scholarly journals Influence of the Periapical Status of the Posterior Maxillary Teeth on the Width of the Schneiderian Membrane of the Maxillary Sinus Mucosa

2021 ◽  
Vol 11 (9) ◽  
pp. 3908
Author(s):  
Igor Tsesis ◽  
Eyal Rosen ◽  
Ilan Beitlitum ◽  
Einat Dicker-Levy ◽  
Shlomo Matalon

Background: Various parameters are known to affect the amount and type of mucosal thickening. The aim of this retrospective study was to investigate these effects through a survey of cone-beam computed tomography (CBCT) images. CBCT scans of 150 patients, which included the area of the MS and maxillary teeth (canine, first premolar, second premolar, first molar, second molar, and third molar), were evaluated retrospectively for the presence of sinus mucosal thickening. The parameters evaluated as possible causes of mucosal thickening were age, sex, tooth type, proximity to the maxillary sinus, endodontic treatment, and periapical lesion. Descriptive statistics and multiple logistic regression were used to analyze the data. A total of 28% of the teeth presented with mucosal thickening, which was associated with periapical lesions in 57.1% of 77 cases. The size of the lesion was the only parameter that was found to be significantly connected to the presence of mucosal thickness. More than 50% of teeth with periapical lesions in the posterior maxilla exhibited mucosal thickening. Other parameters such as age, sex, and the position of the root tips in relation to the MS floor did not influence the probability of developing mucosal thickening.

2020 ◽  
Vol 46 (4) ◽  
pp. 415-422
Author(s):  
Junho Jung ◽  
Jung Soo Park ◽  
Seoung-Jin Hong ◽  
Gyu-Tae Kim ◽  
Yong-Dae Kwon

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.


2020 ◽  
Author(s):  
min xu ◽  
xiaoxiao zhang ◽  
jiacai he ◽  
xinxing guo ◽  
yuanyuan sang ◽  
...  

Abstract Background: The correlation between extension of the maxillary sinus floor and vertical facial skeletal patterns is important for designing orthodontic treatment plans. We correlated the extension of the maxillary sinus (MS) floor with different facial skeletal malocclusion in adolescent patients aged 10-19 years old using a cone-beam computed tomography. Methods: The relationship between the root tips of upper posterior teeth and the sinus floor was typed and scored (0-4) using cone-beam computed tomography (CBCT) images. Scores of each tooth and each patient were formulated.The cephalometric radiographs were analyzed with Dolphin software to diagnose patients' facial skeletal types into three groups according to Frankfort mandibular plane angle (FMA) as high-angle, average-angle and low-angle groups and ANB angle as Class I, Class II and Class III groups separately. The influences caused by age, sex, and facial skeletal malocclusion on the tooth and patient score were analyzed. Results: In high-angle group, the first molar (FM) score was significantly higher than that in the average-angle and low-angle groups (P = 0.018). Age has a positive effect on the patient score and some of the tooth scores, such as the second premolar (SPM) score, FM score, and the second molar (SM) score, and in the skeletal facial malocclusion. With increasing age, SM score increased along with the Frankfort mandibular plane angle (FMA). No significant difference was found in the distribution of patient and tooth scores by ANB angles. Conclusion: The relationship between the maxillary posterior roots and the sinus floor is correlated with facial skeletal malocclusion in 10- to 19-year-old adolescents. More first molar root tips were inside the sinus in the high-angle group compared with the average-angle and low-angle skeletal patterns. With advancing age, more second molar root tips were more close to contact the sinus floor in the high-angle group. Consideration of the root-sinus position in the posterior maxillary area before establishing an orthodontic treatment plan is recommended.


2020 ◽  
Author(s):  
Min Xu ◽  
Xiaoxiao Zhang ◽  
Jiacai He ◽  
Xinxing Guo ◽  
Yuanyuan Sang ◽  
...  

