• Title/Summary/Keyword: Maxillary wall

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CLINICAL AND RADIOLOGICAL STUDY OF THE POSTOPERATIVE MAXILLARY CYST (술후성상악낭의 임상적, 방사선학적 연구)

  • Lee Geon-Ill;Park Tae-Won
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.24 no.1
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    • pp.47-55
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    • 1994
  • Post operative maxillary cyst may arise after the surgical treatment for maxillary sinusitis with the symtoms of swelling, pain, and pus discharge in the buccal region. It is examined by Waters' view, panoramic view and other intraoral radiographs, but quite variable radiologically. Most of the cyst is seen round or ovoid shape radiolucency, destruction, expansion and thinning of the lateral wall or posterior wall, and roots of the adjacent teeth may be resorbed. We studied about 117 cases of the post operative maxillary cysts which diagnosed in department of oral and maxillofacial radiology, Seoul National University Hospital. We analyzed and obtained following results. 1. These cysts occured more frequently in male than in female and the incidence is highest in the 4th and 5th decade. 2. Initial radical operation of maxillary sinus were performed mainly between the age of 10 and 45 years, and about 60% of the patients were 15 to 25 years. 3. Pain and swelling on buccal area, pus discharge, and toothache are most chief compaints, seven cases were found at routine examination without symtoms. 4. Most of these cysts were unilocular with smooth and well-defined border. 5. The majority of the cysts occurred in the anterolateral wall of maxillary sinus. 6. Dental changes of the lesional area were loss of lamina dura and root resorption, but about 55% were not changed.

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EVALUATION OF THE MAXILLARY SINUS AND ADJACENT STRUCTURES ON THE ORTHOPANTOMOGRAPH ACCORDING TO THE HEAD POSITIONS (머리의 위치변화에 따른 파노라마방사선 사진상에서의 상악동 및 인접조직의 평가)

  • Lee Jin-Kyung;Kim Jae-Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.22 no.2
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    • pp.315-327
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    • 1992
  • The purpose of this study was to evaluate the utilization of the orthopantomograph as a diagnostic aid to observe maxillary sinus and adjacent structures. For achieving this goal. the lead plates were attached to the five walls of the maxillary sinus of a human dry skull. The dry skull was placed in fourteen different positions; standard. 20mm forward. 20mm backward. 10 degree upward. 10 degree downward. 20mm lateral. forward & upward, forward & downward. forward & lateral. backward & upward. backward & downward, backward & lateral. upward & lateral. downward & lateral position. The obtained results were as follows: 1. The image of the medial wall was observed very differently according to the head positions. 2. The image of the anterior wall was observed at medial third to half of the maxillary sinus in each head position. 3. the image of the posterior wall was always observed at lateral third of the maxillary sinus in all head positions and more obviously in the downward-lateral position. 4. The image of the superior wall was observed at the inferior third to half of the orbit in each head position. 5. The image of the inferior wall was always observed at the inferior third of maxillary sinus in all head positions and observed more obviously in the standard and downward-lateral positions. 6. The images of the zygomatic process. zygomatic arch and zygomaticotemporal suture were observed very well in the downward-lateral position.

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Reduction of the Isolated Anterior Wall of the Maxillary Sinus Fracture with Double Urinary Balloon Catheters and Fibrin Glue

