ASSESSMENT OF BONE MORPHOLOGY AND STATUS OF MAXILLARY SINUS IN THE POSTERIOR MAXILLA: THREE-DIMENSIONAL ANALYSIS FOR IMPLANT THERAPY

Year 2019, Volume: 21 Issue: 3, 313 - 324, 31.12.2019

Duygu Göller Bulut , Yıldıray Şişman

https://doi.org/10.24938/kutfd.550667

Abstract

Objective: The
purpose of this study was to assess morphologic features of alveolar bone
supporting maxillary premolars and molars and to determine the relationship
between maxillary sinus and teeth using cone beam computed tomography (CBCT).

Material and Methods: In
CBCT scans of 100 patients, the thickness of both trabecular bone and cortical
plates surrounding 652 posterior teeth were measured and the relationship
between teeth and maxillary sinus was classified. Also,
the angle between the teeth and the alveolar crest was measured.

Results: Of the teeth examined, 25 % were in contact
with the inferior wall of maxillary sinus, 12% had penetrated the sinus and 63
% were far away from maxillary sinus. The closest root to the maxillary sinus floor was
mesiobuccally root of second molar teeth with 1.3 mm distance. The
teeth which had thinnest bone configuration were maxillary first premolars. There
were no significant differences for measurements between sides and gender
(p>005). Buccal bone thickness and distance to the maxillary sinus floor
showed a negative correlation in molars (p˂0.001 and 0.003).

Conclusion:
In order to prevent possible complications, a
three-dimensional analysis of the posterior maxilla and maxillary sinus is
required before implant procedures to be performed on the maxillary posterior
region.

Keywords

Bone thickness, CBCT, maxillary molars, maxillary premolars

Posteriyor Maksillanın Kemik Morfolojisi ve Maksiller Sinüsün Seyri: İmplant Tedavisi için Üç Boyutlu Analiz

Abstract

Amaç: Bu çalışmanın amacı, maksiller
premolar ve molar dişleri destekleyen alveoler kemiğin morfolojik özelliklerini
ve maksiller sinüs ile dişler arasındaki ilişkiyi koni ışınlı bilgisayarlı
tomografi (KIBT) kullanarak değerlendirmektir.

Gereç ve Yöntemler: 100 hastanın KIBT taramalarında, 652
arka dişi çevreleyen hem trabeküler kemik hem de kortikal kemik kalınlığı
ölçüldü ve dişler ile maksiller sinüs arasındaki ilişki sınıflandırıldı. Ayrıca,
dişlerin alveol kreti ile arasındaki açı ölçüldü.

Bulgular: İncelenen dişlerin % 25'i maksiller
sinüsün alt duvarı ile temas halinde, %12'si sinüsün içinde, % 63'ü ise
maksiller sinüsten uzaktaydı. Maksiller sinüs tabanına en yakın kök 1.3 mm
mesafe ile ikinci molar dişlerin meziyobukkal kökleriydi. En ince kemik
konfigürasyonuna sahip dişler maksiller birinci premolardı. Taraflar ve
cinsiyet arasında ölçümler açısından anlamlı fark yoktu (p>005). Bukkal
kemik kalınlığı ve maksiller sinüs tabanına olan uzaklık, azı dişlerinde
negatif korelasyon gösterdi (p˂0.001 ve 0.003).

Sonuç: Olası komplikasyonları önlemek için,
maksiller posterior bölgeye yapılacak implant işlemlerinden önce, posterior
maksilla ve maksiller sinüsün üç boyutlu analizine ihtiyaç vardır.

