Comprehensive sinus contour classification and its characteristics from radiographic examination: a cross-sectional...

Area of Science:

• Dentistry
• Oral and Maxillofacial Surgery
• Radiology

Background:

• Maxillary sinus (MS) anatomy presents significant variations impacting surgical procedures like sinus floor elevation (SFE).
• Accurate presurgical evaluation is crucial for successful SFE outcomes.
• Existing classification systems may not fully capture the anatomical diversity of the MS.

Purpose of the Study:

• To propose a comprehensive maxillary sinus (MS) contour classification system.
• To evaluate anatomical characteristics using cone beam computed tomography (CBCT).
• To investigate the relationship between MS contours and sinus floor elevation (SFE).

Main Methods:

• Analysis of 283 CBCT scans from patients undergoing SFE.
• Classification of MS contours based on buccal-palatal (Type A-E) and mesial-distal (Type 1-4) evaluations.
• Measurement of key anatomical parameters: residual bone height (RBH), sinus width (SW), maxillary sinus angle (MSA), buccal dip angle (BDA), palatonasal recess (PNR), and sinus depth.

Main Results:

• Eleven distinct MS contour groups were identified.
• Statistically significant differences in RBH, MSA, BDA, and SW were observed across groups.
• The narrow-taper and slope MS (A2) group showed the highest RBH, while the square and concave sinus (D3) group had the lowest.
• Strong positive correlation between SW and MSA (r=0.67); strong negative correlation between SW and BDA (r=-0.65).
• Palatonasal recess (PNR) prevalence was 38%, frequently seen in the ovoid and slope MS (C2) group.

Conclusions:

• Significant anatomical variations in the maxillary sinus (MS) exist, necessitating a robust classification system.
• The proposed MS contour classification system aids surgeons in presurgical evaluation.
• This system facilitates a more precise understanding of MS anatomy for improved SFE planning.