Influence of Lateral Sinus Floor Elevation Procedures on the Pulpal and Periapical Status of Adjacent Vital Teeth

The aim of the present study was to evaluate the pulpal and periapical status of vital teeth within the area of a lateral sinus floor elevation (LSFE). The files of patients treated by LSFE between 2009 and 2015 were retrospectively evaluated. The radiographic bone measurements and the periapical status of the teeth adjacent to the LSFE area were evaluated preoperatively and 6 months following the surgery by CBCT. The pulpal status of the adjacent teeth was clinically evaluated using thermal pulp vitality testing. Vital teeth within the sinus floor elevation area were the main inclusion criteria for this study. A total of 158 LSFE procedures were evaluated; 18 cases fulfilled the inclusion criteria, and 20 adjacent teeth were vital. There were no cases of periapical pathology or loss of pulp vitality. There was a statistically significant difference in the ridge height between the baseline and 6 months postoperatively and in the distance from the apex to the sinus floor between pre- and 6 months postoperatively (p < 0.01).The pulpal and periapical status of vital teeth was not affected following LSFE.

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Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-18-00229 ◽

2020 ◽

Vol 46 (4) ◽

pp. 415-422

Author(s):

Junho Jung ◽

Jung Soo Park ◽

Seoung-Jin Hong ◽

Gyu-Tae Kim ◽

Yong-Dae Kwon

Keyword(s):

Maxillary Sinus ◽

Surgical Techniques ◽

Lateral Sinus ◽

Sinus Floor Elevation ◽

Second Molar ◽

Sinus Wall ◽

Posterior Maxilla ◽

Significant Difference ◽

Sinus Floor ◽

Molar Region

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.

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