Abstract Background: The correlation between extension of the maxillary sinus floor and vertical facial skeletal patterns is important for designing orthodontic treatment plans. We correlated the extension of the maxillary sinus (MS) floor with different facial skeletal malocclusion in adolescent patients aged 10-19 years old using a cone-beam computed tomography. Methods: The relationship between the root tips of upper posterior teeth and the sinus floor was typed and scored (0-4) using cone-beam computed tomography (CBCT) images. Scores of each tooth and each patient were formulated. The cephalometric radiographs were analyzed with Dolphin software to diagnose patients' facial skeletal types into three groups according to Frankfort mandibular plane angle (FMA) as high-angle, average-angle and low-angle groups and ANB angle as Class I, Class II and Class III groups separately. The influences caused by age, sex, and facial skeletal malocclusion on the tooth and patient score were analyzed. Results: In high-angle group, the first molar (FM) score was significantly higher than that in the average-angle and low-angle groups (P = 0.018). Age has a positive effect on the patient score and some of the tooth scores, such as the second premolar (SPM) score, FM score, and the second molar (SM) score, and in the skeletal facial malocclusion. With increasing age, SM score increased along with FMA angles. No significant difference was found in the distribution of patient and tooth scores by ANB angles. Conclusion: The relationship between the maxillary posterior roots and the sinus floor is correlated with facial skeletal malocclusion in 10- to 19-year-old adolescents. More first molar root tips were inside the sinus in the high-angle group compared with the average-angle and low-angle skeletal patterns. With advancing age, more second molar root tips were more close to contact the sinus floor in the high-angle group. Consideration of the root-sinus position of the posterior maxillary area in different skeletal malocclusion before establishing an orthodontic treatment plan is recommended.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yiping Wei ◽  
Bo Zhang ◽  
Gang Yang ◽  
Tao Xu ◽  
Wenjie Hu ◽  
...  

Abstract Background Information regarding the reaction of bone augmentation in terms to sinus mucosa thickness of periodontally compromised molar extraction sites is limited. This retrospective study aimed to analyze the effect of ridge preservation procedures following the extraction of molars with severe periodontitis on the healing pattern of adjacent maxillary sinus mucosal membranes. Methods Thirty-one periodontally compromised maxillary molar teeth either receiving ridge preservation (test group, n = 20) or undergoing spontaneous healing (control group, n = 11) were investigated. Cone-beam computed tomography (CBCT) scanning was performed before the extraction procedure and repeated 6 months later. The mucosa thickness (MT) of the adjacent periodontally compromised molar tooth was measured from CBCT images before tooth extraction and after 6 months of healing at nine assigned measurement points. The data were analyzed at α = 0.05. Results The prevalence of pre-extraction maxillary sinus mucosal thickening was 60.0% and 63.6% in the test and control groups, respectively. The average MT of the thickened sinus mucosa before tooth extraction was 3.78 ± 2.36 mm in the test group and 4.63 ± 3.20 mm in the control group (P = 0.063). The mean mucosal thickening reductions in the thickened MT subjects after 6 months of healing were 2.20 ± 2.05 mm (test group) and 2.64 ± 2.70 mm (control group), P = 0.289. The differences of MT between the time prior to extraction and after 6 months of healing were statistically significant within both groups (P < 0.05). Conclusions Following extraction of molars with severe periodontitis, a reduction in swelling of the Schneiderian membrane has been observed regardless of the addition of a DBBM socket graft. However, a mucosal thickness > 2 mm was still frequently observed.


2016 ◽  
Vol 10 (1) ◽  
pp. 261-267
Author(s):  
Tsutomu Sugiura ◽  
Kazuhiko Yamamoto ◽  
Chie Nakashima ◽  
Kazuhiro Murakami ◽  
Yumiko Matsusue ◽  
...  

We report a case of chronic maxillary sinusitis caused by denture lining material entering through an oroantral fistula after tooth extraction. The patient was an 80-year-old female who visited us with a complaint of pus discharge from the right posterior maxilla. She had extraction of the upper right second molar and had her upper denture relined with silicone lining material. The patient noticed swelling of the right cheek and purulent rhinorrhea 20 days before her first visit to our clinic. Oral examination showed an oroantral fistula with a diameter of 3 mm in the posterior alveolar ridge of the right maxilla. Computed tomography revealed a hyperdense foreign body in the right maxillary sinus and thickening of the mucosal lining. Under diagnosis of maxillary sinusitis caused by a foreign body, endoscopic maxillary surgery was performed simultaneously with the removal of the foreign body. The foreign body removed was 12 × 6 mm in size, oval in shape, light pink in color, and compatible with silicone denture lining material. During the follow-up it was observed that the oroantral fistula closed spontaneously after the removal of the foreign body. The maxillary sinus was in a good shape without recurrence of sinusitis seven months after surgery.


2021 ◽  
Vol 15 (3) ◽  
pp. 163-171
Author(s):  
Selen Ince Yusufoglu ◽  
Güzin Neda Hasanoglu Erbasar ◽  
Orhan Gülen

Background. This retrospective study aimed to investigate the effect of various dental and maxillary sinus variables on maxillary sinus mucosal thickness (MT). The variables included periodontal bone loss (PBL), periapical status, dental restorations of posterior maxillary teeth, and the distance from the root apices to the sinus mucosa. Methods. Cone-beam computed tomography (CBCT) images of the maxillary sinuses (n=600) in 300 patients were examined. The sinus MT and the distance of the roots from maxillary sinuses were measured. Apical lesions of the roots, PBL, and situations of adjacent teeth were recorded. The relationships between these conditions and MT and characterization of MT were evaluated. The Kruskal–Wallis H test was used to compare groups due to the non-normal distribution of the data. The relationship between categorical variables was analyzed using chi-squared test. Results. There was a significant correlation between maxillary sinus MT and periapical lesions, PBL, and restorations (P<0.05). MT increased as the apical lesions of premolar teeth enlarged (P<0.05, P=0.022). MT increased in cases of mild PBL of molar teeth (P=0.041). Conclusion. In this retrospective study, the MT significantly increased in patients with periapical lesions, inadequate endodontic treatment, increased PBL, and inadequate dental restorations.


