Figure - available via license: Creative Commons Attribution 4.0 International
Content may be subject to copyright.
Images of pneumatization in the maxillary sinus. The CBCT (A) and panoramic radiograph (B) of a 68-year-old female undergoing preoperative planning for implantation of a left maxillary molar. The pneumatization is clearly visualized in the palatine area and anterior of the maxillary sinus on CBCT (A), but not on panoramic radiographs (B).
Source publication
Objectives
The purpose of the present study was to elucidate the significance of cone bean computed tomography (CBCT) for patients hoping to undergo implant-supported restorations of the maxilla. Therefore, two studies were planned. One was to compare the prevalence of anatomic variations and lesions in the maxillary sinus on CBCT of patients hopin...
Similar publications
Migration of dental implants into the maxillary sinus is uncommon. However, poor bone quality and quantity in the posterior maxilla can increase the potential for this complication to arise during implant placement procedures. The aim of this report is to present a dental implant that migrated into the maxillary sinus and disappeared. A 53-year-old...
Purpose: To assess surgical success rate of placing dental implants in the atrophic posterior maxilla engaging the maxillary sinus floor in patients with inadequate posterior maxillary alveolar bone height (PMABH). Methods: 26 patients with PMABH of 7 - 10 mm had 39 implants placed between July 2012 and June 2014. These implants were placed protrud...
The maxillary sinus lifting procedure is an important preprosthetic surgical procedure for the creation of adequate bone volume in the edentulous posterior maxilla for the placement of dental implants. The presence of a maxillary sinus cyst has been considered a contraindication for this operation. Perforation of the membrane and hence the elongati...
Dental implant placement in the posterior maxilla may be complicated by implant migration into the maxillary sinus.
To report the clinical and radiological characteristics of a patient who experienced dental implant displacement into the maxillary sinus following sinus floor elevation, and to compare our findings with those of other published repor...
Displacement of dental implants into the maxillary sinus is a rare complication. This article presents a case of displaced dental implant into maxillary sinus. Retrieval of the dental implant from left maxillary sinus was performed via endoscopic sinus surgery. This case highlighted a delayed referral of a 53-year old gentleman by a general dental...
Citations
... Both PR and CBCT are available for diagnosis and planning before dental procedures [10,11]. Due to the size and distribution of anatomical structures, not every area of interest can be clearly visualized on PR images and can therefore be negatively influenced by various structures [24]. In their experimental and comparative diagnostic study, Dau et al. found that PR alone remained insufficient for evaluating pathologies in the maxillary sinus. ...
... On the other hand, it is also possible that the visibility of MSS in PR is influenced by anatomical variations as described by Shiki et al., which are stronger in the posterior region of the maxillary sinus [24]. The same rationale applies to the presence of pathologies that affect the visibility of anatomical structures [25][26][27]. ...
Purpose
To analyze the visibility of the maxillary sinus septa (MSS) in panoramic radiography (PR) versus cone beam computed tomography (CBCT) and to investigate whether the buccal cortical bone thickness (BT) or the septa dimensions influence their visibility.
Methods
Corresponding PR and CBCT images of 355 patients were selected and examined for MSS visibility. The septa dimensions (width, height, depth) and the BT were measured. Results were analysed statistically.
Results
Comparing the corresponding regions on CBCT and PR, 170 MSS were identified; however, only 106 of these were also visible using PR. The MSS visibility was significantly higher on CBCT versus PR images (P1: p = 0.039, P2: p = 0.015, M1: p = 0.041, M2: p = 0.017, M3: p = 0.000), except region C (p = 0.625). Regarding the measurements of MSS dimensions, only the height in region M1 (p = 0.013) and the width in region P2 (p = 0.034) were significantly more visible on CBCT. The BT in the area of the MSS was found to have a marginal influence on its visibility on the PR images only in regions M3 and M1 (M3: p = 0.043, M1: p = 0.047). In terms of MSS visibility based on the dimensions, significance was found for all three influencing variables only in region P2 (width; p = 0.041, height; p = 0.001, depth; p = 0.007). There were only isolated cases of further significance: M3 for width (p = 0.043), M2 for height (p = 0.024), and P1 for depth (p = 0.034), no further significance was noted.
