Relationship of Maxillary Sinus Mucosal Thickening and Residual Alveolar Ridge Height: A CBCT Analysis
-
Solmaz Akbari
,
Mina Taheri
,
Hoori Aslroosta
,
Alireza Ordoukhani
,
Mojgan Paknejad
,
Flora Hashemi
,
Zeynab Farimani
Abstract
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<0.05).
Conclusion: Maxillary sinus membrane thickening (mostly with flat appearance) is frequently observed on CBCT scans taken prior to augmentation and implant placement. This, in return, may trigger a reduction in ridge height.
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2. Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic review. Clin Implant Dent Relat Res. 2012 May;14 Suppl 1:e159-68.
3. Raghoebar GM, Onclin P, Boven GC, Vissink A, Meijer HJA. Long-term effectiveness of maxillary sinus floor augmentation: A systematic review and meta-analysis. J Clin Periodontol. 2019 Jun;46 Suppl 21:307-18.
4. Beretta M, Poli PP, Grossi GB, Pieroni S, Maiorana C. Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures: results of a 15-year retrospective study. J Dent. 2015 Jan;43(1):78-86.
5. Tavelli L, Borgonovo AE, Re D, Maiorana C. Sinus presurgical evaluation: a literature review and a new classification proposal. Minerva Stomatol. 2017 Jun;66(3):115-31.
6. Testori T, Weinstein T, Taschieri S, Wallace SS. Risk factors in lateral window sinus elevation surgery. Periodontology 2000. 2019 Oct;81(1):91-123.
7. Al-Dajani M. Incidence, Risk Factors, and Complications of Schneiderian Membrane Perforation in Sinus Lift Surgery: A Meta-Analysis. Implant Dent. 2016 Jun;25(3):409-15.
8. Khalighi Sigaroudi A, Dalili Kajan Z, Rastgar S, Neshandar Asli H. Frequency of different maxillary sinus septal patterns found on cone-beam computed tomography and predicting the associated risk of sinus membrane perforation during sinus lifting. Imaging Sci Dent. 2017 Dec;47(4):261-7.
9. Al-Moraissi E, Elsharkawy A, Abotaleb B, Alkebsi K, Al-Motwakel H. Does intraoperative perforation of Schneiderian membrane during sinus lift surgery causes an increased the risk of implants failure?: A systematic review and meta regression analysis. Clin Implant Dent Relat Res. 2018 Oct;20(5):882-9.
10. Testori T, Yu SH, Tavelli L, Wang HL. Perforation risk assessment in maxillary sinus augmentation with lateral wall technique. Int J Periodontics Restorative Dent. 2020 May/Jun;40(3):373-80.
11. 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 Oct;26(10):1158-64.
12. 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 May;27(5):612-7.
13. Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for preoperative planning of implant placement. Clin Oral Investig. 2006 Mar;10(1):1-7.
14. Penarrocha-Oltra S, Soto-Penaloza D, Bagan-Debon L, Bagan JV, Penarrocha-Oltra D. Association between maxillary sinus pathology and odontogenic lesions in patients evaluated by cone beam computed tomography. A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2020 Jan;25(1):e34-e48.
15. Shanbhag S, Karnik P, Shirke P, Shanbhag V. Association between periapical lesions and maxillary sinus mucosal thickening: a retrospective cone-beam computed tomographic study. J Endod. 2013 Jul;39(7):853-7.
16. Carmeli G, Artzi Z, Kozlovsky A, Segev Y, Landsberg R. Antral computerized tomography pre-operative evaluation: relationship between mucosal thickening and maxillary sinus function. Clin Oral Implants Res. 2011 Jan;22(1):78-82.17. Phothikhun S, Suphanantachat S, Chuenchompoonut V, Nisapakultorn K. Cone-beam computed tomographic evidence of the association between periodontal bone loss and mucosal thickening of the maxillary sinus. J Periodontol. 2012 May;83(5):557-64.
