Radiological evaluation of maxillary sinus anatomy: a cross-sectional study of 300 patients

Abstract

Objective: The aim of the present study was to evaluate the principal anatomical characteristics of the maxillary sinus using Cone Beam Computed Tomography (CBCT) in order to facilitate prevention of intra- and post-operative complications. Materials and methods: Three hundred CBCT scans from patients undergoing implant surgery were analysed. The following anatomical structures were evaluated: (1) Residual ridge height (RRH) and width (RRW); (2) Ridge bone density (BD); (3) Maxillary sinus angle (MSA); (4) Maxillary sinus lateral wall thickness (LWT); (5) Schneiderian membrane thickness (MT); (6) Maxillary sinus septa (SS); (7) Posterior superior alveolar artery (PSAA).‘ Results: Mean patient age was 59.5 ± 13.6. Mean RRH at upper second premolar (2PM) was 8.66 ± 3.95 mm, 4.90 ± 2.28 mm at first molar (1 M), and 5.26 ± 2.13 mm at second molar (2 M). Mean RRW was 6.72 ± 2.69 mm at 2PM, 6.87 ± 2.65 mm at 1 M and 7.09 ± 2.80 mm at 2 M. Bone density was 330.93 ± 211.02 Hounsfield Units (HU) at first molar position and MSA was 73.39 ± 15.23°. LWT was 1.95 ± 0.98 mm. Mean Schneider Membrane thickness (MT) was 1.82 ± 1.59 mm; MT was ≤3 mm in 72.9% of patients and >3 mm in 27.10%. 20.56% of patients presented bucco-palatal oriented septa with a mean height of 13.11 ± 3.82 mm. PSAA was observed in 48.60% and mean distance to the top of the ridge was 13.15 ± 3.71 mm, and was mostly observed inside the sinus (53.85%). Conclusions: CBCT scanning has been shown to be a useful tool for evaluating maxillary sinus anatomical variations. CBCT should be considered the gold standard when evaluating the maxillary sinus area.