Radiographic assessment of maxillary sinus anatomy effects on sinus augmentation

Abstract

Objectives: The purpose of this study was to determine the effects of maxillary sinus anatomy on the amount of bone height gained after maxillary sinus augmentation both before and after implant placement. Methods: Patients (137) requiring sinus grafting (<6mm bone height) prior to implant placement were used in this study. A single image site per patient was compared from computerized tomography (CT) scans taken at 3 different time points during treatment. Scans were taken prior to sinus grafting, 6 months after sinus grafting, and 6 months after implant placement. Anatomical variables identified at the baseline CT included the presence of septa, width of the sinus, and the occurrence of soft tissue pathology. Results: There was a significant association between sinus width and the amount of graft resorption measured after implant placement (P = 0.0487, linear regression). The relationship between the presence of septa and/or soft tissue pathology to the amount of graft resorption after implant placement is also apparent (P = 0.086 and P = 0.073, respectively). The measured bone height 6 months after the sinus augmentation operation directly correlates with the amount of graft resorbed 6 months after implant placement (P = 0.000). Conclusions: Maxillary sinus anatomy appears to affect the results of bone augmentation surgery. Certain anatomical variables appear to have a stronger influence on the outcome of bone grafting. These variables include the presence of septa, bone height measured 6 months after augmentation, sinus width, and the presence of soft tissue pathology. Variables that were measured in this study that appeared to have no statistical relevance include the classification of the implant placement based on its relationship to the grafted sinus floor and the original bone height. Supported by CO*STAR training grant NIDCR T-32 DE14318.