• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.432-439
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• 2012

Purpose: The aim of this study was to investigate the blood supply to the maxillary sinus in Koreans using computed tomography of the lateral wall of the sinus, and to analyze the data according to demographic data, and to compare our results with previously published research. Methods: One hundred and three patients (males 51, females 52) who visited the dental clinic were evaluated. We investigated the canals with cone-beam computed tomography, and measured the diameter and length from the bony notch of the vascular canal at the lateral wall of the sinus to each of the reference planes. Results: Most types of vascular canal were type I & II (total 72.2%) which were driving through inside the sinus wall. Type IV, V were frequently investigated in 1st premolar and 2nd molar. Mean height; from anterior nasal spine-posterior nasal spine plane to vascular canal was 5.56 mm in 1st premolar, 2.11 mm in 2nd premolar, 0.98 mm in 1st molar, 4.32 mm in 2nd molar; from the basal layer of the sinus was 4.93 mm in 1st premolar, 5.00 mm in 2nd premolar, 6.05 mm in 1st molar, 7.91 mm in 2nd molar; and from alveolar crest, 20.80 mm in 1st premolar, 16.57 mm in 2nd premolar, 14.01 mm in 1st molar, 16.17 mm in 2nd molar. The mean height of the vascular canal of each reference plane showed no significant difference between sex, site (left or right) and age. The mean diameters of the canals were 1.76 mm in male, and 1.50 mm in female. Diameter decreased with age, and tooth site (from 1st premolar to 2nd molar). Conclusion: These results show that the mean diameter of the vascular canal of the maxillary sinus varies according to age, sex, and tooth site, but that the mean height of canal had no significant difference based on these three factors.

• 대한두경부종양학회지
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• 제10권2호
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• pp.128-136
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• 1994

Maxillary cancer is usually detected late, and the majority of patients have advanced($T_3\;or\;T_4$) diseases at the first diagnosis. It invades outside the maxillary antrum, superiorly the orbit, ethmoid sinus and the anterior cranial base, anteriorly the facial skin. If the cancer extends through the posterior antral wall, the pterygoid plates, pterygoid muscles and infratemporal fossa are to be involved that make the conventional maxillectomy impossible to remove all the involved structures in infratemporal fossa completely. So, more extensive surgical apprdoach is necessary. We report surgical experience using infratemporal fossa approach(lateral facial approach) in four cases of maxillary cancer and one case of hard palate cancer which extends through the posterior antral wall and involving pterygoid muscles, pterygoid plates and temporalis muscle.

• Imaging Science in Dentistry
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• 제33권3호
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• pp.137-141
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• 2003

Purpose: To evaluate the precision of measurements taken of dental implants in bucco-lingually sectioned views of the maxilla by linear tomograms of the panorama and to assess the visibility of the inferior wall of the maxillary sinus. Materials and Methods : Eighty sites prepared with implants of gutta percha cone in the sockets of the upper premolars and molars of 10 dry skulls were radiographically examined using linear tomograms of panorama, and scanned coronally and axially by computed tomography. The differences in mm between the measurements in bucco-lingually sectioned images of maxillary alveolar bone and the true length and width of the implanted gutta percha cones were compared as mean values (mean) and standard deviations (SD) for each radiographic technique. Linear tomography of panorama was compared with computed tomography for visualization of the relationship between the inferior wall of maxillary sinus and the end of each implant. Results: The deviations between the actual implant length and the measured values taken from the linear tomograms (0.44±0.39 mm) was significantly less than the measured values from the multiplanar reconstructed images of the axially scanned computed tomogram (1.21 ± 0.90 mm). There was statistically significant difference (p < 0.05) between two techniques in the differences between the measurements and true implant length. The relationship of the inferior border of maxillary sinus with end of implant was worse identified with the linear tomogram of panorama (68%) than the multiplanar reconstructed image of axially scanned computed tomogram (99%). Conclusion: We could not find any differences in the accuracy of length measurement between the linear tomogram of panorama and computed tomogram, but computed tomogram allowed for a better visualization of the inferior wall of the maxillary sinus than the linear tomogram.

• 대한두개안면성형외과학회지
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• 제14권2호
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• pp.111-114
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• 2013

The anterior maxillary sinus walls are the most frequently injured sites in midfacial fractures. The maxillary sinus is a difficult surgical site for reduction and fixation due to its narrow surgical field, and has a chance of developing sinusitis when sufficient treatment is not given. In this study, the methods developed by the authors for managing such are introduced. Two small openings were made on both sides of the fracture line, then a suture knot was tied instead of wiring for reduction and fixation. Then an absorbable mesh was applied on top of the fracture site, with a suture knot for additional fixation. This method was applied on an actual patient, and it was a convenient method despite the narrow surgical field that was provided. The authors believe that using suture knots to fixate fractured segments and absorbable mesh is relatively convenient and economically efficient when it comes to the reduction and fixation of the maxillary sinus wall fracture with several fragments.

