Palatal versus vestibular piezoelectric window osteotomy for maxillary sinus elevation: a comparative clinical study of two surgical techniques
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A strategic surgical approach is necessary for patients who cannot undergo maxillary sinus augmentation due to a large perforation of the sinus membrane as a result of complex sinus septa. The technique includes partial cutting and removal of the sinus septum and graftless mucosal elevation of the concavity area. Six months after the procedure, bone growth was observed in the area where the septum had been partially removed. The sinus mucosa was slightly thicker because of scarring; consequently, maxillary sinus augmentation was safely achieved. This two-step procedure is effective for safe maxillary sinus augmentation in patients with complex sinus morphology.
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The maxillary sinus is an essential anatomical structure in close relation to maxillary teeth roots. The aim of the present study is to evaluate the anatomic proximity of the maxillary posterior roots’ apices to the maxillary sinus floor using cone-beam CT in a population attending King Saud University. Materials and methods: CBCT images for patients attending the dental school of king Saud university were screened, and images containing maxillary sinuses were evaluated. The relation between teeth roots and sinus floor was divided into Root tips penetrating the sinus (In the sinus, Type 1), Root tips in contact with the sinus floor (On the sinus, Type 2), and Root tips below the sinus floor (Type 3). Results: around 288 scans were included. The average age was 40.63 ±6.53. Root tips contacting the sinus floor (root on the sinus) formulated the largest category (45.1%). A strong correlation was found between all age groups and root relation to sinus (p<0.000), with most roots penetrating the sinus belongs to younger patients. Around (41.7%) of molar roots were in direct contact with the sinus floor (on the sinus), while 50% of premolar roots had no relation to the sinus floor. Conclusion: Molar roots appear closer to the sinus floor than premolars, with age appearing to influence the root relation to the sinus.
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The aim of the present study was to assess long-term changes in sinus-graft height after maxillary sinus floor augmentation and simultaneous placement of implants. A total of 191 patients who underwent maxillary sinus floor augmentation were radiographically followed for up to about 10 years. A 2 : 1 mixture of autogenous bone and bovine xenograft (Bio-Oss) was used as the graft material. Sinus-graft height was measured using 294 panoramic images immediately after augmentation and up to 108 months subsequently. Changes in sinus-graft height were calculated with respect to implant length and original sinus height. Patients were divided into three groups based on the height of the grafted sinus floor relative to the implant apex: Group I, in which the grafted sinus floor was above the implant apex; Group II, in which the implant apex was level with the grafted sinus floor; and Group III, in which the grafted sinus floor was below the implant apex. After augmentation, the grafted sinus floor was consistently located above the implant apex. After 2-3 years, the grafted sinus floor was level with or slightly below the implant apex. This relationship was maintained over the long term. Sinus-graft height decreased significantly and approached original sinus height. The proportion of patients classified as belonging to Group III reached a maximum from year 3 onwards. The clinical survival rate of implants was 94.2%. All implant losses occurred within 3 years after augmentation. We conclude that progressive sinus pneumatization occurs after augmentation with a 2 : 1 autogenous bone/xenograft mixture, and long-term stability of sinus-graft height represents an important factor for implant success.
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Maxillary sinus abnormalities were demonstrated to be associated with maxillary sinus infundibulum narrowing as well as nasal airflow resistance secondary to nonspecific nasal inflammation.There is no consensus regarding the pathogenetic roles of allergy and anatomic variations in sinus mucosa abnormalities. We investigated the correlation between allergy and anatomic variations in sinus abnormalities in chronic rhinitis patients in the presence or absence of allergy.In all, 148 adult patients with allergic rhinitis (AR) and non-allergic rhinitis (NAR) were enrolled. Opacification of sinuses, the size of the maxillary sinus infundibulum, Haller cells, and concha bullosa were evaluated based on computed tomography (CT) images. Simultaneously, nasal airflow resistance was measured.The AR group comprising 105 patients showed maxillary sinus opacification in 45 patients. In the NAR group including 43 patients, soft tissue opacification was observed in 13 patients. There was no significant difference in the incidence of sinus opacification between the AR and NAR groups. Both nasal resistance and the infundibulum size in both the AR and NAR groups with sinus opacification showed significant differences from those without sinus abnormalities. The presence of concha bullosa influenced the sinus opacification in both the AR and NAR groups.
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The topographical relationships between the root tips and the floor of the maxillary sinus favour the occurrence of odontogenic maxillary sinus pathologies. Knowledge of these relationships may help to prevent such pathologies. The aim of this study was to investigate the anatomical relationships between the maxillary sinuses and the apices of the maxillary roots in a Beninese population using computed tomography (CT) images of the maxilla. : This was a descriptive study of CT scans of facial masses performed between January 2020 and January 2023 in subjects aged at least 18 years without tumour or traumatic sinus pathology. The CT images were in Dicom format. Horos, Excel and SPSS software were used for data collection, entry and analysis. : Of the 346 CT scans collected, 255 were included in the analysis. The mean age of the subjects was 42.65±16.57 years and the sex ratio was 2. More than half of the cases involved 3rd molars within the sinus. In 99% of cases, the sinus alveolar recess was located in the root furcation zone. The mean volume of the right sinus was 13.78±4.59 ml and that of the left sinus was 13.65±4.75 ml. Anterior sinus extensions were located in the premolar region (75%) and posterior sinus extensions were located in the tuberosity region (88 to 90%). In 3 out of 4 subjects the sinus floor had an irregular shape. : These various insights into the relationships between the maxillary root apices and the sinus floor will be of considerable help to dental surgeons in the prevention of odontogenic maxillary sinus pathology.
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Periapical Abscess
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