Maxillary sinuses, multiple aspects to consider prior to bone grafting procedure: a retrospective study in a sample of a Palestinian population

Abstract

Objectives: To analyze various anatomical aspects of the maxillary sinuses on CBCT volumes, mainly, the posterior superior alveolar artery (PSAA), and to compare its visibility on CBCT vs. panoramic radiographs. Material and methods: A retrospective radiographic analysis was conducted on 120 patients (240 maxillary sinuses) using their CBCT coronal views (CCV) and panoramic radiographs (CP). On CCV, the PSAA's maximum dimension (MD), vertical distance (PVD) to the alveolar crest, and bone plate thickness (T1 and T2) buccally and inferiorly to the PSAA, respectively, were analyzed. Additionally, on CCV, the ostium vertical distance (OVD) and location were recorded, and the height of the remaining bone height inferior to the maxillary sinuses (MVD) was also measured. The PSAA's visibility was evaluated and compared between CCV and CP. All these variables were studied at the apical region of the second maxillary premolar (P2), first molar (M1), and second molar (M2). Age, gender, and face side (right vs. left) factors affecting the sinus dimensions and visibility were investigated. Several statistical tests were used to analyze these variables. Results: PSAA was detected in 96.53% of the records on CCV, where it was significantly superior to CP in the detection of the PSAA structure (p value 0.000) at all sites analyzed. The PSAA's MD, PVD, T1 and T2 thicknesses, and MVD were on average 1.19 mm, 19.54 mm, 0.69 mm, 1.36 mm, and 10.25, respectively. OVD average was 31.04 mm where 42.9% of the ostia were within the mesiodistal extent of the second upper molar. No significant relation was found between different age groups, gender, and the visibility level of PSAA. Conclusion: Age, gender, and the side of the face investigated showed no discernible effects on the maxillary sinus's bone thickness, vertical dimensions, or PSAA diameter among the studied Palestinian sample. As CCV was superior to CP in the identification of PSSA, preoperative evaluation of PSSA using CBCT volumes is thus recommended.