Análise volumétrica do septo no seio maxilar exibida por tomografia computadorizada feixe cônico na população peruana ­ estudo retrospectivo transversal / Volumetric analysis of the maxillary sinus septa by CBCT in a Peruvian population ­ cross-sectional retrospective study

Objetivos: avaliar a presença do septo sinusal na população peruana. Materiais e métodos: um estudo transversal foi realizado em 298 seios maxilares de pacientes encaminhados ao Serviço de Radiologia Oral e Maxilofacial do Hospital Nacional Arzobispo Loayza, em Lima, Peru. A presença do septo, o número, a localização, o comprimento e a orientação dos avaliados, bem como idade, sexo e tipo de dentulismo, foram quantificados nas imagens da tomografi a computadorizada feixe cônico (TCFC), usando o software CS 3D Imaging. O teste Qui-quadrado foi realizado para tentar identifi car associações entre a presença do septo, condição dentária, idade e sexo, com 5% de significância, usando-se o SPSS20. Resultados: o septo no seio maxilar foi visto em 36,2% dos casos e estava ausente em 63,8%. Quanto à localização, 49,4% dos septos estavam no lado direito e 50,6% no lado esquerdo. Houve septos completos em 22,9% e incompletos em 77,1% dos casos. A localização do septo em maior proporção foi encontrada na parede basal, com 48,2%, seguido pelo setor anterior e medial do seio maxilar. O comprimento médio foi de 6,86 mm. Houve associação entre a frequência do septo e o sexo dos pacientes (teste Qui-quadrado de Pearson, p=0,015, graus de liberdade 1, ᵪ2= 5,894). Conclusão: cada população apresentará variações na localização e tamanho do septo do seio maxilar que devem ser cuidadosamente estudadas por TCFC para evitar rompimento da membrana e outras intercorrências que levam ao insucesso das terapias regenerativas e restauradoras.

Objectives: to evaluate the presence of the sinus septa in a Peruvian population. Materials and methods: a cross-sectional study was performed on 298 maxillary sinuses of patients referred to the Oral and Maxillofacial Radiology Service of the Arzobispo Loayza National Hospital, Lima, Peru. The presence of the septum, the number, location, length and orientation of the evaluated, as well as age, gender, type of dentulism were quantified in conical beam computed tomography (CTT) images using CS 3D Imaging software. The Chi-square test was performed to try to identify associations between the presence of the septum, dental condition, age and sex, with 5% of signifi cance, using SPSS20. Results: the septum in the maxillary sinus was seen in 36.2% of the cases and absent in 63.8%. Regarding the location, 49.4% of the septa on the right side and 50.6% on the left side. There were complete septa in 22.9% and incomplete septa in 77.1% of the cases. The location of the septum in greater proportion was found in the basal wall with 48.2%, followed by the anterior and medial sector of the maxillary sinus. The average length was 6.86 mm. There was an association between septum frequency and patients' gender (Pearson's Chi-Square test, p=0.015, degrees of freedom 1, ᵪ2 = 5.894). Conclusions: each population will present variations in the location and size of the septum of the maxillary sinus that must be carefully studied by CBCT to avoid membrane rupture and other intercurrences that lead to the failure of regenerative and restorative therapies.

Use of cone-beam computed tomographyto demonstrate morphology of maxillary sinus and association of-maxillary sinus with maxillary posterior teeth / 实用医学杂志

Objective To study the morphological variations of maxillary sinus and to provide anatomical basis for maxillary posterior teeth implantation and extraction usingcone-beam computed tomography (CBCT) scan-ning. Methods CBCT images from 403 patients were reviewed. The minimal distance from sinus floor to alveolar ridge wasmeasured and the number of patients with clinical features such as having sinus septum , mucosal thicken-ing and posterior teeth roots extend into maxillary sinus were counted. Results The mean value of the minimal dis-tance from maxillary sinus floor to alveolar ridge was about 8.3 mm, there was no significant statistical difference between sex, but there was a significant statisticalsignificant difference between the left sides and the right sides. Occurrences of sinus septum, mucosal thickening and roots into sinus were 98.6%, 31% (in which 56.3% of mu-cosal thickening were related to apical periodontitis) and 47%. there was no significantstatisticaldifference between the two sides in males females. Conclusions The morphological variations of maxillary sinus are significant. Chron-ic inflammation in maxillary sinuis is closely related to the position of maxillary posterior teeth roots and periapical lesions.

