Evaluation of maxillary sinus anatomy by cone-beam CT prior to sinus floor elevation.
OBJECTIVE
Surgical complications during sinus floor elevation are frequently caused by septa in the maxillary sinus. In this study, the prevalence of septa was retrospectively determined via three-dimensional imaging to assess the necessity for appropriate imaging prior to sinus floor elevation.


METHODS
The cone-beam computed tomography scans of 1,029 consecutive patients were evaluated to assess the prevalence of septa, taking into account patient age and sex as well as the number and orientation of septa and their locations. If septa were present, the height was measured and the orientation was determined.


RESULTS
Septa were found in 47% of patients and 33.2% of sinuses. There was no statistical difference in prevalence with respect to age, sex, or side. Most patients with septa showed one septum in one sinus (24.6%); 13.7% showed one septum in each sinus. Other combinations (up to three septa per sinus) were found in 8.7% of patients. Septa were most commonly located in the first molar region (256 septa), followed by the second molar region (225 septa), the third molar region (144), second premolar region (136), the first premolar region (44), and the canine region (5). The mean septal height was 11.7 +/- 6.08 mm for septa in a sagittal orientation (n = 206, 25.3%; maximum height of 37 mm) and 7.3 +/- 5.08 mm for those oriented transversely (n = 608, 74.7%; maximum height of 36 mm). The variance was larger for the sagittal orientation group (37.03 mm) than for transversely oriented septa (25.9 mm).


CONCLUSIONS
Septa were found in 47% of the patients in this sample. Appropriate imaging prior to performing sinus surgery seems justified, since complications and the success rate of sinus floor elevation are clearly related to the presence of septa. Int J Oral Maxillofac Implants 2010;25:258-265.
Neugebauer
Joerg
J
Interdisciplinary Outpatient Department of Oral Surgery amd Implantology, Department of craniomaxillofacial and Plastic Surgery, University of cologne, Germany. joerg.neugebauer@uk-koeln.de
Ritter
Lutz
L
Mischkowski
Robert A
RA
Dreiseidler
Timo
T
Scherer
Phillip
P
Ketterle
Matthias
M
Rothamel
Daniel
D
Zöller
Joachim E
JE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001641:Bicuspid / Q000000981:diagnostic imaging; D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D054893:Cone-Beam Computed Tomography; D003481:Cuspid / Q000000981:diagnostic imaging; D003724:Dental Arch / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery; D008443:Maxillary Sinus / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging; D008964:Molar, Third / Q000000981:diagnostic imaging; D011300:Preoperative Care; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult