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1.
Shanghai Kou Qiang Yi Xue ; 29(4): 355-358, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-33089281

RESUMO

PURPOSE: To compare the stress distribution of dental implants with different body shapes after maxillary sinus augmentation. MRTHODS: Three different implant models varying in implant shape were investigated in D3-type maxilla. All materials were assumed to be linear elastic, homogenous and isotropic. An oblique force of 150 N was applied to the implant. Maximal equivalent von-Mises of supporting bone around implants were measured. All of the models were measured by Ansys Workbench 14.5. Statistical analysis was performed using SPSS 17.0 software package. RESULTS: Highest stress of supporting bone emerged on the crestal cortical site around the implant neck. There was no significant difference in the maximum EQV of supporting cortical bone between different groups; the maximum EQV of supporting trabecular bone in the tapered implant group was much higher than other groups; application of grafts reduced the maximum EQV of both cortical and trabecular bone in all groups. CONCLUSIONS: Tampered implant can induce elevated stress distribution of the upper trabecular bone, which may promote marginal bone loss. Application of grafts after maxillary sinus augmentation could favors in reducing the stress loading of dental implants.


Assuntos
Implantes Dentários , Maxila , Planejamento de Prótese Dentária , Análise de Elementos Finitos , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Estresse Mecânico
2.
J Laryngol Otol ; 134(7): 636-641, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32686629

RESUMO

OBJECTIVE: This study aimed to assess the outcomes of a prelacrimal recess approach assisted middle meatal antrostomy in the management of hard to reach maxillary sinus pathologies. METHOD: Twenty-five patients with maxillary sinus pathology underwent prelacrimal recess approach assisted middle meatal antrostomy (with a prelacrimal recess width of more than 3 mm). Patients were prospectively evaluated using both the Arabic version of the Sino-Nasal Outcome Test-22 and nasal endoscopy at least 6 months post-operatively. RESULTS: Our study included 25 maxillary sinuses (13 with antrochoanal polyps, 10 with maxillary fungal ball and 2 with a migrated part of a tooth). At a mean follow-up period of 10.9 months, all patients showed significant improvement in total mean Sino-Nasal Outcome Test-22 score. There was recurrence of one case with antrochoanal polyp and two cases with asymptomatic synechia. Injury to the nasolacrimal duct was not reported. CONCLUSION: A prelacrimal recess approach assisted middle meatal antrostomy is a reliable and safe technique to manage pathologies in hard to reach regions within the maxillary sinus.


Assuntos
Seio Maxilar/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Doenças dos Seios Paranasais/cirurgia , Adolescente , Adulto , Idoso , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Cavidade Nasal , Ducto Nasolacrimal/diagnóstico por imagem , Ducto Nasolacrimal/cirurgia , Doenças dos Seios Paranasais/diagnóstico por imagem , Estudos Prospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
3.
Clin Oral Implants Res ; 31(10): 959-967, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32716570

RESUMO

OBJECTIVES: To evaluate graft remodelling according to the distance from the native bone in maxillary sinuses grafted with anorganic bovine bone (ABB). MATERIAL AND METHODS: Bilateral sinus grafting was performed in twenty patients with residual bone height <5 mm before implant placement. After 8 months, biopsy samples were harvested, and histomorphometric analysis was performed to examine bone formation according to the distance (in mm) from the native bone (sinus floor). In the grafted area, the percentages of new bone (NB), residual graft material (rABB), and soft tissue (ST) were evaluated. RESULTS: A total of 103 biopsy samples were evaluated, and the percentages of NB, rABB, and ST were 31.62 ± 9.85%, 18.94 ± 7.88%, and 49.41 ± 9.52%, respectively, in the 1st mm; 27.15 ± 9.83%, 23.33 ± 9.45%, and 49.53 ± 11.73%, respectively, in the 2nd mm; 23.61 ± 13.02%, 21.35 ± 11.08%, and 55.03 ± 16.14%, respectively, in the 3rd mm; and 21.67 ± 12.29%, 19.67 ± 10.28%, and 58.66 ± 12.46%, respectively, in the 4th mm. The 1st millimetre of the grafted area (closer to the native bone) presented a larger amount of NB than the other portions of the grafted areas and a smaller amount of rABB than the 2nd mm of the grafted area (p < .05). The amount of ST was larger in the 3rd and 4th mm of the grafted area than in the first 2 millimetres (p < .05). CONCLUSION: The distance from the native bone influences bone formation following maxillary sinus augmentation.