  • Kim, Jaehee;Yang, Ho Jik;Kim, Jong Hwan;Kim, Su Jin
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.238-242
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    • 2017
  • Background: Conservative treatment is performed for isolated anterior wall of the maxillary sinus fractures, in many cases when the fracture is clinically not severe and asymptomatic. Despite the absence of symptoms, complications such as sinusitis, rhinitis, and chronic purulent secretion may develop; therefore, successful reduction is required. We attempted to reduce the risk of complications using an alternative technique: reduction of the fracture with two urinary balloon catheters inserted through the maxillary ostium and fixation using fibrin glue, which minimizes the damage to the bony fragments and sinus mucosa. Methods: In this study, 38 patients who were diagnosed with an isolated anterior wall of the maxillary sinus fracture at our hospital between January 2014 and January 2017 were enrolled. The fracture site was exposed via the Caldwell-Luc approach followed by reduction through the insertion of two urinary balloon catheters using a nasal endoscope and fixation with fibrin glue. The sex, cause of fracture, physical examination, and presence of complications were examined and patient's medical records and facial bone computed tomography scans were analyzed. Results: Radiological evaluation showed that there was no evidence of collapsed reduction fragments. Although some patients had remaining symptoms of hypoesthesia (15%; 3 patients), there were no complications such as infection, rhinitis, sinusitis, and chronic purulent secretion at the surgical site. Conclusion: In this study, we present an alternative surgical technique using two urinary balloon catheters and fibrin glue for the successful reconstruction of an isolated anterior wall of the maxillary sinus fracture. This technique enables precise restoration with a reduced risk of complications.

A RADIOGRAPHIC STUDY OF THE PANORAMIC INNOMINATE LINE II (파노라마 X선사진상의 무명선에 관한 연구 II)

  • Choi Karp-Shik;Lee Kang-Sook
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.1
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    • pp.109-114
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    • 1995
  • The purpose of this study was to investigate the changes of the shape of the panoramic innominate line and also to examine the relation of the panoramic innominate line to maxillary posterior wall according to positional changes in panoramic radiographs of the patients who had no pathoses in the maxillary sinus and adjacent bony structures. Thus these panoramic radiographs were obtained and evaluated in standard, forward 10mm, backward 10mm, chin down 10°, and chin up 10° positions. And the following results were obtained : 1. Panoramic innominate lines were not changed in shape according to various positional changes in panoramic radiography. 2. The panoramic innominate line was observed to be more clear images and decreased distance to the posterior wall of maxillary sinus at forward 10mm and chin down 10° positions. And the panoramic innominate line was observed more blurred images and increased distance to the posterior wall of maxillary sinus at backward 10mm and chin up 10° positions.

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Implant treatment to reduce complications : Maxillary sinus elevation and bone graft (lateral wall approach) Failures and Problem solving (Complication을 줄이기 위한 임플란트 치료 상악동거상술 및 골 이식술(측벽접근법) 실패 및 문제점 해결)

  • Choi, Byung-Joon
    • The Journal of the Korean dental association
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    • v.58 no.9
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    • pp.573-582
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    • 2020
  • Today, maxillary sinus graft is considered to be the most prognostic of bone augmentation surgery as a preprosthetic treatment. Implant survival rates of more than 95% can be expected if appropriate decisions are made on the basis of implants, implant surface morphology, and use of a shield over the maxillary sinus front-wall. In addition, maxillary sinus grafty has a low rate of complications, and even if complications occur during or after maxillary sinus graft, most are localized and easily recovered.

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Sinus mucosal healing pattern according to pterygomaxillary disjunction type after Le Fort I osteotomy