Conclusion
MSS visibility appears significantly higher on CBCT versus PR images. It is concluded that the septa dimensions and BT can influence MSS visibility on PR images just in certain regions.
Graphical Abstract
... Ainda nesse contexto, mesmo não abordadas extensamente pela literatura, as variações anatômicas relacionadas ao seio maxilar e complexo nasossinusal devem ser analisadas antes de uma abordagem cirúrgica desta região 24 . Na Odontologia, esta área é frequentemente manipulada durante procedimentos cirúrgicos, como exodontias, levantamento de seio maxilar, enxertos e implantes 25 . ...
... Na Odontologia, esta área é frequentemente manipulada durante procedimentos cirúrgicos, como exodontias, levantamento de seio maxilar, enxertos e implantes 25 . Isto se deve por estas variações estarem relacionadas a maior recorrência de inflamação pós-operatória, o que influencia diretamente no desenvolvimento de alterações sinusais 15,18,24 . ...
Objetivo: O objetivo do estudo foi avaliar a prevalência de variações anatômicas no complexo nasossinusal por meio de tomografia computadorizada (TC) em pacientes com sinusite não odontogênica. Métodos: Um estudo observacional e retrospectivo consistiu em 860 prontuários com indicação de tomografias computadorizadas multislice para avaliação de sinusite. A sinusite odontogênica foi caracterizada pela presença de espessamento da mucosa sinusal maior que 2 milímetros e ausência de alterações dentárias na região. Posteriormente, foram avaliadas as variações do complexo nasossinusal e realizada uma análise descritiva. Em seguida, 33 tomografias computadorizadas foram analisadas com sinusopatia não odontogênica, e o complexo nasossinusal foi avaliado quanto à presença das seguintes variações anatômicas como desvio do septo nasal associado a esporão ósseo, concha média bolhos, aumento do seio frontal entre outras. Resultados: Variações anatômicas foram observadas em 87,9% dos casos, sendo 15 do gênero masculino (46,0%) e 18 do gênero feminino (54,0%) e distribuídos em 45,5% dos pacientes entre 41-60 anos. A variação anatômica mais frequente foi a concha média bolhosa (37,9%), seguida de septações no seio maxilar (10,3%) e seio frontal alargado (13,8%). Conclusão: Verificou-se uma considerável incidência de variações anatômicas associadas à sinusite não odontogênica, com evidência para a concha média bolhosa.
... The average age of the female patients was 62.1 years, and the average age of the male patients and 58.4 years. However, in contrast to similar comparative studies, the remaining 335 patients (with 635 sites) represent a high number of admissions used for statistical analysis [15,18,19]. ...
... The size and distribution of anatomical structures and lesions in the maxillary sinus affect visibility in PR. Furthermore, small maxillary sinus lesions (retention cysts, polyps, etc.) with a diameter of less than 3 mm show poor detection rates [18]. Particularly, CBCT leaves little room for interpretation of the findings and thus enables an examiner-independent assessment of specific findings that may be relevant for planned subsequent surgical interventions [24]. ...
... They reported that soft tissues of the maxillary sinus cannot be effectively visualized in panoramic radiographs. One key result of this study was that the incidence of maxillary sinusitis was twice as high in patients opting for implant-supported restoration than in patients who did not [18]. ...
Purpose
Sinus lift operations are a tried and tested means of providing adequate implant prosthetics to patients with compromised jawbones. Knowledge of the arterial supply of the maxillary sinus region is essential for surgical treatment in this area. The aim of the present comparative study was to determine whether alveolar antral artery (AAA) canal can be diagnosed both in corresponding panoramic radiography (PR) and cone-beam computed tomography (CBCT).
Methods
A total of 335 patients with 635 sites and corresponding maxillary sinus in both PR and CBCT were selected and examined for AAA canal visibility.
