Morphological Assessment of Maxillary Sinus Septa Variations with Cone-Beam Computed Tomography in a Turkish Population

Abstract

Objective The purpose of this study was to measure and classify sinus septa variables (prevalence, numbers, heights, locations, orientations, and morphology) and to determine the effects of age, gender, and dental status on the presence of septa and also to evaluate the effects of septa on pathological mucosal thickening.

Materials and Methods A total of 2,000 patients were analyzed through conebeam computed tomography (CBCT). The total of 500 maxillary sinuses were included in this study. The number of maxillary sinus septa was determined on axial sections of CBCT images. Their locations, orientations, and morphologies were determined on both the axial and sagittal sections, and their heights were determined only on the sagittal sections. The influence of age, gender, dental status, and pathological mucosal thickening on the presence of septa was statistically analyzed. Mann–Whitney U-test and descriptive statistics were used for statistical analysis.

Results The average height of the determined 287 septa was measured as 7.36 mm. The highest rates of septa location, morphology, and orientation were found, respectively, in the middle region septa (57.49%), completed septa (75.95%), and transverse septa (93.37%). The effect of dental status, age, and gender on the presence of septa was not statistically significant (p > 0.05).

Conclusion These high rates of findings support the importance of CBCT in the diagnosis of the variations of the maxillary sinus septa. Therefore, it is important to evaluate CBCT images of the relevant region to increase the success of surgical interventions in the maxillary posterior region and to eliminate possible complications.

Keywords

cone-beam computed tomography - maxillary sinus - septa - sinus floor augmentation

• References

• 1 Irinakis T, Dabuleanu V, Aldahlawi S. Complications during maxillary sinus augmentation associated with interfering septa: a new classification of septa. Open Dent J 2017; 11: 140-150
• 2 Vinter I, Krmpotić-Nemanić J, Hat J, Jalsovec D. [Does the alveolar process of the maxilla always disappear after tooth loss?]. Laryngorhinootologie 1993; 72 (12) 605-607
• 3 Orhan K, Kusakci Seker B, Aksoy S, Bayindir H, Berberoğlu A, Seker E. Cone beam CT evaluation of maxillary sinus septa prevalence, height, location and morphology in children and an adult population. Med Princ Pract 2013; 22 (01) 47-53
• 4 Krennmair G, Ulm C, Lugmayr H. Maxillary sinus septa: incidence, morphology and clinical implications. J Craniomaxillofac Surg 1997; 25 (05) 261-265
• 5 Shibli JA, Faveri M, Ferrari DS. et al. Prevalence of maxillary sinus septa in 1024 subjects with edentulous upper jaws: a retrospective study. J Oral Implantol 2007; 33 (05) 293-296
• 6 Jang SY, Chung K, Jung S, Park HJ, Oh HK, Kook MS. Comparative study of the sinus septa between dentulous and edentulous patients by cone beam computed tomography. Implant Dent 2014; 23 (04) 477-481
• 7 Hadchiti W, Nasseh I, Hayek E, Mora F, Bouchard P. Prevalence, location and orientation of maxillary sinus septa. Ann Oral Maxillofac Surg 2014; 2: 9
• 8 Shen EC, Fu E, Chiu TJ, Chang V, Chiang CY, Tu HP. Prevalence and location of maxillary sinus septa in the Taiwanese population and relationship to the absence of molars. Clin Oral Implants Res 2012; 23 (06) 741-745
• 9 Ella B, Noble RdaC, Lauverjat Y. et al. Septa within the sinus: effect on elevation of the sinus floor. Br J Oral Maxillofac Surg 2008; 46 (06) 464-467
• 10 Sakhdari S, Panjnoush M, Eyvazlou A, Niktash A. Determination of the prevalence, height, and location of the maxillary sinus septa using cone beam computed tomography. Implant Dent 2016; 25 (03) 335-340
• 11 Faramarzie M, Babaloo AR, Oskouei SG. Prevalence, height, and location of antral septa in Iranian patients undergoing maxillary sinus lift. JIPD 2009; 1: 43-47
• 12 Teng M, Cheng Q, Liao J, Zhang X, Mo A, Liang X. Sinus width analysis and new classification with clinical implications for augmentation. Clin Implant Dent Relat Res 2016; 18 (01) 89-96
• 13 Cakur B, Sümbüllü MA, Durna D. Relationship among Schneiderian membrane, Underwood's septa, and the maxillary sinus inferior border. Clin Implant Dent Relat Res 2013; 15 (01) 83-87
• 14 Ozeç I, Kılıç E, Müderris S. Maxillary sinus septa: Evaluation with computed tomography and Panoramic radiography. Cumhuriyet Dental Journal 2008; 11: 82-86
• 15 Underwood AS. An inquiry into the anatomy and pathology of the maxillary sinus. J Anat Physiol 1910; 44 (Pt 4) 354-369
• 16 Ulm CW, Solar P, Krennmair G, Matejka M, Watzek G. Incidence and suggested surgical management of septa in sinus-lift procedures. Int J Oral Maxillofac Implants 1995; 10 (04) 462-465
• 17 Velásquez-Plata D, Hovey LR, Peach CC, Alder ME. Maxillary sinus septa: a 3-dimensional computerized tomographic scan analysis. Int J Oral Maxillofac Implants 2002; 17 (06) 854-860
• 18 Rancitelli D, Borgonovo AE, Cicciù M. et al. Maxillary sinus septa and anatomic correlation with the Schneiderian membrane. J Craniofac Surg 2015; 26 (04) 1394-1398
• 19 Almog DM, Romano PR. CT-based dental imaging for implant planning and surgical guidance. N Y State Dent J 2007; 73 (01) 51-53
• 20 Krennmair G, Ulm CW, Lugmayr H, Solar P. The incidence, location, and height of maxillary sinus septa in the edentulous and dentate maxilla. J Oral Maxillofac Surg 1999; 57 (06) 667-671 discussion 671–672