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Cone‐beam computed tomographic analysis of sinus membrane thickness, ostium patency, and residual ridge heights in the posterior maxilla: implications for sinus floor elevation
Author(s) -
Shanbhag Siddharth,
Karnik Prabodh,
Shirke Prashant,
Shanbhag Vivek
Publication year - 2014
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1111/clr.12168
Subject(s) - ostium , maxillary sinus , medicine , sinus (botany) , cone beam computed tomography , maxilla , ridge , nuclear medicine , anatomy , computed tomographic , coronal plane , radiology , computed tomography , surgery , geology , biology , genus , paleontology , botany
Objective To determine, using cone‐beam computed tomography ( CBCT ), the residual ridge height ( RRH ), sinus floor membrane thickness ( MT ), and ostium patency ( OP ) in patients being evaluated for implant placement in the posterior maxilla. Materials and methods CBCT scans of 128 patients (199 sinuses) with ≥1 missing teeth in the posterior maxilla were examined. RRH and MT corresponding to each edentulous site were measured. MT >2 mm was considered pathological and categorized by degree of thickening (2–5, 5–10 mm, and >10 mm). Mucosal appearance was classified as “normal”, “flat thickening”, or “polypoid thickening”, and OP was classified as “patent” or “obstructed”. Descriptive and bivariate statistical analyses were performed. Results MT >2 mm was observed in 60.6% patients and 53.6% sinuses. Flat and polypoid mucosal thickening had a prevalence of 38.1% and 15.5%, respectively. RRH ≤4 mm was observed in 46.9% and 48.9% of edentulous first and second molar sites, respectively. Ostium obstruction was observed in 13.1% sinuses and was associated with MT of 2–5 mm (6.7%), 5–10 mm (24%), and >10 mm (35.3%, P  <   0.001). Polypoid mucosal lesions were more frequently associated with ostium obstruction than flat thickenings (26.7% vs. 17.6%, P  <   0.001). Conclusion Thickened sinus membranes (>2 mm) and reduced residual ridge heights (≤4 mm) were highly prevalent in this sample of patients with missing posterior maxillary teeth. Membrane thickening >5 mm, especially of a polypoid type, is associated with an increased risk for ostium obstruction. In the presence of these findings, an ENT referral may be beneficial prior to implant‐related sinus floor elevation.

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