Results
The visibility of the AAA canal was significantly higher in CBCT than in PR. A total of 154 (46.0%) AAA canals could be identified in the maxillary sinus on the right. However, only four (1.2%) of these were also visible in PR. The detected values of the AAA canals in the maxillary sinus on the left in the PR and CBCT images were similar to those of the right. While 164 AAA canals (49%) were observed in CBCT images, only 1 (0.3%) was identifiable in PR.
Conclusions
The results show that CBCT can be recommended for visualising the AAA canal when surgically planning sinus augmentation procedures.
Graphical Abstract
... In the maxilla, the degree the antral roots protrude into the maxillary sinus tends to be overestimated. Another drawback is that the soft tissues of the sinus cannot be viewed effectively [8]. ...
Introduction and objective: The aim of this review is to evaluate to what extent sinus pathology originates from dental pathology or treatment, and to assess the occurrence frequency of sinus pathology in its different forms using cone beam computed tomography (CBCT). Method: The literature review was conducted using PubMed, Scopus and the Cochrane Library. Forty-two articles were included (25 case series, ten cross- sectional studies, three case-control studies, two cohort studies, one prospective study, and one retrospective study). Results: Forty-two articles involving a total of 13,191 patients and 17,374 CBCTs were included in this review. The most frequent pathological findings were, by a considerable degree, inflammatory diseases, which represented 75.16% of the total findings, followed by infection (12.13%), tumours (6.88%), and high pneumatisation (2.07%). Within dental pathology, there is a direct Pearson correlation with polyps (1) and opacification (0.999), and an almost direct correlation with retention cysts (0.981) and sinus-associated dental elements (0.972). Conclusions: Our results further support the argument that dental modifications and treatments are an important cause of sinus pathology. For this reason, dental aetiologies must be taken into account by both dentists, maxillofacial surgeons and ENT when considering the most appropriate treatment for patients with maxillary sinusitis.
... Diversos pesquisadores apontaram o espessamento mucoperiosteal como a alteração mais frequente em SM, com prevalências variando entre 25,1% e 70% (Carneiro, 2010;Ritter et al., 2011;Rege, 2011;Pagin, 2011;Lim & Spanger, 2012;Gracco et al., 2012;Dobele et al., 2013;Manji, Faucher, Resnik & Suzuki, 2013;Nogueira, 2013;Raghav et al., 2014;Dragan et al., 2014;Shiki et al., 2014). Embora os parâmetros encontrados neste estudo estejam aquém aos dos autores referenciados acima, o cisto de retenção de muco apresentou-se como a anomalia de maior constância, com 1,7% (15 exames). ...
Os seios maxilares, estrutura anatômica visualizada radiograficamente por uma ampla área radiolúcida na região posterior de maxila e são considerados como as maiores das cavidades paranasais, podendo ser localizados em radiografias panorâmicas digitais. Nessa área podem ser encontradas extensões, septos intrassinusais e algumas alterações patológicas. Essa pesquisa objetiva investigar e determinar a prevalência dos principais tipos de alterações anatômicas e patológicas em seios maxilares com suas exatas localizações através de radiografias panorâmicas digitais do banco de imagens da Clínica de Radiologia da Universidade Tiradentes (UNIT). A amostra foi composta por 878 exames, totalizando em 1756 seios maxilares. Para avaliar a associação entre as variáveis, utilizou o teste não paramétrico de associação Qui-quadrado, com nível de significância estatística em p<0,05. Para verificar o grau de concordância entre os examinadores foi utilizado o teste estatístico Kappa (p<0,001). Os dados obtidos mostraram que houve uma predominância ao gênero feminino (66,2%). Observou-se maior número de alterações entre indivíduos de 46 a 55 anos (84,78%). Referente às alterações anatômicas, os septos intra sinusais (69,2%) apresentaram-se em maior frequência e, como alterações patológicas, o cisto de retenção de muco (1,17%). Foi observado diferença estatística entre a presença de alterações sinusais em relação à faixa etária (p<0,0001). Houve maior prevalência de alterações sinusais em mulheres, sendo estatisticamente significante (<0,0001). Esse estudo contribuiu para o conhecimento sobre a estrutura anatômica da população estudada, onde a radiografia panorâmica digital, trata-se de uma ferramenta importante para o diagnóstico de alterações na região maxilomandibular.