Assuntos
Substitutos Ósseos , Levantamento do Assoalho do Seio Maxilar , Animais , Transplante Ósseo , Bovinos , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Osteogênese
4.
PLoS One ; 15(6): e0234915, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555640

RESUMO

OBJECTIVES: The aim of this study is 1) to obtain the area and volumes of the maxillary sinuses in patients affected by clinically unilateral sinus pathology by comparing the results to the contralateral sinus and 2) to determine the importance of the volumetric measures when diagnosing the percentage of sinus obliteration. MATERIALS AND METHODS: A single-centre observational retrospective clinical study was conducted in 214 patients with clinically unilateral sinus pathologies. Linear (mm), area (mm2) and volume (mm3) measurements were taken from Cone Beam Computed Tomography (CBCT) images of the affected sinus as well as from the contralateral ones. Histopathological study was performed using haematoxylin/eosin and PAS or Groccot stains. The lesions were classified into non-specific sinusitis, polyps, inverted papilloma, fungal sinusitis, cysts, mucocele and other lesions. Chi-squared test, ANOVA for independent samples and Pearson test were used for the statistical analysis. RESULTS: A total of 100 sinuses were measured in 50 patients (28 men and 22 women, with an age of 43.6 years (SD = 18.3), 50 pathological and 50 healthy contralateral sinuses. The three-dimensional occupation volume of the affected sinuses was 97.1 mm3 (62.5%) vs. 40.6 mm3 (22.8%) in the healthy ones (p<0.0001). The medial-lateral width of the sinus in the frontal plane was significantly higher in the cysts group (32.4 mm, CI: 23-41.8 mm). CONCLUSION: In medical terms, the global percentage of occupation determined using the classic manual determination method does not differ from the three-dimensional percentage calculated using specific complex software.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
J Oral Maxillofac Surg ; 78(9): 1529-1537, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32531267

RESUMO

The purpose of this article was to present a guided lateral window sinus lift procedure with the aid of a fully digital workflow using surgical templates for window osteotomy preparation and implant placement. A 22-year-old patient with insufficient residual bone height in the posterior maxilla was treated with a maxillary sinus augmentation procedure with a lateral window technique and simultaneous implant installation using 3-dimensionally printed surgical guides. The surgical guides, used for the preparation of both the lateral window and the implant site according to the optimal prosthodontic and anatomic position, were based on a fully digital workflow and virtual pre-planning with modified implant-planning software. Successful functional and esthetic rehabilitation of the patient was accomplished using standard surgical techniques and instruments but an innovative method for the production and application of surgical templates ensured a precise and safe approach for the lateral window osteotomy preparation. This guided lateral window sinus lift technique may reduce the incidence of surgical complications and failures and enhance patient-related outcomes.


Assuntos
Levantamento do Assoalho do Seio Maxilar , Seios Transversos , Adulto , Implantação Dentária Endo-Óssea , Estética Dentária , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Adulto Jovem
6.
Int. j. odontostomatol. (Print) ; 14(2): 150-153, June 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1090667

RESUMO

El seno maxilar (SM) es una cavidad par presente en el hueso maxilar, que puede presentar diversas alteraciones o lesiones patológicas factibles de ser pesquisadas mediante estudios imagenológicos. En este sentido, la opacidad, el ocupamiento y/o engrosamiento de las mucosas son los signos orientadores para el diagnóstico de patologías en estas estructuras, las que pueden ir desde sinusitis, hasta antrolitos, pasando por hipoplasias, pseudoquistes u osteomas. En el siguiente reporte presentamos el caso de una mujer de 75 años de edad en la cual mediante examinación radiográfica de rutina se observa un cuerpo extraño en el SM derecho en relación a diente 1.6. De acuerdo a esto, se solicitó una tomografía computarizada cone-beam (CBCT) para evaluar posibles implicancias con tratamiento dental rehabilitador. Al examen se observan dos estructuras de alta densidad (densidad metálica), redondeadas, una al lado de la otra, en contacto inmediato a la cortical sinusal sin comprometerla. También se observa una cortical sinusal conservada en todo su recorrido y discreto engrosamiento mucoso en relación a dichas estructuras. En consideración con los antecedentes de la paciente, se opta por un manejo conservador del hallazgo mediante controles periódicos. Se propone la hipótesis de la formación de un antrolito de origen exógeno, que se corresponde con el historial de tratamiento endodóntico en la zona. El diagnóstico diferencial de los hallazgos radiográficos encontrados es fundamental para establecer los lineamientos terapéuticos de nuestros pacientes, por ello es importante contar con personal clínico capacitado para la interpretación de las imágenes.


The maxillary sinus (SM) is an even cavity present in the maxillary bone, which may present a number of pathological alterations or lesions that can be investigated through imaging analysis. In this sense, opacity, location and / or thickening of the mucous membranes are guides for the diagnosis of pathologies in these structures. These can range from sinusitis, to antrolites, to hypoplasias, pseudocysts or osteomas. In this study the case of a 75-year-old woman is presented. During routine radiographic examination, a foreign body was observed in the right MS in relation to tooth 1.6. A cone-beam computed tomography (CBCT) was requested to evaluate possible rehabilitative dental treatment. Upon examination, two highdensity rounded structures (metal density) adjacent to each other were noted. The structures were in direct contact with the sinus cortex without compromising it. Furthermore in relation to the above structures, scant cortical sinus was observed throughout its course, as well as slight mucous thickening. Considering the patient's background, it was determined to use conservative treatment through periodic controls. Hypothesis of an exogenous mass is proposed, corresponding to the history of endodontic treatment in the area. In view of the differential diagnosis of radiographic findings found, it is essential to implement therapeutic guidelines for patients and have trained clinical staff available to interpret the images.


Assuntos
Humanos , Feminino , Idoso , Corpos Estranhos/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Radiografia Panorâmica , Achados Incidentais , Tomografia Computadorizada de Feixe Cônico , Tratamento Conservador
7.
J Craniofac Surg ; 31(5): 1274-1278, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32282691

RESUMO

Isolated fracture of maxillary sinus anterior wall is relatively uncommon. If the extent of fracture is minimal, only conservative care is amenable, however, there is no agreement on whether infraorbital nerve dysfunction can be used as an indication for surgical intervention. This study was conducted to verify the effect of decompression surgery of infraorbital foramen for recovery of hypoesthesia. A total of 26 patients with unilateral fracture of maxillary sinus anterior wall were enrolled. Ten who received only conservative therapy were allocated in the control group, while sixteen patients were assigned to the decompression group. Pre- and post-treatment sensory assessment using visual analogue scale (VAS) was recorded. Overall treatment satisfaction was also evaluated by means of global assessment scale (GAS). Both absolute VAS value and score increment showed statistical difference only at 4 weeks (P = 0.010 and P = 0.021, respectively), but no significant difference at 1, 12, and 24 weeks. GAS score also showed no statistical significance (P = 0.386). Decompression surgery of infraorbital foramen does not have a significant effect on hypoesthesia recovery in isolated fracture of maxillary sinus anterior wall. Therefore, it is not recommended to perform the operation when the infraorbital nerve hypoesthesia is the only indication for the open reduction.


Assuntos
Hipestesia/cirurgia , Fraturas Maxilares/cirurgia , Nervo Maxilar/cirurgia , Seio Maxilar/cirurgia , Fraturas Orbitárias/cirurgia , Adolescente , Adulto , Idoso , Feminino , Humanos , Hipestesia/diagnóstico por imagem , Masculino , Fraturas Maxilares/diagnóstico por imagem , Nervo Maxilar/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Fraturas Orbitárias/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Escala Visual Analógica , Adulto Jovem
8.
J Oral Implantol ; 46(4): 415-422, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32315428

RESUMO

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.