2019 ◽  
Vol 48 (6) ◽  
pp. 20190066 ◽  
Author(s):  
Yuan Meng ◽  
Ya-Ning Zhao ◽  
Ya-Qiong Zhang ◽  
Deng-Gao Liu ◽  
Yan Gao

Objectives: To characterize the radiographic features of maxillary ameloblastoma (AM), odontogenic keratocyst (OKC) and dentigerous cyst (DC) comparatively by using spiral CT and cone beam CT (CBCT). Methods: Clinical records, histopathological reports, and nonenhanced spiral CT or CBCT images of 191 consecutive patients with primary maxillary AMs, OKCs, or DCs were retrospectively acquired, and radiographic features were analyzed. Results: The study included 118 males and 73 females (age: 5–84 years). 72.0% of AMs and 84.3% of OKCs originated from the posterior maxilla, while 69.6% of DCs occurred in the anterior maxilla. Among 25 AMs, 44.0% were of desmoplastic type, with honey-combed appearance. 84.0% of AMs were circular or oval in shape, 84.0% expanded buccally, and 36.0% invade the nasal floor. Among 89 OKCs of 88 patients, 61.8% were circular or oval, 58.4% expanded buccally, 49.4% were dentigerous, 41.6% nearly filled the maxillary sinus, and 13.5% invaded the nasal floor. 93.7% (74/79) of DCs enveloped a single tooth, and the tooth–cyst relationship was centripetal in 35, eccentric in 30, and circumferential in 9. Moreover, 98.2% (55/56) of the cysts enveloping a supernumerary tooth were DCs, while 80.9% (38/47) of the cysts enveloping the third molar were OKCs. Conclusions: Maxillary AMs tend to grow with buccal expansion and invade the nasal floor, and DAs with honey-combed lobularity are common. Maxillary OKCs have variant shapes and tend to invaginate the maxillary sinus. The tooth–cyst relationship of dentigerous OKCs and DCs can be centripetal, eccentric, or circumferential.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 209
Author(s):  
Khairy Elmorsy ◽  
Lubna K. Elsayed ◽  
Sara M. El Khateeb

Ectopic development of teeth in nondental areas is uncommon, especially in the maxillary sinus. A panoramic radiograph is the routine diagnostic radiographic examination performed for this type of eruption, although cone beam computed tomography (CBCT) is highly recommended for further localization of the ectopic tooth and assessment of the characteristics of any associated lesion before a surgical procedure. We report a case of a 13-year-old female student who presented with purulent discharge posterior to the upper right second molar with a bad taste and foul odour. Radiographic examination revealed a maxillary third molar tooth located at the posterosuperior aspect of the right maxillary sinus with a hyperdense lesion surrounding the crown, obliterating the sinus cavity. Both the tooth and dentigerous cyst were surgically removed under general anaesthesia through Caldwell-Luc antrostomy. After a three-month follow-up, the patient was symptom free and had an uneventful recovery. The rare and critical location of the reported third molar along with the infected dentigerous cyst indicates its complete enucleation to avoid complications as recurrence or malignant transformation.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 209
Author(s):  
Khairy Elmorsy ◽  
Lubna K. Elsayed ◽  
Sara M. El Khateeb

Ectopic development of teeth in nondental areas is uncommon, especially in the maxillary sinus. A panoramic radiograph is the routine diagnostic radiographic examination performed for this type of eruption, although cone beam computed tomography (CBCT) is highly recommended for further localization of the ectopic tooth and assessment of the characteristics of any associated lesion before a surgical procedure. We report a case of a 13-year-old female student who presented with purulent discharge posterior to the upper right second molar with a bad taste and foul odour. Radiographic examination revealed a maxillary third molar tooth located at the posterosuperior aspect of the right maxillary sinus with a hyperdense lesion surrounding the crown, obliterating the sinus cavity. Both the tooth and dentigerous cyst were surgically removed under general anaesthesia through Caldwell-Luc antrostomy. After a three-month follow-up, the patient was symptom free and had an uneventful recovery. The rare and critical location of the reported third molar along with the infected dentigerous cyst indicates its complete enucleation to avoid complications as recurrence or malignant transformation.


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