RADIOLOGICAL CHANGES IN MAXILLARY SINUS MORPHOLOGY AFTER LATERAL SINUS FLOOR AUGMENTATION

Background: Restoration of the masticatory function in patients with edentulous posterior maxilla is often challenging due to the severe atrophy of the alveolar ridges and insufficient bone quantity for implant supported dentures. The purpose of this study was to analyze the change in Shneiderian membrane thickness after lateral sinus floor augmentation (LSFA) using cone beam computed tomography (CBCT). Methodology/Principal: LSFA procedures using different bovine bone materials with and withaut immediate implantation were performed at the Stomatological Medical Center of Bohomolets National Medical University in 87 patients, from 2016 to 2018. CBCT examination was performed before LSFA procedure in all patients, postoperative period: up to 1 month after surgery; and after 6 months, before implant placement or loading. Results: Postoperative CBCT performed in early postsurgical period demonstrated that the number of cases with type A decreased significantly from 86,67 to 26,75%. Type B radiological picture increased from 20,33% to 26,75 %. Type C was observed in 7,5 vs 41,73%. Type D and E were observed in 13.91 and 2.14%. The clinical signs of the acute sinusitis or specific complaints were recorded only in 2 cases. In 3 cases radiological findings resembled to F type. Conclusions: The minor radiologic changes in mucous morphology were observed preoperatively in 17.12% of patients who underwent LSFA procedures. The incidence of sinusitis consisted 19.26 % while the frequency of asymptomatic radiological changes was significantly higher. It consisted 68.48 in early and 47.1 % in late (6 months). As the differential diagnosis for such changes based only on clinical and radiological data is difficult, the obtained results prove the importance of preoperative endoscopic examination.

Download Full-text

Radiological changes in maxillary sinus morphology after lateral sinus floor augmentation

Otolaryngologia Polska ◽

10.5604/01.3001.0014.8015 ◽

2021 ◽

Vol 75 (2) ◽

pp. 1-8

Author(s):

Oleksandr Shpachynskyi ◽

Vyacheslav Didkovskyi ◽

Andrii Kopchak

Keyword(s):

Maxillary Sinus ◽

Mucous Membrane ◽

Clinical Signs ◽

Membrane Thickness ◽

Lateral Sinus ◽

Posterior Maxilla ◽

Sinus Floor Augmentation ◽

Sinus Floor ◽

Radiological Changes ◽

Mucosal Thickening

Background: Restoration of the masticatory function in patients with edentulous posterior maxilla is often challenging due to the severe atrophy of the alveolar ridges and proximity of the maxillary sinus, resulting in insufficient bone quantity for implant-supported dentures. Aim: The purpose of this study was to analyze the changes in Schneiderian membrane thickness after lateral sinus floor augmentation (LSFA) using cone beam computed tomography (CBCT). Material and methods: W LSFA procedures using different bone grafting materials were performed in 87 patients, operated on in two clinical institutions from 2016 to 2018. CBCT examination was performed in all patients before the LSFA procedure, at 1 month after surgery, and after 6 months, before implant placement or loading. Results: Minor r adiological changes in mucous membrane morphology were observed preoperatively in 17.1% of patients. Postoperative CBCT in the early postsurgical period demonstrated that the number of intact non-specific sinuses decreased significantly, i.e. from 86.7% to 26.7%. The number of cases with local hypertrophia of the mucous membrane increased from 20.3% to 26.7%. Mucosal thickening was observed in 41.7% vs 7.5%. The number of intact sinuses increased to 57.8%. The number of cases with local membrane hypertrophia also increased – to 37.4%. The number of cases with mucosal thickening or fluid accumulation decreased significantly to 11.8 and 5.3% respectively. In 2 cases the development of chronic sinusitis required secondary surgeries. Conclusion: The present retrospective study revealed that minor radiological changes in the morphology of the maxillary sinus mucosa were observed preoperatively in 17.1% of patients who underwent LSFA procedures. In the early and late postoperative period their frequency increased to 68.5% and 47.1%, r espectively. However, the clinical signs o f sinusitis developed only in 19.26% of patients. No significant correlations were found between the frequency and severity of postoperative radiological changes and residual bone height, sinus anatomy, initial state of the mucous membrane and type of the grafting material.