Keywords

Kemik kalınlığı, KIBT, maksiller molarlar, maksiller premolar

References

• 1. Calandriello R, Tomatis M. Simplified Treatment of the Atrophic Posterior Maxilla via Immediate/Early Function and Tilted Implants: A Prospective 1‐Year Clinical Study. Clin Implant Dent Relat Res. 2005;7(1):1-2.
• 2. Yoshimine S-i, Nishihara K, Nozoe E, Yoshimine M, Nakamura N. Topographic analysis of maxillary premolars and molars and maxillary sinus using cone beam computed tomography. Implant Dent. 2012;21(6):528-35.
• 3. Atalay B. Rehabilitation of severe atrophied maxillas with zygomatic implants. J Istanb Univ Fac Dent. 2010;44(2):133.
• 4. Waite DE. Maxillary sinus. Dent Clin North Am. 1971;15(2):349.
• 5. Narang S, Narang A, Jain K, Bhatia V. Multiple immediate implants placement with immediate loading. J Indian Soc Periodontol. 2014;18(5):648.
• 6. Loveless TP, Kilinc Y, Altay MA, Flores-Hidalgo A, Baur DA, Quereshy FA. Hounsfield unit comparison of grafted versus non-grafted extraction sockets. J Oral Sci. 2015;57(3):195-200.
• 7. Kwak H, Park H, Yoon H, Kang M, Koh K, Kim H. Topographic anatomy of the inferior wall of the maxillary sinus in Koreans. Int J Oral Maxillofac Surg. 2004;33(4):382-8.
• 8. Pagin O, Centurion BS, Rubira-Bullen IRF, Capelozza ALA. Maxillary sinus and posterior teeth: accessing close relationship by cone-beam computed tomographic scanning in a Brazilian population. J Endod. 2013;39(6):748-51.
• 9. De Vos W, Casselman J, Swennen G. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. Int J Oral Maxillofac Surg. 2009;38(6):609-25.
• 10. Neugebauer J, Ritter L, Mischkowski RA, Dreiseidler T, Scherer P, Ketterle M 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.
• 11. Nowzari H, Molayem S, Chiu CHK, Rich SK. Cone beam computed tomographic measurement of maxillary central incisors to determine prevalence of facial alveolar bone width≥ 2 mm. Clin Implant Dent Relat Res. 2012;14(4):595-602.
• 12. Hashimoto K, Kawashima S, Araki M, Iwai K, Sawada K, Akiyama Y. Comparison of image performance between cone-beam computed tomography for dental use and four-row multidetector helical CT. J Oral Sci. 2006;48(1):27-34.
• 13. Loubele M, Van Assche N, Carpentier K, Maes F, Jacobs R, van Steenberghe D et al. Comparative localized linear accuracy of small-field cone-beam CT and multislice CT for alveolar bone measurements. Oral Surg Oral Med Oral Pathol Oral Radiology Endod. 2008;105(4):512-8.
• 14. Sharan A, Madjar D. Correlation between maxillary sinus floor topography and related root position of posterior teeth using panoramic and cross-sectional computed tomography imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(3):375-81.
• 15. Freisfeld M, Drescher D, Schellmann B, Schüller H. The maxillary sixth-year molar and its relation to the maxillary sinus. A comparative study between the panoramic tomogram and the computed tomogram. Fortschritte der Kieferorthopadie. 1993;54(5):179-86.
• 16. Kilic C, Kamburoglu K, Yuksel SP, Ozen T. An assessment of the relationship between the maxillary sinus floor and the maxillary posterior teeth root tips using dental cone-beam computerized tomography. Eur J Dent. 2010;4(4):462.
• 17. Ericson S, Finne K, Persson G. Results of apicoectomy of maxillary canines, premolars and molars with special reference to oroantral communication as a prognostic factor. Int J Oral Surg. 1974;3(6):386-93.
• 18. Ioannides C, Borstlap W. Apicoectomy on molars: a clinical and radiographical study. Int J Oral Surg. 1983;12(2):73-9.
• 19. Schulze R, Heil U, Groβ D, Bruellmann D, Dranischnikow E, Schwanecke U et al. Artefacts in CBCT: a review. Dentomaxillofac Radiol. 2011;40(5):265-73.
• 20. Sgaramella N, Tartaro G, D'amato S, Santagata M, Colella G. Displacement of dental ımplants ınto the maxillary sinus: A retrospective study of twenty‐one patients. Clin Implant Dent Relat Res. 2016;18(1):62-72.
• 21. Sharan A, Madjar D. Maxillary sinus pneumatization following extractions: a radiographic study. International Journal of Oral & Maxillofacial Implants. 2008;23(1):48-56.
• 22. Ganz SD. Bone grafting assessment: focus on the anterior and posterior maxilla utilizing advanced 3-D imaging technologies. Dent Implantol Update. 2009;20(6):41-8.
• 23. Eberhardt JA, Torabinejad M, Christiansen EL. A computed tomographic study of the distances between the maxillary sinus floor and the apices of the maxillary posterior teeth. Oral Surg Oral Med Oral Pathol. 1992;73(3):345-7.
• 24. Ibrahim N, Parsa A, Hassan B, van der Stelt P, Aartman IH, Wismeijer D. Accuracy of trabecular bone microstructural measurement at planned dental implant sites using cone-beam CT datasets. Clin Oral Implants Res. 2014;25(8):941-5.
• 25. Draenert FG, Gebhart F, Neugebauer C, Coppenrath E, Mueller-Lisse U. Imaging of bone transplants in the maxillofacial area by NewTom 9000 cone-beam computed tomography: a quality assessment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(1):31-5.
• 26. Maillet M, Bowles WR, McClanahan SL, John MT, Ahmad M. Cone-beam computed tomography evaluation of maxillary sinusitis. J Endod. 2011;37(6):753-7.
• 27. Del Fabbro M, Testori T, Francetti L, Taschieri S, Weinstein R. Systematic review of survival rates for immediately loaded dental implants. The International journal of periodontics & restorative dentistry. 2006;26(3):249-63.
• 28. Pauwels R, Jacobs R, Singer SR, Mupparapu M. CBCT-based bone quality assessment: are Hounsfield units applicable? Dentomaxillofac Radiol. 2015;44(1):20140238.
• 29. Harrison DF. Surgical anatomy of maxillary and ethmoidal sinuses-a reappraisal. The Laryngoscope. 1971;81(10):1658-64.