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Odontogenic Maxillary Sinusopathies: a Radiological Classification.

Stefano Di Girolamo1, Federica Martino1, Mariapia Guerrieri1

  • 1Department of Translational Medicine, Otolaryngology, University of Rome "Tor Vergata", Via Montpellier,1, 00133 Rome, Italy.

Journal of Maxillofacial and Oral Surgery
|April 11, 2022
PubMed
Summary

A new classification system for maxillary sinus mucosal thickening helps guide dental implant surgery. This approach standardizes evaluation, aiding in timely treatment of sinus pathologies to prevent complications.

Keywords:
Dental implantESSMucosal thicknessOdontogenic sinusitisSchneiderian membrane

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Area of Science:

  • Dentistry
  • Radiology
  • Otolaryngology

Background:

  • Preoperative radiological evaluation is crucial for identifying maxillary inflammatory conditions before dental implant surgery.
  • Untreated maxillary sinus pathologies can lead to dental procedure failure and potential medical-legal issues.

Purpose of the Study:

  • To standardize reference values for maxillary sinus mucosal thickening.
  • To classify mucosal thickening based on its association with odontogenic or disventilatory causes.
  • To guide therapeutic options for sinus pathologies to reduce dental surgery complications.

Main Methods:

  • Measurement of maximum mucosal thickness at the maxillary sinus floor in 270 adult patients undergoing dental diagnostics.
  • Classification of mucosal thickness into four main classes (I, IIA, IIB, III A, III B, IV) based on millimeters and extension.
  • Correlation of mucosal thickening patterns with etiological factors (odontogenic, disventilatory, sinonasal, oroantral fistula).

Main Results:

  • Class I (<2 mm): Non-pathological.
  • Class IIA (2-5 mm, floor): Non-pathological, 'wait-and-see'.
  • Class IIB (>5 mm, floor): Pathological, odontogenic etiology, requires dental treatment.
  • Class IIIA (>5 mm, concentric): Disventilatory, requires antrostomy.
  • Class IIIB: Sinonasal manifestations, requires endoscopic sinus surgery (ESS).
  • Class IV: Oroantral fistula, requires endoscopic or oral approach.

Conclusions:

  • The proposed classification aids in selecting appropriate therapeutic strategies based on the extent and cause of mucosal thickening.
  • Implementing this classification can help minimize complication and failure rates in dental implant surgeries.
  • Accurate diagnosis and treatment of sinus pathologies are essential for successful dental procedures.