18. Lum AG, Ogata Y, Pagni SE, Hur Y. Association Between Sinus Membrane Thickness and Membrane Perforation in Lateral Window Sinus Augmentation: A Retrospective Study. J Periodontol. 2017 Jun;88(6):543-9.
19. Yilmaz HG, Tozum TF. Are gingival phenotype, residual ridge height, and membrane thickness critical for the perforation of maxillary sinus? J Periodontol. 2012 Apr;83(4):420-5.
20. 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 Dec;22(12):1446-53.
21. Low KM, Dula K, Burgin W, von Arx T. Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. J Endod. 2008 May;34(5):557-62.
22. Sheikhi M, Pozve NJ, Khorrami L. Using cone beam computed tomography to detect the relationship between the periodontal bone loss and mucosal thickening of the maxillary sinus. Dent Res J (Isfahan). 2014 Jul;11(4):495-501.
23. Ata-Ali J, Diago-Vilalta JV, Melo M, Bagan L, Soldini MC, Di-Nardo C, et al. What is the frequency of anatomical variations and pathological findings in maxillary sinuses among patients subjected to maxillofacial cone beam computed tomography? A systematic review. Med Oral Patol Oral Cir Bucal. 2017 Jul;22(4):e400-e9.
24. Tarp B, Fiirgaard B, Christensen T, Jensen JJ, Black FT. The prevalence and significance of paranasal sinus abnormalities on MRI. Rhinology. 2000 Mar;38(1):33-8.
25. Shiki K, Tanaka T, Kito S, Wakasugi-Sato N, Matsumoto-Takeda S, Oda M, et al. The significance of cone beam computed tomography for the visualization of anatomical variations and lesions in the maxillary sinus for patients hoping to have dental implant-supported maxillary restorations in a private dental office in Japan. Head Face Med. 2014 May;10:20.
26. 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 Dec;65(6):303-10.
27. Schneider AC, Bragger U, Sendi P, Caversaccio MD, Buser D, Bornstein MM. Characteristics and dimensions of the sinus membrane in patients referred for single-implant treatment in the posterior maxilla: a cone beam computed tomographic analysis. Int J Oral Maxillofac Implants. 2013 Mar-Apr;28(2):587-96.
28. Vogiatzi T, Kloukos D, Scarfe WC, Bornstein MM. Incidence of anatomical variations and disease of the maxillary sinuses as identified by cone beam computed tomography: a systematic review. Int J Oral Maxillofac Implants. 2014 Nov-Dec;29(6):1301-14.
29. Vallo J, Suominen-Taipale L, Huumonen S, Soikkonen K, Norblad A. Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: results from the Health 2000 Health Examination Survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Mar;109(3):e80-7.
30. Moosazadeh M, Ziaaddini H, Mirzazadeh A, Ashrafi-Asgarabad A, Haghdoost AA. Meta-analysis of Smoking Prevalence in Iran. Addict Health. 2013 Summer-Automn;5(3-4):140-53.
31. Dobele I, Kise L, Apse P, Kragis G, Bigestans A. Radiographic assessment of findings in the maxillary sinus using cone-beam computed tomography. Stomatologija. 2013;15(4):119-22.
32. Nascimento EH, Pontual ML, Pontual AA, Freitas DQ, Perez DE, Ramos-Perez FM. Association between Odontogenic Conditions and Maxillary Sinus Disease: A Study Using Cone-beam Computed Tomography. J Endod. 2016 Oct;42(10):1509-15.
33. Rege IC, Sousa TO, Leles CR, Mendonca EF. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health. 2012 Aug;12:30.
34. Feng Z, Weinberg A. Role of bacteria in health and disease of periodontal tissues. Periodontol 2000. 2006;40:50-76.
35. Stelzle F, Rohde M. Elevation forces and resilience of the sinus membrane during sinus floor elevation: preliminary measurements using a balloon method on ex vivo pig heads. Int J Oral Maxillofac Implants. 2014 May-Jun;29(3):550-7.
2. Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic review. Clin Implant Dent Relat Res. 2012 May;14 Suppl 1:e159-68.
3. Raghoebar GM, Onclin P, Boven GC, Vissink A, Meijer HJA. Long-term effectiveness of maxillary sinus floor augmentation: A systematic review and meta-analysis. J Clin Periodontol. 2019 Jun;46 Suppl 21:307-18.
4. Beretta M, Poli PP, Grossi GB, Pieroni S, Maiorana C. Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures: results of a 15-year retrospective study. J Dent. 2015 Jan;43(1):78-86.
5. Tavelli L, Borgonovo AE, Re D, Maiorana C. Sinus presurgical evaluation: a literature review and a new classification proposal. Minerva Stomatol. 2017 Jun;66(3):115-31.
6. Testori T, Weinstein T, Taschieri S, Wallace SS. Risk factors in lateral window sinus elevation surgery. Periodontology 2000. 2019 Oct;81(1):91-123.
7. Al-Dajani M. Incidence, Risk Factors, and Complications of Schneiderian Membrane Perforation in Sinus Lift Surgery: A Meta-Analysis. Implant Dent. 2016 Jun;25(3):409-15.
8. Khalighi Sigaroudi A, Dalili Kajan Z, Rastgar S, Neshandar Asli H. Frequency of different maxillary sinus septal patterns found on cone-beam computed tomography and predicting the associated risk of sinus membrane perforation during sinus lifting. Imaging Sci Dent. 2017 Dec;47(4):261-7.
9. Al-Moraissi E, Elsharkawy A, Abotaleb B, Alkebsi K, Al-Motwakel H. Does intraoperative perforation of Schneiderian membrane during sinus lift surgery causes an increased the risk of implants failure?: A systematic review and meta regression analysis. Clin Implant Dent Relat Res. 2018 Oct;20(5):882-9.
10. Testori T, Yu SH, Tavelli L, Wang HL. Perforation risk assessment in maxillary sinus augmentation with lateral wall technique. Int J Periodontics Restorative Dent. 2020 May/Jun;40(3):373-80.
11. 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 Oct;26(10):1158-64.
12. 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 May;27(5):612-7.
13. Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for preoperative planning of implant placement. Clin Oral Investig. 2006 Mar;10(1):1-7.
14. Penarrocha-Oltra S, Soto-Penaloza D, Bagan-Debon L, Bagan JV, Penarrocha-Oltra D. Association between maxillary sinus pathology and odontogenic lesions in patients evaluated by cone beam computed tomography. A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2020 Jan;25(1):e34-e48.
15. Shanbhag S, Karnik P, Shirke P, Shanbhag V. Association between periapical lesions and maxillary sinus mucosal thickening: a retrospective cone-beam computed tomographic study. J Endod. 2013 Jul;39(7):853-7.
16. Carmeli G, Artzi Z, Kozlovsky A, Segev Y, Landsberg R. Antral computerized tomography pre-operative evaluation: relationship between mucosal thickening and maxillary sinus function. Clin Oral Implants Res. 2011 Jan;22(1):78-82.17. Phothikhun S, Suphanantachat S, Chuenchompoonut V, Nisapakultorn K. Cone-beam computed tomographic evidence of the association between periodontal bone loss and mucosal thickening of the maxillary sinus. J Periodontol. 2012 May;83(5):557-64.
18. Lum AG, Ogata Y, Pagni SE, Hur Y. Association Between Sinus Membrane Thickness and Membrane Perforation in Lateral Window Sinus Augmentation: A Retrospective Study. J Periodontol. 2017 Jun;88(6):543-9.
19. Yilmaz HG, Tozum TF. Are gingival phenotype, residual ridge height, and membrane thickness critical for the perforation of maxillary sinus? J Periodontol. 2012 Apr;83(4):420-5.
20. 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 Dec;22(12):1446-53.
