Haller Hücreleri ve Schneiderian Membran Kalınlığı Arasındaki İlişkinin Analizi

Abstract

Amaç: Bu çalışmanın ilk amacı, Haller hücreleri varlığı ile Schneiderian membran kalınlığı (SMT) arasında; yaş ve cinsiyet gibi faktörleri de göz önünde bulundurarak, bir ilişki olup olmadığını belirlemekti. Bu çalışmanın ikinci amacı ise panaromik röntgen ve konik ışınlı bilgisayarlı tomografi (CBCT)’de Haller hücrelerinin görünürlüğünün korelasyonunu araştırmaktı. Materyal ve Metot: 78 dişsiz hasta çalışmaya dahil edildi. CBCT’lerden elde edilen kesitsel görüntüler, sinüs membran kalınlığını belirlemek için kullanıldı. Cinsiyet ve yaş gibi parametreler ayrıca incelendi. Bulgular: Haller hücresi olan ve olmayanlar arasında, maksiller sinüs tabanındaki sinüs membran kalınlığındaki fark anlamlı bulundu (p <0,05). Haller hücrelerinin CBCT ve dijital panoramik radyografilerde görünürlüğü arasında korelasyon bulunmuştur (p <0,01). Sinüs membran kalınlığı, erkeklerde kadınlardan daha yüksek görülmekle beraber bu fark anlamlı bulunmamıştır (p> 0,05). Sonuç: Çalışmamızdaki sonuçlar göz önüne alındığında, Haller hücresi varlığı sinüs membranının tabanında kalınlaşmaya yol açabilmektedir. Haller hücrelerinin dijital panoramik radyografilerde de görülebilmesi nedeniyle; sinüs yükseltme cerrahisi öncesinde alınan dijital panaromik görüntü, Schneiderian membran kalınlığı hakkında klinisyenlere ameliyat öncesi ipucu verebilir.

Keywords

• Haller hücreleri
• konik işınlı bilgisayarlı tomografi
• maksiller sinus anatomisi
• schneiderian membran kalınlığı

Analysis of relationship between Haller cells and Schneiderian Membrane Thickness

Abstract

Objective: This first aim of this study was to determine whether there is a relationship between the presence of Haller cells and Schneiderian membrane thickness (SMT) by considering factors such as age and gender. The second aim of this study was to investigate correlation between the visibility of Haller cells on cone beam computed tomography (CBCT) and digital panoramic radiographs. Materials and Methods: Seventy-eight edentulous patients were included in the study. Cross-sectional views obtained from CBCTs were used to determine the mean sinus membrane thickness. Parameters such as gender and age were also investigated. Results: The difference in SMT at the base of the maxillary sinus was significant between those with and without Haller cells (p <0.05). A correlation was found between the detection of Haller cells on CBCT and digital panoramic radiographs (p <0.01). Although SMT was higher in men than in women, this difference was not significant (p> 0.05). Conclusion: Considering the results of our study, the presence of Haller cells may cause sinus membrane thickness at base of maxillary sinus. Since Haller cells can also be seen in digital panoramic radiographs, digital panoramic view taken prior to sinus lift surgery can provide clinicians with preoperative hint about SMT.

Keywords

• Haller Cells
• maxillary sinus anatomy
• Scheiderian membrane thickness
• Cone beam computed tomography