  • Jang, Tae-Seok;Lee, Seung-Woo;Lee, Baek-Soo;Shim, Gyujo;Seon, Suyun;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.5
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    • pp.292-296
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    • 2022
  • Objectives: During Le Fort I osteotomy, the separation of the pterygomaxillary junction (PMJ) is a difficult procedure for most surgeons because it is invisible. In this process, damage to the posterior structures constituting the sinus or those adjacent to it, including the maxillary sinus posterior wall and pterygoid plate, may occur. We would like to investigate the effects of this on the inside of the maxillary sinus after surgery and whether there are complications. Materials and Methods: One-hundred patients who underwent Le Fort I osteotomy from 2013 to 2020 using cone-beam computed tomography images were classified into two groups (clean-cut type and fractured type) according to the PMJ cutting pattern. In addition, the mucosal thickness in the maxillary sinus was divided into preoperative, postoperative three months, one year, and the change over the course of surgery was evaluated retrospectively. Results: Of the total 100 cases, the clean-cut type numbered 28 cases and the fractured type totaled 72 cases. Among the fracture types, part of the sinus wall and the pterygoid plate were broken in 69 cases, and the maxillary sinus posterior wall was detached in three cases. There was no statistically significant difference in sinus mucosal thickening between the clean-cut type and fractured type of the PMJ, three months and one year after surgery between the two groups. However, there was a significant difference in sinus mucosal thickness at postoperative one year in the case where a partial detachment of the maxillary sinus posterior wall occurred compared to not. Conclusion: Even if there is some damage to the structures behind the PMJ, it may not be reasonable to spend some time on the PMJ separation process considering the overall postoperative complications, if there is no significant difference inside the sinus, or increased probability of postoperative complications.

Middle superior and anterior superior alveolar nerve injury following trauma to the maxillary sinus: a prospective clinico-radiographic evaluation

  • Sathish Radhakrishna;Eashwari Narayanan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.5
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    • pp.262-269
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    • 2023
  • Objectives: Anterior maxillary sinus wall fractures are common in all types of maxillofacial trauma. They can result in various complications, including injury to the surrounding nerves. Owing to its anatomy, trauma to the maxillary antrum can result in injury to the middle superior alveolar nerve (MSAN) and the anterior superior alveolar nerve (ASAN). The purpose of this study is to evaluate neurosensory deficits (NSD) present in maxillary gingiva, incisors, and premolars after injury to the anterior wall of the maxillary antrum. Materials and Methods: This prospective study was conducted among 39 patients sustaining unilateral fractures of the anterior maxillary sinus wall. Clinical neurosensory tests including two-point discrimination and fine touch discrimination were performed to classify the extent of nerve injuries as mild, moderate, severe, or anesthetic. Additional temperature discrimination and pulpal sensibility tests (electric pulp testing and cold testing) were carried out. A comparison of radiographic fracture patterns and severity of nerve injury was done. Testing was carried out immediately after trauma and at 2-month follow-up. Results: More than half of the patients assessed in the study group presented with NSD of the teeth and gingiva after trauma. The incidence of deficits varied with the type of test used to measure them. Most frequently, patients presented with both loss of two point as well as fine touch discrimination thresholds. Severe nerve injuries were associated with loss of temperature discrimination clinically and displaced fractures radiographically. There was no significant relationship between the recovery of pulpal and gingival sensation. The patterns of injury and recovery in ASAN and MSAN were similar. Conclusion: NSD after trauma to the maxillary antrum is relatively common. Clinical loss of temperature discrimination and radiographic signs of fracture lines passing through the canalis sinuosus are predictors of persistent and severe oral NSD.

Maxillary Sinus Mucocele as a Late Complication in a Patient Underwent Lefort I Procedure (Lefort I 술식 후 후기 합병증으로 발생한 상악동 점액낭종 1례)

  • Cho, Sang Hyun;Park, Beyoung Yun;Lee, Jung Kwon
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.501-503
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    • 2007
  • Purpose: The authors report unusual one case of a patient presenting with maxillary sinus mucocele who had underwent Lefort I procedure 7 years ago. Methods: Case report and literature review Results: A 25 year old man came to us with fullness, pain and nasal obstruction on his left cheek area. He had a history of multiple operations due to cleft lip and palate since birth. Two jaw surgery was performed for correcting class III malocclusion 7 years ago. Computed tomography showed haziness, and fluid filled cystic mass on left maxillary sinus. Nasoendoscopy revealed the bulging of inferior turbinate and mucosa coincided in medial wall of maxillary sinus. Antrostomy with Caldwell-Luc approach was performed. Mucin contaning brownish exudate was leaked out. Severe inflammation of maxillary inner wall and exposure of 2 screws fixed previously were noticed. The curettage and marsupialization were accomplished. The symptoms of patient were improved after that procedure. Conclusion: Maxillary sinus mucocele is related with Lefort I procedure and it may occur even long after that procedure.