21. Low KM, Dula K, Burgin W, von Arx T. Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. J Endod. 2008 May;34(5):557-62.
22. Sheikhi M, Pozve NJ, Khorrami L. Using cone beam computed tomography to detect the relationship between the periodontal bone loss and mucosal thickening of the maxillary sinus. Dent Res J (Isfahan). 2014 Jul;11(4):495-501.
23. Ata-Ali J, Diago-Vilalta JV, Melo M, Bagan L, Soldini MC, Di-Nardo C, et al. What is the frequency of anatomical variations and pathological findings in maxillary sinuses among patients subjected to maxillofacial cone beam computed tomography? A systematic review. Med Oral Patol Oral Cir Bucal. 2017 Jul;22(4):e400-e9.
24. Tarp B, Fiirgaard B, Christensen T, Jensen JJ, Black FT. The prevalence and significance of paranasal sinus abnormalities on MRI. Rhinology. 2000 Mar;38(1):33-8.
25. Shiki K, Tanaka T, Kito S, Wakasugi-Sato N, Matsumoto-Takeda S, Oda M, et al. The significance of cone beam computed tomography for the visualization of anatomical variations and lesions in the maxillary sinus for patients hoping to have dental implant-supported maxillary restorations in a private dental office in Japan. Head Face Med. 2014 May;10:20.
26. 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 Dec;65(6):303-10.
27. Schneider AC, Bragger U, Sendi P, Caversaccio MD, Buser D, Bornstein MM. Characteristics and dimensions of the sinus membrane in patients referred for single-implant treatment in the posterior maxilla: a cone beam computed tomographic analysis. Int J Oral Maxillofac Implants. 2013 Mar-Apr;28(2):587-96.
28. Vogiatzi T, Kloukos D, Scarfe WC, Bornstein MM. Incidence of anatomical variations and disease of the maxillary sinuses as identified by cone beam computed tomography: a systematic review. Int J Oral Maxillofac Implants. 2014 Nov-Dec;29(6):1301-14.
29. Vallo J, Suominen-Taipale L, Huumonen S, Soikkonen K, Norblad A. Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: results from the Health 2000 Health Examination Survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Mar;109(3):e80-7.
30. Moosazadeh M, Ziaaddini H, Mirzazadeh A, Ashrafi-Asgarabad A, Haghdoost AA. Meta-analysis of Smoking Prevalence in Iran. Addict Health. 2013 Summer-Automn;5(3-4):140-53.
31. Dobele I, Kise L, Apse P, Kragis G, Bigestans A. Radiographic assessment of findings in the maxillary sinus using cone-beam computed tomography. Stomatologija. 2013;15(4):119-22.
32. Nascimento EH, Pontual ML, Pontual AA, Freitas DQ, Perez DE, Ramos-Perez FM. Association between Odontogenic Conditions and Maxillary Sinus Disease: A Study Using Cone-beam Computed Tomography. J Endod. 2016 Oct;42(10):1509-15.
33. Rege IC, Sousa TO, Leles CR, Mendonca EF. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health. 2012 Aug;12:30.
34. Feng Z, Weinberg A. Role of bacteria in health and disease of periodontal tissues. Periodontol 2000. 2006;40:50-76.
35. Stelzle F, Rohde M. Elevation forces and resilience of the sinus membrane during sinus floor elevation: preliminary measurements using a balloon method on ex vivo pig heads. Int J Oral Maxillofac Implants. 2014 May-Jun;29(3):550-7.
| Issue | Vol 19 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v19i19.9965 | |
| Keywords | ||
| Cone-Beam Computed Tomography Maxillary Sinus Mucous Membrane Alveolar Process | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Akbari S, Taheri M, Aslroosta H, Ordoukhani A, Paknejad M, Hashemi F, Farimani Z. Relationship of Maxillary Sinus Mucosal Thickening and Residual Alveolar Ridge Height: A CBCT Analysis. Front Dent. 2022;19.