• 치과방사선
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• 제11권1호
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• pp.41-50
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• 1981

Radiographic features of maxillary sinusitis, types of mucosal thickening, types of bony wall change, and relationship between the radiographic features and symptoms of patients were observed and classified in the Waters' view of 360 patients with 441 maxillary sinuses demonstrating radiologic changes. And the classification of antral floor and pathologic change was observed in the 154 periapi- cal films. Finally, the value of orthopantomography in the diagnosis of maxillary sinusitis was evaluated in the 138 cases, The obtained results were as followings. 1. Among 441 maxillary sinuses examined by Waters' projection, mucosal thickening was seen in 56.7% and generalized opacification was seen in 36.3%. 2. Among 270 mucosal thickenings classified 8 types, overall regularly thickened type was the highest in incidence (36.3%). 3. Bony wall change was seen in 35.6% of all cases and the indistinct white line of the cortical plates was the highest in incidence (78.2%) among the 6 types. 4. Pain (41.9%) and pus discharge (21.0%) were the most frequent symptoms. And pus discharge, foul odor, and headache was more prevalent in type of generalized opacification than any other types. 5. Regular pneumatization involving all roots of premolars and molars was the highest in incidence (55.0%). The first molar presented the most frequent involvement (61.0%). 6. In orthopantomography, 46.4% showed apparent increased radiopacity and 23.9% showed suspicious increased radiopacity in comparison to Waters' projection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.122-126
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• 2011

Introduction: In the lateral window approach for a maxillary sinus bone graft, there has been considerable controversy regarding the placement of a barrier membrane over the osteotomy site. In particular, when there is no damage to the Schneiderian membrane, clinicians should decide whether to use a barrier membrane or not, considering the benefits and costs. This study presents the clinical cases to demonstrate that only repositioning the detached window can lead to satisfactory bony healing of the grafted material without using a barrier membrane in the lateral approach for a maxillary sinus bone graft. Materials and Methods: Five consecutive patients were treated with the same surgical procedures. After performing the antrostomy on the lateral maxillary wall using a round carbide bur and diamond bur, the bony window was detached by a gentle levering action. After confirming no perforation of the Schneiderian membrane, the grafting procedure was carried out the detached window of the lateral maxillary wall was repositioned over the grafted material without using a barrier membrane. A gross examination was carried out at the postoperative 6 month re-entry, and the the preoperative and postoperative dental computed tomography (CT) at re-entry were compared. Results: All the procedures in the 5 patients went on to uneventful healing with no complications associated with the bone graft. Satisfactory bone regeneration without the interference of fibrous tissue on the gap between the repositioned window and lateral wall of the maxillary sinus was observed in the postoperative 6 month re-entry. The CT findings at re-entry revealed the, reconstruction of the external cortical plate including repositioned bony window. In addition, the loss of the discontinuity of the lateral maxillary wall was confirmed. Conclusion: This preliminary report showed that the detached window, which was just repositioned on the grafted material, could function as a barrier membrane in the lateral approach for a maxillary sinus bone graft. Therefore additional morphometric and histologic studies will be needed.

• Imaging Science in Dentistry
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• 제32권4호
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• pp.195-200
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• 2002

Purpose: To evaluate the computed tomographic appearances of post-operative maxillary sinuses. Materials and Methods: 33 asymptomatic cases of post-operative maxillary sinus without evidence of any pathologic changes and clinical symptoms were selected. CT images were classified as opacification, soft tissue shadow, anterior wall depression, naso-antral communication, and compartmentalization. The relationships between the CT image and the age of patients at the time of operatation, and between the CT image and the duration of time elapsed since the surgical procedure were evaluated. Results: The most commonly presented radiological characteristics that occurred after the Caldwell-Luc procedure were opacification and soft tissue shadow. Anterior wall depression and naso-antral communication were radiographic indications that a Caldwell-Luc operation had been carried out. The age of patients when they had been first operated on, and the duration between the surgical procedure and the time of evaluation had no effect on the CT appearances of normal changes. In cases involving a longer time interval between the antral surgery and evaluation, the anterior wall depression with bony healing was more commonly observed than soft tissue healing. Conclusion: The radiographic information regarding the normal healing state using computed tomography can distinguish post-operative changes from inflammatory and cystic disease in patients who have undergone a Caldwell-Luc type of radical maxillary antrostomy.

