, Leles CR, Mendonça EF. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health. 2012;12:30-36.
  • 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.
  • Raghav M, Karjodkar FR, Sontakke S, Sansare K. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent. 2014;5:361-65.
  • Dobele I, Kise L, Apse P, Kragis G, Bigestans A. Radiographic assessment of findings in the maxillary sinus using cone-beam computed tomography. Stomatologija. 2013;15(4):119-22.
  • Block MS, Dastoury K. Prevalence of sinus membrane thickening and association with unhealthy teeth: A retrospective review of 831 consecutive patients with 1,662 cone-beam scans. J Oral Maxillofac Surg. 2014;72(12):2454-60.
  • Schneider AC, Brager U, Sendi P, Caversacio MD, Busre D, Bornstein MM. Characteristics and dimensions of the sinus membrane in patients referred for single– implant treatment in the posterior maxilla: a cone beam computed tomographic analysis. Int J Oral Maxillofac Implants. 2013;28:587-96.
  • Janner SFM, Caversaccio M, 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. Clinical Oral Implants Research. 2011;22:1446-53.

Details

Primary Language Turkish
Subjects Medicine
Journal Section Articles
Authors

Ayşe BULUT> (Primary Author)
Cyprus Internaitonal University
0000-0002-3893-5691
Cyprus


Ahmet Murat ÖZER>
KIBRIS SAĞLIK VE TOPLUM BİLİMLERİ ÜNİVERSİTESİ
0000-0003-1950-2724
Türkiye

Publication Date April 30, 2022
Published in Issue Year 2022, Volume , Issue 16

Cite

Bibtex @research article { igusabder949252, journal = {İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi}, issn = {2536-4499}, eissn = {2602-2605}, address = {İstanbul Gelişim Üniversitesi Sağlık Bilimleri Yüksekokulu - Cihangir Mah. Şehit Jandarma Komando Er Hakan Öner Sk. No: 1 Avcılar / İstanbul / Türkiye}, publisher = {İstanbul Gelisim University}, year = {2022}, number = {16}, pages = {63 - 74}, doi = {10.38079/igusabder.949252}, title = {Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi}, key = {cite}, author = {Bulut, Ayşe and Özer, Ahmet Murat} }
APA Bulut, A. & Özer, A. M. (2022). Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi . İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi , (16) , 63-74 . DOI: 10.38079/igusabder.949252
MLA Bulut, A. , Özer, A. M. "Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi" . İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi (2022 ): 63-74 <https://dergipark.org.tr/en/pub/igusabder/issue/69769/949252>
Chicago Bulut, A. , Özer, A. M. "Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi". İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi (2022 ): 63-74
RIS TY - JOUR T1 - Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi AU - Ayşe Bulut , Ahmet Murat Özer Y1 - 2022 PY - 2022 N1 - doi: 10.38079/igusabder.949252 DO - 10.38079/igusabder.949252 T2 - İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 63 EP - 74 VL - IS - 16 SN - 2536-4499-2602-2605 M3 - doi: 10.38079/igusabder.949252 UR - https://doi.org/10.38079/igusabder.949252 Y2 - 2022 ER -
EndNote %0 Istanbul Gelisim University Journal of Health Sciences Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi %A Ayşe Bulut , Ahmet Murat Özer %T Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi %D 2022 %J İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi %P 2536-4499-2602-2605 %V %N 16 %R doi: 10.38079/igusabder.949252 %U 10.38079/igusabder.949252
ISNAD Bulut, Ayşe , Özer, Ahmet Murat . "Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi". İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi / 16 (April 2022): 63-74 . https://doi.org/10.38079/igusabder.949252
AMA Bulut A. , Özer A. M. Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi. IGUSABDER. 2022; (16): 63-74.
Vancouver Bulut A. , Özer A. M. Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi. 2022; (16): 63-74.
IEEE A. Bulut and A. M. Özer , "Erişkinlerde Maxiller Sinüs Septa ve Mukozal Kalınlaşmanın KIBT ile Değerlendirilmesi", İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, no. 16, pp. 63-74, Apr. 2022, doi:10.38079/igusabder.949252

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