Assessment of Maxillary Sinus Septum and its prevalence in a Sample of Syrian Population using 3D CBCT A Cross-Sectional Study

Abstract

Background & Aim: Preoperative assessment of maxillary sinus anatomy may prevent

complications associated with sinus grafting or implant procedures. Maxillary sinus may have some anatomical variations; one of these is the maxillary sinus septum. It was noted that septal presence during sinus lift procedures might cause sinus membrane perforation leading to greater consequences as graft migration with concomitant graft failure and sinus infection. Moreover, diagnostic methods for verification of sinus disorders, as endoscopy, may be hindered due to septal presence. These concerns have led to a different attitude towards the maxillary sinus and its anatomical variations.

The purpose of this study was to measure the frequency, numbers, locations, orientations and heights of maxillary sinus septa

Materials and methods: To assess the anatomical variations (prevalence, location, orientation and height) of the maxillary sinus septa in a sample of Syrian population using 3D cone beam computed tomography. Reconstructed cone-beam computed tomography (CBCT) images of 720 sinuses were analyzed using Ez3Di ver.5.0.2.0. To establish the multiple predictors in this study, groups were defined according to the different radiographic features of the septa. The differences between the gender groups were tested with chi-square tests, and the level of significance was set at 5%.

Result: Based on the number of patients, the prevalence of septa was 48.6%. However, this value dropped to 27.9% based on the number of sinuses included. The patient-based prevalence rates were 46.9% for the men and 49.5% for the women, and the corresponding sinus-based rates were 27.9% for the men and 28.7% for the women, respectively. These differences were not statistically significant (P>0.05). Analysis of the location of the septa revealed that 51.6% were in the middle, 37 % in the anterior and 11.2% in the posterior areas. Among all septa, the majority of the maxillary sinus septa traversed the sinus in a buccopalatal direction (88.7%). The mean height of septa was 4.3 mm to 9.3mm.

Conclusion: It is necessary to perform careful and extensive evaluations of septa to prevent avoidable complications during the maxillary sinus elevation process in dental implantation Maxillary sinus septa can jeopardize the oral and maxillofacial and ENT surgeons’ plans astoundingly if not well assessed. Fortunately, it is essential and effective to analyze CT images of sinuses to evaluate the characteristics of septa before performing surgical procedures evaluate the characteristics of septa before performing surgical procedures.