References

1. Aimetti M, Massei G, Morra M, Cardesi E, Romano F. Correlation between gingival phenotype and Schneiderian membrane thickness. Int J Oral Maxillofac Implants. 2008;23(6):1128-1132.
2. Proussaefs P, Lozada J, Kim J, Rohrer MD. Repair of the perforated sinus membrane with a resorbable collagen membrane: a human study. Int J Oral Maxillofac Implants. 2004;19(3):413-420.
3. Wiltfang J, Schultze-Mosgau S, Merten HA, Kessler P, Ludwig A, Engelke W. Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion. Oral Surg, Oral Med, Oral Pathol, Oral Radiol. 2000;89(3):288-291.
4. Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol. 2008;35(8):216-240.
5. Goller-Bulut D, Sekerci AE, Kose E, Sisman Y. Cone beam computed tomographic analysis of maxillary premolars and molars to detect the relationship between periapical and marginal bone loss and mucosal thickness of maxillary sinus. Med Oral, Patol Oral Cir Bucal. 2015;20(5):572-579.
6. Yilmaz HG, Tozum TF. Are gingival phenotype, residual ridge height, and membrane thickness critical for the perforation of maxillary sinus? J Periodontol. 2012;83(4):420-425.
7. 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):633-637.
8. Garcia-Denche JT, Wu X, Martinez PP, et al. Membranes over the lateral window in sinus augmentation procedures: a two-arm and split-mouth randomized clinical trials. J Clin Periodontol. 2013;40(11):1043-1051.

9. Berengo M, Sivolella S, Majzoub Z, Cordioli G. Endoscopic evaluation of the bone-added osteotome sinus floor elevation procedure. Int J Oral and Maxillofac Surg. 2004;33(2):189-194.
10. van den Bergh JP, ten Bruggenkate CM, Disch FJ, Tuinzing DB. Anatomical aspects of sinus floor elevations. Clin Oral Implants Res. 2000;11(3):256-265.
11. Lin YH, Yang YC, Wen SC, Wang HL. The influence of sinus membrane thickness upon membrane perforation during lateral window sinus augmentation. Clin Oral Implants Res. 2016;27(5):612-617.
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):1158-1164.
13. Lu Y, Liu Z, Zhang L, et al. Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study. J Endod. 2012;38(8):1069-1074.
14. Yanagisawa E, Marotta JC, Yanagisawa K. Endoscopic view of a mucocele in an infraorbital ethmoid cell (Haller cell). Ear, nose, throat j. 2001;80(6):364-368.
15. Kamdi P, Nimma V, Ramchandani A, Ramaswami E, Gogri A, Umarji H. Evaluation of haller cell on CBCT and its association with maxillary sinus pathologies. J Indian Acad Oral Med Radiol. 2018;30(1):41-45.
16. Ali IK, Sansare K, Karjodkar FR, Vanga K, Salve P, Pawar AM. Cone-beam computed tomography analysis of accessory maxillary ostium and Haller cells: Prevalence and clinical significance. Imaging Sci Dent. 2017;47(1):33-37.
17. Stackpole SA, Edelstein DR. The anatomic relevance of the Haller cell in sinusitis. Am J Rhinol. 1997;11(3):219-224.
18. 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):51-57.
19. 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(8):888-899.
20. Maska B, Lin GH, Othman A, et al. Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening. Int J Implant Dent. 2017;3(1):1.
21. 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):303-310.
22. 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):1446-1453.
23. Yildirim TT, Guncu GN, Goksuluk D, Tozum MD, Colak M, Tozum TF. The effect of demographic and disease variables on Schneiderian membrane thickness and appearance. Oral Surg, Oral Med, Oral Pathol, Oral Radiol. 2017;124(6):568-576.
24. Pazera P, Bornstein MM, Pazera A, Sendi P, Katsaros C. Incidental maxillary sinus findings in orthodontic patients: a radiographic analysis using cone-beam computed tomography (CBCT). Orthod Craniofac Res. 2011;14(1):17-24.
25. Yoo JY, Pi SH, Kim YS, Jeong SN, You HK. Healing pattern of the mucous membrane after tooth extraction in the maxillary sinus. J Periodontal Implant Sci. 2011;41(1):23-29.
26. 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):755-760.
27. Zinreich SJ, Kennedy DW, Rosenbaum AE, Gayler BW, Kumar AJ, Stammberger H. Paranasal sinuses: CT imaging requirements for endoscopic surgery. Radiology. 1987;163(3):769-775.