Download Full-text

TOMOGRAPHIC EXAMINATION OF CHANGES IN MUCOPERIOST OF THE MAXILLARY SINUS AFTER SINUS LIFTING

Ukrainian Scientific Medical Youth Journal ◽

10.32345/usmyj.4(112).2019.54-63 ◽

2019 ◽

Vol 112 (4) ◽

pp. 54-63

Author(s):

Oleksandr Shpachynskyi ◽

Vadym Skibitskyi ◽

Larisa Filippenkova ◽

Kostiyntin Vasilevskyi ◽

Vyacheslav Didkovskyi ◽

...

Keyword(s):

Postoperative Period ◽

Medical Center ◽

Clinical Signs ◽

Endoscopic Examination ◽

Bovine Bone ◽

Lateral Sinus ◽

Postoperative Rehabilitation ◽

Type D ◽

Postoperative Control ◽

Posterior Maxilla

Restoration of the masticatory function in patients with edentulous posterior maxilla is often challenging due to the severe atrophy of the alveolar ridges and insufficient bone quantity for implant supported dentures. The purpose of this study was to analyze the change in mucoperiost after lateral sinus floor augmentation (LSFA) using cone beam computed tomography (CBCT). LSFA procedures using different bovine bone materials with and withaut immediate implantation were performed at the Stomatological Medical Center of Bohomolets National Medical University in 87 patients, from 2016 to 2018. CBCT examination was performed before LSFA procedure in all patients, postoperative period: up to 1 month after surgery; and after 6 months, before implant placement or loading. Images were acquired using Planmeca ProMax 3D. Postoperative CBCT performed in early postsurgical period demonstrated that the number of case with type A decreased significantly from 86,67 to 26,75%. The number of cases with type B radiological picture increased from 20,33% to 26,75 %. Mucoperiost type C was observed in 7,5 vs 41,73%. Type D and E were observed in 13.91 and 2.14% However, the clinical signs of the acute sinusitis or specific complaints were recorded only in 2 cases. In 3 cases radiological findings resembled to F type. According to the results of the present study the minor radiologic changes in mucoperiost morphology were observed preoperatively in 17.12% of patients who underwent LSFA procedures. The incidence of sinusitis or graft failure in long term follow up consisted 19.26 % while the frequency of asymptomatic radiological changes was significantly higher. It consisted 68.48 in early and 47.1 % in late (6 months) postoperative period. As the differential diagnosis for such changes based only on clinical and radiological data is difficult, the obtained results prove the importance of preoperative endoscopic examination, intraoperative and postoperative control in patients with LSFA and the benefits of multidisciplinary approach of oral and ENT surgeons in asset of indications, ricks of the procedure, postoperative rehabilitation and complication management.

Download Full-text

Sinus Augmentation by Platelet-Rich Fibrin Alone: A Report of Two Cases with Histological Examinations

Case Reports in Dentistry ◽

10.1155/2016/2654645 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Naofumi Aoki ◽

Takeo Kanayama ◽

Michinori Maeda ◽

Koichiro Horii ◽

Hironori Miyamoto ◽

...

Keyword(s):

Tissue Sample ◽

Lateral Sinus ◽

Graft Material ◽

Sinus Augmentation ◽

Platelet Rich Fibrin ◽

First Case ◽

Posterior Maxilla ◽

Sinus Floor Augmentation ◽

Sinus Floor ◽

The Right

In sinus floor augmentation of an atrophic posterior maxilla, platelet-rich fibrin (PRF) has been used as a graft material. We herein report two cases with histological evaluations of PRF after the surgery. The first case was a 28-year-old female with an atrophic right posterior maxilla who was treated with sinus floor augmentation and simultaneous implant placement using PRF as the sole graft material in our hospital. Twenty-four months after surgery, the implant was unfortunately removed because of occlusal overloading by parafunctional habits. During implant replacement, a tissue sample was obtained from the site of augmentation with PRF and was evaluated histologically. The second case was a 58-year-old man with severe alveolar atrophy of the right maxilla who underwent lateral sinus augmentation using only PRF in a two-stage procedure in our hospital. Samples were obtained at the second-stage surgery and histological examinations were performed. As a result, new bone formation was confirmed histologically in both cases. Our findings show that the use of PRF as a graft material during sinus floor augmentation induces natural bone regeneration.

Download Full-text

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.

Download Full-text