... The difference in the reported prevalence rates among various studies can be attributed to dissimilar definitions for thickening, various inclusion criteria, differences in measurement methods, various diagnostic criteria for mucosal thickening, as well as the effects of seasonal changes on mucosal thickening [20,24]. Furthermore, in a study by Shiki et al, [25] the prevalence of sinus mucosal thickening was significantly higher in patients requiring dental implants compared with the non-implant control group. The authors related this to the fact that most patients requiring implant restorations have lost their teeth due to inflammatory lesions like pulpal and periapical or periodontal diseases, which can trigger membrane thickening [26]. ...
... Tooth-related lesions (i.e. pulp and periapical [32] or periodontal inflammatory lesions [25,32]) can cause sinus mucosal thickening. A significant relationship between mucosal 6 / 8 thickening and periapical lesions around the adjacent teeth was found on CBCT and panoramic radiographs [22,29]; however, such a relationship was not observed in the current study, as was reported by Rege et al, [33] Phothikhun et al, [17] and Janner et al [20]. ...
Objectives: Maxillary sinus pathological conditions, like thickening of the Schneiderian membrane, can influence the outcomes of augmentation procedures and implant treatment. The present study aimed to evaluate the relationship between the residual ridge height and maxillary sinus membrane thickening.
Materials and Methods: A total of 240 cone-beam computed tomography (CBCT) images of the maxillary sinus of 141 patients (62.1% males and 37.9% females, bilateral in 99 patients and unilateral in 42 patients) who were candidates for implant placement were evaluated. The CBCT scans were subsequently assessed for the following variables: residual ridge height, sinus membrane thickening at future implant(s) site(s), the ostium patency, and presence of periapical lesion adjacent to the edentulous area.
Results: The total prevalence of sinus membrane thickening (66.2%) was sub-classified as follows: flat in 53.7%, polypoid in 12.1%, and complete opacification in 0.4%. The prevalence of sinus membrane thickening was higher in male participants. It was revealed that age had no significant relationship with presence of a periapical lesion or sinus membrane thickening (P>0.05). Membrane thickening was detected in all sinuses with obstructed ostium. Reduced residual ridge height was significantly associated with higher sinus membrane thickening at the second premolar and first molar sites (P
... The present study revealed polypoidal mucosal thickening as a major finding with a prevalence of 36.7% similar to study conducted by Shiki et al. [30] who reported a prevalence of 25% while contradictory results with lower prevalence were found in study conducted by Raghav et al. [22] who reported 7.2% prevalence for polypoidal mucosal thickening in their study. A prevalence of 15% was reported in study conducted by Kihara et al., [23] 8% in study conducted by Lim and Spanger [28] and 10.1% in study conducted by Rege et al. [29] for polypoidal mucosal thickening. ...
... In the present study, mucosal thickening was found to be the second most common finding with a reported prevalence of 29.3% in accordance with studies conducted by Raghav et al. [22] who found 35.1% and Carmeli et al. [31] who found 36.1% prevalence of mucosal thickening in their studies. The prevalence of mucosal thickening, though, was a little higher in studies conducted by Kihara et al. [23] who found 43%, Shiki et al. [30] who reported 49% and Dobele et al. [32] who found 48.5% prevalence of mucosal thickening in their studies, though, in all these studies, mucosal thickening was the second most common accidental finding reported. Contrary to findings of aforementioned studies, Vallo et al. [26] found 12% and Lim and Spanger [28] found 16.8% prevalence of mucosal thickening in their studies. ...
... In the present study, prevalence of partial opacification was found in 2% of patients which was in accordance with study conducted by Lim and Spanger [28] who found a prevalence of 2.3% while contradictory to findings of study conducted by Shiki et al. [30] who reported 0% prevalence of partial opacification in their study. The said variations might be due to difference in season or, climate during the period studies were conducted. ...