Assuntos
Levantamento do Assoalho do Seio Maxilar , Tomografia Computadorizada de Feixe Cônico Espiral , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia
9.
BMC Oral Health ; 20(1): 96, 2020 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-32252728

RESUMO

BACKGROUND: The posterior regions of the jaws usually represent a significant risk for implant surgery. A non-valid assessment of the available bone height may lead to either perforation of the maxillary sinus floor or encroachment of the inferior alveolar nerve and consequently to implant failure. This study aimed to evaluate the reliability of surgeon's decision in appraising the appropriate implant length, in respect to vital anatomical structures, using panoramic radiographs. METHODS: Only implants that are inserted in relation to the maxillary sinus (MS) or the mandibular canal (MC) were enrolled (first premolars [1P], second premolars [2P], first molars [1M], and second molars [2M]). All preoperative panoramic radiographs were evaluated under standard conditions. The postoperative estimation (under/over) was determined depending on the available bone height (ABH) measured from the apical end of the implant to the floor of the MS and the roof of the MC using cone beam computed tomography (CBCT). Any complication or side effect that associated with overestimated implants insertion was recorded. RESULTS: The study sample included 73 patients (predominantly females) who had consecutively received 148 implants, of which 68 were inserted in the posterior maxilla and 80 in the posterior mandible. Underestimation was recorded in 93.2% of the measurements. The remaining bone height after implants insertion was < 2 mm in the majority of underestimated cases (73.9%); they were significantly (P < 0.01) more than sites with remaining bone ≥ 2 mm (26.1%). In the posterior mandible, overestimation was significantly higher than posterior maxilla. Five cases with transient paresthesia were reported in the mandibular overestimated implants. CONCLUSIONS: This study specified that surgeon's choice of implants length, based on panoramic radiographs, was reliable regarding the incapability to insert implants with further length in the majority of underestimated cases, the low percent of overestimated measurements, and the minor associated complications.


Assuntos
Competência Clínica , Implantes Dentários , Arcada Edêntula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Radiografia Panorâmica/métodos , Cirurgiões , Adolescente , Adulto , Idoso , Processo Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endo-Óssea/métodos , Feminino , Humanos , Masculino , Nervo Mandibular/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes
10.
Am J Otolaryngol ; 41(3): 102444, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32127210

RESUMO

PURPOSE: The non-invasive diagnosis of acute rhinosinusitis (ARS) remains an unresolved problem of modern otolaryngology. Analog diaphanoscopy of reduced transillumination (shading) could be enhanced by a digital image processing of the maxillary sinuses. By this means, the limited ergonomics of this safe and low-cost method can be overcome, and merits renewed the investigation. Here, we compared the diagnostic sensitivity and specificity of digital diaphanoscopy and computed tomography (CT) in detecting shading in the maxillary sinus. MATERIALS AND METHODS: We examined 103 adults using both digital diaphanoscopy of the maxillary sinus and native-phase cranial CT. We developed a scoring system for investigation of shading in the maxillary sinus using diaphanoscopy and compared the sensitivity and specificity with that of CT. Also, we documented a follow-up of acute rhinosinusitis. RESULTS: In diagnosing shading in the maxillary sinus, digital diaphanoscopy had a sensitivity of 86% and a specificity of 88%. Digital diaphanoscopy can be used not only in the screening of ARS but also for documentation of its course. CONCLUSION: This study supports the role of modern digital diaphanoscopy in the diagnosis of shading in the maxillary sinus, especially in patients with ARS when CT imaging is not recommended. The ergonomics of analog diaphanoscopy could be significantly improved for physicians and patients by the implementation of modern hardware and software components. Further development of the technique and the use of several discrete wavelengths will improve this method's sensitivity and specificity.


Assuntos
Técnicas de Diagnóstico Otológico , Rinite/diagnóstico por imagem , Sinusite/diagnóstico por imagem , Transiluminação/métodos , Doença Aguda , Humanos , Seio Maxilar/diagnóstico por imagem , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
11.
Niger J Clin Pract ; 23(3): 329-336, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32134031