• Archives of Plastic Surgery
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• 제34권1호
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• pp.128-130
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• 2007

Purpose: Pnumosinus dilatans is a rare disease that one or more of the paranasal sinuses are dilatated without functional alteration. The most frequently involved sites are frontal and sphenoid sinus. Facial asymmetric contour is the most common signs and nasal obstruction and pain may be combined. The purpose of reconstruction of pneumosinus dilatans is two-fold, to re-establish a permanent pressure equilibrium of sinus and to correct the possible facial deformities. Methods: We present a case of a 24-year-old female with a 7-year history of protrusion of right malar region. Plane radiography and computed tomography detailed an abnormal expansion of the right maxillary sinus without thinning of bony wall, leading to diagnosis of maxillary pneumosinus dilatans. Surgical decompression and maxilloplasty were achieved by ostectomy of anterior wall of maxillary sinus and repositioning of removed bony fragment with miniplate. Results: Post operative course was uneventful without complication and malar height became symmetric by physical and radiologic examination. Conclusion: We corrected successfully pneumosinus dilatans of maxillary sinus by surgical decompression and maxilloplasty. For this case, we reviewed literature related to this topic.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권1호
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• pp.34-39
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• 2021

Objectives: The purpose of the study was to assess the occurrence, location, and dimensions of the intraosseous vascular canal in the lateral wall of the maxillary antrum using cone-beam computed tomography (CBCT). Materials and Methods: In this retrospective study, we examined 400 CBCT scans from our archive of patients who had earlier reported to a dental teaching hospital in the United Arab Emirates. The prevalence, location, and dimensions of the lateral antral intraosseous canal (LAIC) in the maxillary antrum were evaluated by 2 examiners using standardised methods. A third examiner was consulted in cases of disagreement. Results: The prevalence of LAIC was 62.3% (249 maxillary antra) among the study population. The mean distance between the most inferior point of the alveolar bone and the inferior border of the LAIC in the posterior maxillary region was 19.83±3.12 mm. There was a significant difference (P=0.05) between the maxillary molar and premolar regions in mean distance from the most inferior point of the alveolar bone and the inferior border of the LAIC. There was no statistically significant difference in mean distance between the most inferior point of the alveolar bone and the inferior border of the LAIC between dentulous and edentulous areas (P=0.1). The G3-intrasinusal type canal less than 1mm in diameter was the most common type of LAIC. Conclusion: This study established the approximate location of the LAIC in a United Arab Emirates cohort, which will assist the oral surgeon in selecting the appropriate site for sinus lift procedures with reduced risk of surgical hemorrhage.

• 치과방사선
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• 제27권1호
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• pp.283-295
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• 1997

The purpose of this study was to evaluate the Waters' views, panoramic and periapical radiograms as well as clinical symptoms in the diagnosis of maxillary sinusitis. The author analyzed the types of mucosal thickenings, the types of bony wall changes, the pathologic changes of antral floors and total amount of agreement on radiograms in 495 patients with 505 maxillary sinuses which demonstrated radiographic changes. The results were obtained as follows : 1. 125 cases (24.8％) showed the mucosal thickening of antral floor and lateral wall (Type II), 106 cases (20.9％) showed the mucosal thickening around the whole antral wall (Type N) and 75 cases (14.8％) showed increased radiopacity of whole antrum. 2. Among 505 cases of mucosal thickenings, 319 cases<63.2％) showed the bony wall changes: 114 cases (35.9％) showed the thinning of lateral walls, 105 cases (32.8％) showed the thickening of lateral walls and 47 cases(14.7％) showed indistinct antral walls. 3. Among 6 types of mucosal thickenings, the incidence of bony wall changes was high in type VI(73.3％) and in type IV(71.6％). 4. 139 cases(25.1％) showed no pathologic change of antral floor, 127 cases(22.9％) showed the indistinct antral floor and 122 cases (22.1％) showed the halo appearance of antral floor on panoramic and periapical radiograms. 5. 449 cases (88.9％) showed apparent increased radiopacity and 47 cases(9.3％) showed suspicious increased radiopacity on Waters' views. 280 cases (71.6％) showed apparent increased radiopacity and 88 cases (22.5％) showed suspicious increased radiopacity on panoramic radiograms. And 141 cases (31.6％) showed apparent increased radiopacity and 133 cases(33.4％) showed suspicious increased radiopacity on periapical radiograms.