Computed tomographic analysis of maxillary sinus anatomy relevant to sinus lift procedures in edentulous ridges in Taiwanese patients

  • Yu, Shun-Jen;Lee, Yi-Hao;Lin, Ching-Ping;Wu, Aaron Yu-Jen
    • Journal of Periodontal and Implant Science
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    • v.49 no.4
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    • pp.237-247
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    • 2019
  • Purpose: To analyze the maxillary sinus anatomy over edentulous ridges in the bilateral posterior maxillary area in Taiwanese patients using cone-beam computed tomography (CBCT). Methods: In total, 101 anatomical sites from 61 patients, including 32 premolar and 69 molar regions, were analyzed using CBCT. Measurements were made of the width and height of edentulous ridges, the thickness of the lateral wall of the maxillary sinus, and the presence of a sinus septum and the posterior superior alveolar artery (PSAA). A statistical analysis of the measurements was performed, and correlations among the measurements were assessed. Results: The average ridge width was $10.26{\pm}3.16mm$, with a significantly greater ridge width in the second molar region than in the premolar region. The mean residual ridge height was $8.55{\pm}4.09mm$, and ridge height showed an opposite trend from ridge width for the premolar and molar regions. A sinus septum was present at 5.9% of the sites, and the PSAA was observed in 24.5%. The average thickness of the lateral wall of the maxillary sinus was $2.08{\pm}0.94mm$, with no significant difference between the tooth position and lateral wall thickness. Conclusions: This study presents the anatomical features of the maxillary sinus, which should be considered in sinus lift procedures for implant placement, in the Taiwanese population. The use of CBCT is recommended to avoid intraoperative complications.

A RADIOGRAPHIC STUDY ON THE MORPHOLOGY OF MAXILLARY SINUS IN ADOLESCENTS AND ADULTS. (정상인 상악동의 형태에 관한 방사선학적 연구)

  • Ko Kwang Joon;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.14 no.1
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    • pp.17-26
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    • 1984
  • The purpose of this study was radiographic analysis of the morphology of maxillary sinus in adolescents and adults. In order to analize the morphology of maxillary sinus in view point of anteroposterior width of medial wall, vertical distance between antral floor and nasal floor level, anterior extension, distance between antral floor and maxillary 1st molar apex, and types of lower border of maxillary sinus, specialized maxillary projection and periapical view with paralleling technique was taken. The author examined orthopantomograms and intraoral standard views taken from 400 adolescents and adults ranged 15-65 year-old. The obtained results were as follows: 1. The antero-posterior width of medial wall of maxillary sinus was 32.80mm in 15-19 year-old group, 33.86㎜ in 20-24 year-old group, 34.09㎜ in 25-29 year-old group, and 33.67㎜ in 30-65 year-old group, and the left maxillary sinus was somewhat smaller than the right. 2. The vertical distance between antral floor and nasal floor level was 8.49㎜ in 15-19 year-old group, 9.05㎜ in 20-24 year-old group, 8.95㎜ in 25-29 year-old group, and 8.32㎜ in 30-65 year-old group. 3. The order of anterior extension of maxillary sinus were distal half of canine, mesial half of canine, mesial half of 1st premolar, and distal half of 1st premolar. 4. The distance between antral floor and maxillary 1st molar were 4.36㎜ in 15-19 year-old group, 4.77㎜ in 20-24 year-old group, 3.58㎜ in 25-29 year-old group, and 2.33㎜ in 30-65 year-old group. 5. The order of the types of lower border of maxillary sinus were entire downward type, close type, partially downward type, waving type, separating type, and indistinct. In the types of antral floor, there was a tendency to increase the seperating type with age.

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