Background:
The aim of the present study was to detect the prevalence of accidental pathological findings in asymptomatic maxillary sinuses in patients referred for head and neck cone-beam computed tomography (CBCT) examination for varied reasons.
Methods:
The present cross-sectional study included a detailed analysis of CBCT scans of 150 patients aged between 18 and 70 years reporting for varied dental complaints for detecting accidental pathological findings in maxillary sinuses while the patients did not have any complaint pertaining to sinuses.
Results:
The findings of the present study revealed 58% patients to have pathological findings in maxillary sinuses while they were asymptomatic for sinuses. Furthermore, the prevalence of mucosal thickening was found in 29.3% of the patients while 36.7% patients presented with polypoidal mucosal thickening.
Conclusion:
Higher prevalence of pathologies in asymptomatic maxillary sinuses found in the present study emphasized significance of a thorough examination of routine dental patients by dento-maxillofacial radiologists with necessary investigations to be advised in the form of higher imaging modalities like CBCT, if necessary.
... The present study revealed polypoidal mucosal thickening as a major finding with a prevalence of 36.7% similar to study conducted by Shiki et al. [30] who reported a prevalence of 25% while contradictory results with lower prevalence were found in study conducted by Raghav et al. [22] who reported 7.2% prevalence for polypoidal mucosal thickening in their study. A prevalence of 15% was reported in study conducted by Kihara et al., [23] 8% in study conducted by Lim and Spanger [28] and 10.1% in study conducted by Rege et al. [29] for polypoidal mucosal thickening. ...
... In the present study, mucosal thickening was found to be the second most common finding with a reported prevalence of 29.3% in accordance with studies conducted by Raghav et al. [22] who found 35.1% and Carmeli et al. [31] who found 36.1% prevalence of mucosal thickening in their studies. The prevalence of mucosal thickening, though, was a little higher in studies conducted by Kihara et al. [23] who found 43%, Shiki et al. [30] who reported 49% and Dobele et al. [32] who found 48.5% prevalence of mucosal thickening in their studies, though, in all these studies, mucosal thickening was the second most common accidental finding reported. Contrary to findings of aforementioned studies, Vallo et al. [26] found 12% and Lim and Spanger [28] found 16.8% prevalence of mucosal thickening in their studies. ...
... In the present study, prevalence of partial opacification was found in 2% of patients which was in accordance with study conducted by Lim and Spanger [28] who found a prevalence of 2.3% while contradictory to findings of study conducted by Shiki et al. [30] who reported 0% prevalence of partial opacification in their study. The said variations might be due to difference in season or, climate during the period studies were conducted. ...
Background: The aim of the present study was to detect the prevalence of accidental pathological findings in asymptomatic maxillary sinuses in patients referred for head and neck cone-beam computed tomography (CBCT) examination for varied reasons. Methods: The present cross-sectional study included a detailed analysis of CBCT scans of 150 patients aged between 18 and 70 years reporting for varied dental complaints for detecting accidental pathological findings in maxillary sinuses while the patients did not have any complaint pertaining to sinuses. Results: The findings of the present study revealed 58% patients to have pathological findings in maxillary sinuses while they were asymptomatic for sinuses. Furthermore, the prevalence of mucosal thickening was found in 29.3% of the patients while 36.7% patients presented with polypoidal mucosal thickening. Conclusion: Higher prevalence of pathologies in asymptomatic maxillary sinuses found in the present study emphasized significance of a thorough examination of routine dental patients by dento-maxillofacial radiologists with necessary investigations to be advised in the form of higher imaging modalities like CBCT, if necessary.
... In cone beam computed tomography (CBCT) images, the maxillary sinuses are visualized as hypodense structures outlined by a round hyperdense margin (Shiki et al., 2014). On the inside, the maxillary sinuses are covered by a membrane that might be visualized depending on thickness. ...