RESUMO

Objectives: The aim of this study is to determine the type, frequency, and location of incidental findings in the maxillofacial region in patients undergoing cone beam computed tomography (CBCT) scan for implant treatment.[5]. Methods: In this study, 300 patients who underwent CBCT imaging for implant treatment planning were evaluated retrospectively. Patients were evaluated in four different categories, namely, maxillary sinus pathologies, temporomandibular joint (TMJ) findings, dentoalveolar findings, and soft-tissue calcifications. In maxillary sinus pathologies, we categorized patients by mucosal thickening, polypoidal lesion, air-liquid level, total opacification, oroantral fistula, periapical lesion related with maxillary sinus, antrolith, hypoplasia, and foreign body presence. In the TMJ findings category, we evaluated patients for erosion, osteophyte, sclerosis, flattening, and bifid condyle. For dentoalveolar findings, we looked for the residual root and impacted tooth. In soft-tissue calcifications, we examined patients for tonsillolith, sialolith, lymph node calcification, styloid ligament calcification, carotid artery calcifications, and osteoma cutis. Results: Mucosal thickening was mostly seen in maxillary sinus pathology. One hundred and forty-eight (49.3%) of the patients had at least one TMJ incidental finding. We detected at least one impacted tooth in 17 (5.7%) patients' maxilla and 14 (4.7%) patients' mandibles. The most frequently seen calcification was styloid ligament calcification. There was no statistically significant relationship between the age groups and incidental findings (P > 0.05). Conclusions: Oral radiologists should be aware of incidental findings and evaluate the possibilities of underlying diseases in a comprehensive way, and if there is a concern about the finding, they should refer the patient to the relevant specialist.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Seio Maxilar/diagnóstico por imagem , Articulação Temporomandibular/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Adulto , Feminino , Humanos , Achados Incidentais , Masculino , Maxila , Seio Maxilar/patologia , Pessoa de Meia-Idade , Fístula Bucoantral/diagnóstico por imagem , Doenças Faríngeas , Estudos Retrospectivos , Dente Impactado/patologia
12.
Gen Dent ; 68(2): e1-e4, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32105233

RESUMO

This study evaluated the relationship between the apices of maxillary posterior teeth (second premolar, first molar, and second molar) and the maxillary sinus floor (MSF) and maxillary cortical bone (MCB). Cone beam computed tomographic (CBCT) scanning was used to analyze 1660 roots from 678 teeth and determine the shortest distance between the root apex and MSF and between the root apex and buccal and palatal cortices of maxillary bone. The root apices were classified based on their relationship to the MSF: type 1, the root apex protruded into the maxillary sinus; type 2, the root apex was from 0 mm (touching the MSF) to 1 mm below the MSF; and type 3, the root apex was greater than 1 mm below the MSF. As the age of the subjects increased (older than 40 years), there was a significantly greater proximity of the teeth to the MCB (P < 0.05) and less proximity of second molars to the MSF (P = 0.005). First and second molars each presented a high prevalence of root apices that protruded into the maxillary sinus (type 1), 47.8% and 43.8%, respectively. Second premolars were more frequently classified as type 3 (71.7%) than first and second molars. The mesiobuccal root of the maxillary second molar was the root closest to the MSF, while the maxillary first molar was the tooth closest to the MCB.


Assuntos
Seio Maxilar/diagnóstico por imagem , Levantamento do Assoalho do Seio Maxilar , Tomografia Computadorizada de Feixe Cônico , Osso Cortical , Maxila/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
13.
Swiss Dent J ; 130(2): 126-138, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32024348

RESUMO

This second article about extraoral anatomy as seen in cone beam computed tomography (CBCT) images presents a literature review of the zygomatico-orbital region. The latter bounds the maxillary sinus superiorly and laterally. Since pathologic changes of the maxillary sinus are a frequent indication for three-dimensional radiography, the contiguous orbital cavity and the zygomatic bone may become visible on CBCT scans. The zygomatic bone forms the cheek prominence and has large contact areas with the maxilla through the zygomaticomaxillary suture in the infraorbital region as well as with the sphenoid bone along the lateral orbital wall. Each of the three surfaces of the zygomatic bone displays foramina that transmit neurovascular structures. The orbital cavity is located immediately above the maxillary sinus from which it is separated only by a thin bony plate simultaneously serving as the orbital floor and the roof of the maxillary sinus. Several openings, such as the superior and inferior orbital fissures, the ethmoidal and cranio-orbital foramina, and the optic and infraorbital canals, connect the orbit to the anterior and middle cranial fossae as well as to the infratemporal and pterygopalatine fossae.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Tomografia Computadorizada de Feixe Cônico Espiral , Maxila/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Zigoma
14.
J Craniofac Surg ; 31(3): e233-e236, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31895847

