Correlation between periodontal phenotype and sinus membrane thickness: A systematic review.

AIM: To assess the correlation between the periodontal phenotype (PP) and sinus membrane thickness (SMT) in humans. METHODS: This review was conducted according to the PRISMA guidelines. Two reviewers independently carried out electronic and manual literature searches of studies published in English, German, and Spanish, from 1970 to September 2022 in four electronic databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, in addition to gray literature. Studies that assessed the correlation between PP and SMT in adults (aged 18 years) were included. Methodological quality was evaluated using the Appraisal Tool for Cross-Sectional Studies (AXIS) for articles that met the eligibility criteria. RESULTS: Six studies, including 510 patients, were considered for qualitative analysis. All included studies were cross-sectional, and the correlation between the PP and SMT was evaluated, finding a positive and high correlation in 83.3% of them, based on a value of ≥0.7. All the included studies were assessed with a high overall risk of bias. CONCLUSIONS: Periodontal phenotype and sinus membrane thickness are likely correlated. Nevertheless, further standardized studies are required to draw definitive conclusions.

An Analysis of Frequency, Morphology, and Locations of Maxillary Sinus Septa Using Cone Beam Computed Tomography.

PURPOSE: To evaluate the frequency, morphology, and locations of maxillary sinus septa using cone beam computed tomographic (CBCT) imaging of the entire maxillary sinus and to analyze factors influencing the presence or absence of septa. MATERIALS AND METHODS: CBCT images of the maxilla taken during a 1-year study period (October 1, 2012, to September 30, 2013) were evaluated for the presence and type of septa as well as the health or pathology of the maxillary sinus. Differences in age, gender, type of dentition, septa location, and sinus pathology with regard to the incidence of sinus septa were analyzed statistically. RESULTS: The study included 294 maxillary sinuses in 212 patients (126 women and 86 men) with a mean age of 53.8 years. Sinus septa were present in 141 patients (66.5%) and in 166 of 294 sinuses (56.5%). The most common orientation of the septa was coronal (61.8%), 7.6% were oriented axially, and 3.6% were aligned sagittally. Most septa were located on the floor of the maxillary sinus (58.6%), commonly (60.7%) in the region of the first and second molars. The maxillary sinuses were diagnosed in 36.4% of cases as healthy and without thickening of the sinus membrane. Sex was a significant variable in the health of the maxillary sinus; 57.7% of the sinuses in women and 72.3% in men were diagnosed as pathologic. CONCLUSION: Septa are common anatomical structures and are most often found in the first or second molar region on the floor of the maxillary sinus. To prevent possible complications during sinus floor elevation procedures, a thorough three-dimensional radiographic examination of the sinus prior to surgery is recommended.

Proximity of premolar roots to maxillary sinus: a radiographic survey using cone-beam computed tomography.

INTRODUCTION: The proximity of the roots of the posterior maxillary teeth to the maxillary sinus is a constant challenge to the dental practitioner. Because the majority of studies have assessed the relationship regarding molars, the present study focused on premolars. METHODS: Cone-beam computed tomographic images of 192 patients were reconstructed in sagittal, coronal, and axial planes to quantify the distances between the root apices of the maxillary premolars and the adjacent maxillary sinus. Measurements were taken for each root, and data were correlated with age, sex, side, and presence of both or absence of 1 of the 2 premolars. RESULTS: A total of 296 teeth (177 first and 119 second premolars) were evaluated. The mean distances from buccal roots of the first premolars to the border of the maxillary sinus in the sagittal, coronal, and axial planes ranged from 5.15 ± 2.99 to 8.28 ± 6.27 mm. From palatal roots, the mean distances ranged from 4.20 ± 3.69 to 7.17 ± 6.14 mm. The mean distances of second premolars were markedly shorter in buccal roots between 2.32 ± 2.19 and 3.28 ± 3.17 mm and in palatal roots between 2.68 ± 3.58 and 3.80 ± 3.71 mm, respectively. The frequency of a premolar root protrusion into the maxillary sinus was very low in first premolars (0%-7.2%) but higher in second premolars (2.5%-13.6%). Sex, age, side, and presence/absence of premolars failed to significantly influence the mean distances between premolar roots and the maxillary sinus. CONCLUSIONS: Based on the calculated mean distances of the present study, only few premolars (and if so second premolars) would present a risk of violating the border of the maxillary sinus during conventional or surgical endodontic treatment or in case of tooth extraction.

Perforation of the sinus membrane during sinus floor elevation: a retrospective study of frequency and possible risk factors.

PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical and radiographic variables potentially influencing the risk of sinus membrane perforation were evaluated and divided into patient-related factors (age, sex, smoking habit); surgery-related factors (type of surgical approach, side, units, sites, and technique of osteotomy); and maxillary sinus-related factors (presence and height of septum, height of residual ridge, thickness of lateral sinus wall, width of antrum, and thickness and status of sinus membrane). RESULTS: The following factors presented with at least a 10% difference in rates of perforations: smokers (46.2%) versus nonsmokers (23.4%), simultaneous (32%) versus staged (18.5%) approach, mixed premolar-molar sites (41.2%) versus premolar-only sites (16.7%) versus molar-only sites (26.2%), presence of septa (42.9%) versus no septa (23.8%), and minimum height of residual ridge ≤4 mm (34.2%) versus > 4 mm (20.5%). These same parameters, except minimum height of residual ridge, also showed an odds ratio above 2. However, none of the comparisons reached statistical significance. CONCLUSION: The present study failed to demonstrate any factor that statistically significantly increased the risk of sinus membrane perforation during SFE using the lateral window approach.