Objective: To test the standard protocols of a CBCT unit in order to find lower-dose alternatives with diagnostically acceptable image quality for the maxillary sinuses visualization. Study design: An observational study was performed. Two dry skulls were used to simulate four conditions of the maxillary sinuses: normality, mucous retention pseudocyst, membrane thickening and bone graft. Cone beam computed tomography scans were obtained with an i-CAT classic unit using different acquisition protocols and a box of polystyrene to simulate soft tissue attenuation. All the protocols were established by the manufacturer, combining different energy parameters, fields of view and voxel sizes. Multiplanar reconstructions were presented to three Oral Radiologists through blind and randomized distribution. The specialists judged general image quality, sharpness, contrast, and the presence of noise and artifacts based on a 4-points scale. Results: Protocols with higher energy parameters had significant association with higher scores for general quality, sharpness and contrast (p<0.05). Protocols with intermediate level of radiation dose had also significant association with good and excellent image quality; for the presence of noise and artifacts the images were rated acceptable. Conclusion: i-CAT default protocols with lower dose of radiation were able to deliver acceptable image quality for the visualization of the maxillary sinuses.
... In the present study, the most prevalent finding was mucosal thickening [25.3 %] which is in accordance with the studies conducted by Pazera et al. [15] [ 23.7%]; Raghav et al. [25] [35.1%] and Carmeli et al. [28] [36.1%]. Dobele et al. [26] , Kihara et al. [29] and Shiki et al. [30] also found mucosal thickening as the most prevalent finding in their studies but the prevalence was significantly higher [48.5%, 43% and 49% respectively] than the present study. Contrary to the findings of the aforementioned studies, Vallo et al. [22] [12%] and Lim and Spanger [24] [16.8%] found less prevalence of mucosal thickening in their studies. ...
... Complete opacification was found to be 4.1 % in the present study which was slightly higher than the studies reported by Dobele et al. [26] [2.9%], Kihara et al. [29] [2%] and Lim and Spangera [24] [2.7%]. Rege et al. [21] [7.8%], Raghav et al. [25] [16.6%] and Shiki et al. [30] [18%] found higher prevalence of complete opacification in their studies. [ Figure 3] In the present study, prevalence of partial opacification with liquid accumulation was 2.7% which was in accordance with the study conducted by Lim and Spangera [24] [2.3%]. ...
... [ Figure 3] In the present study, prevalence of partial opacification with liquid accumulation was 2.7% which was in accordance with the study conducted by Lim and Spangera [24] [2.3%]. Shiki et al. [30] did not find a single case of partial opacification in their study. [ Figure 4] Prevalence of extrinsic diseases in the present study appeared to be 3.4% which included three cystic lesions and one each case of fibro-osseous and benign odontogenic tumor [ Figure 5] and one case of congenitally absence of maxillary sinus bilaterally [0.7%]. ...
Background-The paranasal sinuses are paired sets of air-filled cavities of the craniofacial complex composed of maxillary, frontal, sphenoidal, and ethmoidal air cells. Amongst these, maxillary sinuses, also, called maxillary antra or, Antra of Highmore, are of clinical significance to dental professionals because of their proximity to the teeth and associated structures. Aim-To evaluate the prevalence of abnormalities of the maxillary sinus using cone-beam computed tomography [CBCT] of the maxilla in dental patients. Material and methods-In this retrospective study, CBCT scans of 150 dental patients who were advised CBCT scans for a purpose other than the sinus evaluation were included. CBCT was used to assess incidental maxillary sinus pathologies and the data was tabulated. Statistical analysis was done using descriptive statistics. Results-Seventy-two patients had pathological changes [44.9%], 38 [25.3%] had mucosal thickening, 11[7.4%] had mucous retention cyst, 6 [4.1%] had complete while another 4 [2.7%] had complete opacification, 3 [2%] had cystic lesions and discontinuity of wall and 1 [0.7%] had a benign odontogenic and fibro-osseous lesion, discontinuity of wall each. Conclusions-Incidental findings of abnormalities in the maxillary sinus were a common finding in the present study using CBCT scans of maxilla. Dental professionals reviewing CBCT scans should be cautious and aware of maxillary sinus anatomy and pathologies when interpreting a CBCT scan of the maxilla which can help in early detection of undetected diseases.