RESUMO

To evaluate the ability of the maxillary sinus membrane to produce bone after internal sinus lifting and implant placement without adding exogenous bone graft, and to assess the quality of bone that has been produced 6 months postoperatively.In this retrospective study, 10 subjects who underwent maxillary sinus floor lifting and met the inclusion criteria were selected and then subdivided into: Group-A underwent internal sinus elevation and placement of implants without the use of bone graft and Group-B underwent classical internal sinus lifting and placement of bovine bone particles and then placement of the implant as a control group. Radiofrequency analysis (RFA) values for measuring the Implant Stability Quotient (ISQ) of all implants were measured by Osstell device. CBCT was performed involving linear measurements of the site of sinus lifting for both groups.High RFA values demonstrating excellent biomechanical stability were observed in Group-A compared to Group-B at 6 months postoperatively. Group-A showed a median of ISQ value;78 (8), 77(12), 79(3.5) and 77(4.50). Group-A was significantly higher in ISQ values than Group-B, which showed median and interquartile range (IQR) of ISQ value of [51(12.50), 54(14.50), 55(9), and 55(7.50)]. However, the amount of bone available in group B was significantly higher than group A; [3.5 mm (0.75) and 3.8 mm (0.69)].Internal sinus lifting without bone graft has the ability of bone formation by osteogenic potential of the sinus membrane. Nevertheless, the high quality of bone being produced is of high importance for the success of an implant without the need for an exogenous bone graft. The newly formed bone was significantly of a better quality in Group-A. Thus, it is recommended to perform internal sinus lifting, without adding bone graft material and allow the osteogenic potential of the maxillary sinus membrane to produce its own osteogenic cells.


Assuntos
Implantes Dentários , Seio Maxilar/diagnóstico por imagem , Membranas/diagnóstico por imagem , Animais , Bovinos , Implantação Dentária Endo-Óssea , Humanos , Seio Maxilar/cirurgia , Osteogênese , Estudos Retrospectivos , Levantamento do Assoalho do Seio Maxilar
15.
J Endod ; 46(3): 397-403, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31983459

RESUMO

INTRODUCTION: This retrospective study aimed to assess the radiologic characteristics of the possible associations between mucosal thickening of the maxillary sinuses (MSs) and periodontal and anatomic conditions of healthy and diseased maxillary teeth. METHODS: The periapical health of the maxillary molars in cone-beam computed tomographic (CBCT) images from 50 patients (mean age = 40.60±14.59 years) was evaluated using the CBCT-periapical index. Anatomic associations between maxillary molars and the inferior wall of the MSs and periodontal bone loss and its relation to MS pathology were assessed. The possible effects of these conditions on mucosal thickening of MSs were analyzed. Kruskal-Wallis, Mann-Whitney U, chi-square, and logistic regression (for relative risk) tests were used for statistical analysis. RESULTS: CBCT-periapical index 4 was the most frequently encountered apical periodontitis (AP) lesion. The risk for pathologic changes in the MSs was significantly higher in the presence of AP (P < .001). This risk was 62.364 times greater than that in areas of MSs adjacent to healthy teeth of the same patient (95% confidence interval, 7.968-488.14). Thicker MS mucosae were detected when the molar roots with AP were closer to the MSs (P < .004). No statistically significant difference was found between periodontal status and MS pathology. CONCLUSIONS: The findings of this study showed that MSs were affected by the endodontic health of adjacent molar teeth. Dental and medical practitioners should take into consideration the possible odontogenic causes while examining pathologic changes in the MS.


Assuntos
Seio Maxilar , Dente Molar , Periodontite Periapical , Adulto , Tomografia Computadorizada de Feixe Cônico , Humanos , Seio Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Periodontite Periapical/diagnóstico por imagem , Estudos Retrospectivos
16.
J Craniofac Surg ; 31(2): 507-509, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31895863

RESUMO

Cholesterol granuloma is a foreign body reaction to the deposition of cholesterol crystals, usually found in association to chronic middle ear diseases, being highly uncommon in the paranasal sinuses. Furthermore, a huge and aggressive cholesterol granuloma involving the maxillary sinus, hard palate, buccal space, and maxillary alveolus is extremely rare and has not been reported previously. This article reports a case of huge cholesterol granuloma in the maxillary sinus confused with an expansile odontogenic keratocyst, which was treated successfully via transnasal endoscopic approach.


Assuntos
Granuloma de Corpo Estranho/cirurgia , Seio Maxilar/cirurgia , Cistos Odontogênicos/cirurgia , Doenças dos Seios Paranasais/cirurgia , Idoso de 80 Anos ou mais , Colesterol , Feminino , Granuloma de Corpo Estranho/complicações , Granuloma de Corpo Estranho/diagnóstico por imagem , Humanos , Seio Maxilar/diagnóstico por imagem , Boca , Neuroendoscopia , Cistos Odontogênicos/complicações , Cistos Odontogênicos/diagnóstico por imagem , Doenças dos Seios Paranasais/complicações , Doenças dos Seios Paranasais/diagnóstico por imagem , Alvéolo Dental
17.
J Craniofac Surg ; 31(2): 444-447, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31977703

RESUMO

In hemifacial microsomia (HFM), the aberrant mandible structure has always been the focus of attention. How the maxillary development being affected is not clear. The authors sought to comprehensively evaluate the hemifacial maxillary deficiency and to assess for Pruzansky-Kaban score correlation.This is a retrospective research of children with HFM. Demographic information were recorded, and computed tomographic scan were reconstructed and analyzed by segmentation, volumetric and cephalometric measurements. Analyses involved paired t-test, independent sample t-test and one-way analyses of variance.Demographic information revealed 67 patients diagnosed with HFM were included: 10.4 percent type I, 38.8 percent IIa, 28.4 percent type IIb, 22.4 percent type III. The maxillary total volume was found to be significantly decreased on the affected side in patients with type IIa (P = 0.0426) and IIb (P = 0.0004). No notable differences in maxillary sinus volume were found. No significant differences in maxillary width measurements were found between groups type I and III. A descending trend in maxillary bone volume ratio, an increasing trend in maxillary posterior width ratio and a decreasing trend in maxillary middle height ratio was observed from group I to IIb (pmbv* = 0.020; pmpw* = 0.002; pmmh* = 0.004).This study comprehensively characterized the hemifacial microsomia maxillary deficiency. For maxillary total volume and transverse development, the type III group presented characteristics similar to the type I group. We concluded that the severity of maxillary deficiency is not completely consistent with the mandibular deformity classification.


Assuntos
Síndrome de Goldenhar/diagnóstico por imagem , Imageamento Tridimensional , Maxila/diagnóstico por imagem , Adolescente , Cefalometria , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Micrognatismo , Estudos Retrospectivos
18.
Ann Otol Rhinol Laryngol ; 129(3): 209-215, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31631672

RESUMO

OBJECTIVES: Preoperative maxillary sinus imaging findings have been suggested to be associated with complications and outcomes of sinus lift and dental implant procedures; nonetheless the evidence is controversial. The aim of this study was to examine the association between preoperative maxillary sinus imaging findings and outcomes of sinus lift and dental implant procedures in asymptomatic patients. METHODS: We included all patients who underwent maxillary sinus lift and dental implant procedures between 2014 and 2017. Maxillary sinus imaging findings were extracted from pre-procedural dental computed tomography scans, and outcomes of the procedures were assessed. RESULTS: A total of 145 procedures were included. No sinonasal symptoms were reported preoperatively. In 46% of cases maxillary sinus imaging was abnormal. The most common imaging finding was peripheral mucosal thickening (38%). Sinus floor cyst/polyp was identified in 13% of the cases, of which 47% occupied more than 50% of the sinus volume. Partial or complete opacification of the maxillary sinus was documented in 3% of cases. The sinus ostium and ostiomeatal complex were obstructed in 7% and 1%, respectively. Mucosal perforation was documented in 22% of cases and was inversely related to mucosal thickening (P = 0.011). Other minor post-operative complications did not correlate with radiological findings. Post-surgical sinusitis was not observed in any of the patients regardless of pre-surgical imaging findings. CONCLUSIONS: Incidental maxillary sinus imaging findings such as mucosal swelling, cysts or polyps, regardless of their severity or size, and maxillary ostial obstruction may not need to be addressed prior to sinus augmentation and dental implant procedures in asymptomatic patients. Patients with complete sinus opacification should be referred to an otolaryngologist prior to surgery. Further controlled trials, in larger cohorts, are needed to corroborate our findings.