Localización del Septo del Seno Maxilar a través de Abordaje Endoscópico: Reporte de Caso y Revisión de la Literatura / Location of Maxillary Sinus Septum through an Endoscopic Approach: Report of a Case and Review of the Literature

El abordaje quirúrgico del seno maxilar para maniobras como el levantamiento de la membrana sinusal y la colocación de injerto óseo con o sin implantes simultáneo en la zona subantral, es un procedimiento cada vez más habitual en implantología oral. Una de las mayores complicaciones en este tipo de procedimientos es el abordaje de la pared lateral del seno maxilar con presencia de septos intra-sinusales no diagnosticados, pudiendo producir perforación de la membrana durante el fresado óseo. La presencia de septos en el seno maxilar es muy variable, pudiendo presentarse única o múltiple y en diferentes localizaciones anatómicas en relación a la zona de las raíces de las piezas maxilares antrales en pacientes dentados o desdentados, desde la zona canina hasta el segundo molar. Diversos autores, han descrito diferentes valores de la prevalencia en relación a la presencia de septos intra-sinusales en base a imagenología tridimensional o in vivo en estudios cadavéricos. El objetivo del presente estudio, es realizar una revisión exhaustiva de la literatura desde 1997 hasta noviembre del 2010 en relación a la prevalencia de septos en el seno maxilar y su localización según método de visualización, y el reporte de un caso con una nueva técnica de abordaje quirúrgico que permite una visualización intra y extrasinusal para la localización del septo del seno maxilar in vivo.

Surgery of the maxillary sinus in procedures as elevation of the sinus membrane and bone graft, with or without simultaneous implants in the subantral area, is becoming a more standard procedure in oral implants each time. One of the most common complications in this type of procedure is the approach of the sinus lateral wall, with presence of undiagnosed intra-sinus septa with perforation of the membrane during sinus elevation. The presence of septa in the maxillary sinus is variable, presenting as single or multiple in different locations with relation to the rots in maxillary pieces in dentate or edentulous patients. Various authors have described different values in the prevalence of the intra sinus septum presence, based on three dimensional imaging studies, or the in vivo study of cadavers. The aim of this study is an exhaustive review of the literature since 1997 to November of 2010 in reference to the prevalence of maxillary sinus septa and their location according to observation methods, and the report of a case with innovative surgical approach technique, that allows intra and extra sinus visualization for in vivo maxillary sinus septum location.

CLINICAL STUDY ON KOREAN POSTERIOR MAXILLAE RELATED TO DENTAL IMPLANT TREATMENT

CLINICO-ANATOMICAL STUDY OF SEPTUM IN THE MAXILLARY SINUS

Several reports have suggested a risk of problems due to sinus septum during the sinus lift procedure. However, there has been no wide-ranging clinico-anatomical study of sinus septum. This study was performed to examine the occurrence and anatomical characteristics of sinus septum of the maxillary sinus. The computed tomographs of the maxillary sinus in 488 patients were analyzed. THe incidence, location, and orientation of the septum were examined. The septa were observed in 177 of 488 patients (24.0%). The septa could be observed at any age (from 7 to 74 years). The incidence of sinus septum was higher in female (30.8%) than in male (20.8%). The average number of present septa in one patient was 1.56+/-0.84. One hundred and fifty-seven septa (86.3%) were oriented in a buccopalatal plane, 16 septa (8.8%) in a sagittal plane, and 9 septa (4.9%) in a transverse plane. There were no significant differences in location of septa within the maxillary sinus. These results were suggested that the incidence of sinus septum was 24.0%, and its shape and location were irregular. The identification of sinus septum should occur prior to the sinus lift procedure so that the modification of the basic sinus lift procedure can be planned according to the shape and the location of septa. Then successful results may be achieved through surgical removal of septa or several modifications to the sinus lift procedure.