Assuntos
Implantação Dentária , Seio Maxilar/diagnóstico por imagem , Levantamento do Assoalho do Seio Maxilar , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Cistos/diagnóstico por imagem , Feminino , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/diagnóstico por imagem , Mucosa Nasal/lesões , Obstrução Nasal/diagnóstico por imagem , Pólipos Nasais/diagnóstico por imagem , Osseointegração , Doenças dos Seios Paranasais/diagnóstico por imagem , Cuidados Pré-Operatórios , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
19.
Ann Otol Rhinol Laryngol ; 129(1): 12-17, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31394908

RESUMO

OBJECTIVE: To define a new anatomic relationship in pediatric sinus surgery, assessing the maxillary roof as a constant safe landmark to avoid skull base injury in the pediatric population. STUDY DESIGN: Retrospective analysis. SETTING: Tertiary care children hospital. SUBJECTS AND METHODS: A retrospective analysis was performed of all computed tomography scans of the sinuses and facial bones at the emergency department of a tertiary children's hospital over the course of a year. Radiographic measurements included the lowest cribriform plate and planum sphenoidale (PS) heights, or posterior skull base when not yet pneumatized, as well as the highest maxillary roof height. The nasal floor was used for reference. Statistics were performed via Shapiro-Wilks test with a P-value of .05 indicating statistical significance. RESULTS: Three hundred and seven unique scans were reviewed (38.9% female; n = 122; P = .58). Age stratification was based on previously described sinus growth patterns. In all patients, the maximum maxillary height was inferior to the lowest measured cribriform lamella and PS (P < .001; CI, 98.5%-99%). Inter- and intrarater reliability and accuracy were verified through blinded review and re-review (ρ = .99 and .98 respectively, P ≤ .001). The validity of sole coronal measurements due to incomplete sagittal reformatting was also confirmed (ρ = 1.00, P ≤ .001). CONCLUSION: Despite variation in sinus growth and development in children, the current study demonstrated the validity of the maxillary sinus roof as a constant safe landmark in the pediatric population, offering a novel anatomic relationship for teaching safety in performing pediatric sinus surgery. LEVEL OF EVIDENCE: 4.


Assuntos
Pontos de Referência Anatômicos , Endoscopia/métodos , Seio Maxilar/diagnóstico por imagem , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Base do Crânio/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Seio Maxilar/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Base do Crânio/cirurgia , Tomografia Computadorizada por Raios X , Adulto Jovem
20.
Gen Dent ; 68(1): 66-71, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31859666

RESUMO

Knowledge of the anatomical relationships between the maxillary sinus (MS) and posterior teeth is important to prevent complications when endodontic or oral surgical procedures are performed. The aim of this study was to evaluate the relationships between the root apices of maxillary posterior teeth and the MS floor. Three oral radiologists evaluated 851 posterior teeth (1969 roots) imaged with cone beam computed tomography. The roots were analyzed individually in parasagittal sections, on which the most superior point of the apex was observed. A qualitative evaluation was performed, and each root was assigned a proximity score: 1, root invaginating the MS; 2, root in close contact with the MS floor; 3, root with no relationship with the MS; and 4, root with a measurable proximity to the MS. For roots classified as score 4, the distance to the MS floor was measured (quantitative analysis). Student t tests, 1-way analysis of variance, and simple linear regression analysis were performed (P < 0.05). The qualitative analysis revealed that the mesiobuccal root of the second molar had a pronounced proximity to the MS. The quantitative analysis revealed no differences in distance to the MS between right and left posterior teeth or between the different roots of the same tooth. In relation to the MS, the second molar was positioned closest, followed by the first molar, second premolar, and first premolar. Except for the comparison between mean distances of the second premolar and first molar (P = 0.11), the differences between groups of teeth were statistically significant (P < 0.05). Simple linear regression analysis showed that the more posterior the tooth was in relation to the midline, the shorter the mean distance from the root apex to the MS floor (P < 0.05). The mesiobuccal roots of second molars were closest to the MS. Second molars exhibited the shortest distances between their root apices and the MS and the greatest number of roots that were invaginating or in close contact with the MS. Therefore, second molars require special attention when endodontic or oral surgical approaches involve those regions.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Maxila , Seio Maxilar , Humanos , Processamento de Imagem Assistida por Computador , Maxila/anatomia & histologia , Seio Maxilar/anatomia & histologia , Seio Maxilar/diagnóstico por imagem , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem
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