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Related Experiment Video

Updated: May 28, 2026

Systematic Assessment of Mammalian Skull Specimens for Dental and Temporomandibular Joint Pathology
07:26

Systematic Assessment of Mammalian Skull Specimens for Dental and Temporomandibular Joint Pathology

Published on: August 22, 2022

The Big Nose Pattern at the Second Upper Molar-A Retrospective CBCT Study.

Carol Antonio Dandoczi1, Mugurel Constantin Rusu1, Răzvan Costin Tudose1,2

  • 1Division of Anatomy, Department 1, Faculty of Dentistry, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Dentistry Journal
|May 26, 2026
PubMed
Summary

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The prevalence of the "Big Nose" pattern significantly decreases from the second premolar to the second molar (M2) region. This confirms an anteroposterior gradient, making standard sinus augmentation predictable at M2.

Area of Science:

  • Anatomy and Morphology
  • Dental Implantology
  • Radiology

Background:

  • Anteroposterior gradient of nasal fossa pneumatization documented at the second premolar level.
  • Pneumatization patterns above the maxillary alveolar base at the second upper molar (M2) remain uncharacterized.
  • M2 is a primary site for posterior implant rehabilitation.

Purpose of the Study:

  • Quantify the pneumatization gradient at M2.
  • Classify pneumatization patterns (Type 1: pure antral; Type 2: antral with palatine recess; Type 3: Big Nose pattern).
  • Assess bilateral symmetry, sex distribution, and compare with second premolar data.

Main Methods:

  • Retrospective study of 165 cone-beam computed tomography (CBCT) scans (330 sides) from a Romanian population.
Keywords:
Big Nose patterncone-beam computed tomographymaxillary sinusnasal fossapneumatisationposterior maxillasinus floor elevation

Related Experiment Videos

Last Updated: May 28, 2026

Systematic Assessment of Mammalian Skull Specimens for Dental and Temporomandibular Joint Pathology
07:26

Systematic Assessment of Mammalian Skull Specimens for Dental and Temporomandibular Joint Pathology

Published on: August 22, 2022

  • Classification of pneumatization patterns into Type 1, Type 2, and Type 3.
  • Bilateral symmetry assessed using Cohen's kappa; sex differences analyzed using Fisher's exact test.

    • Main Results:

    • Type 1 pattern observed in 93.3% of sides, Type 2 in 4.2%, and Type 3 in 2.4%.
    • High bilateral symmetry (98.8%, kappa = 0.904), with Type 3 patterns occurring bilaterally.
    • The 'Big Nose' pattern was 6.8-fold less prevalent at M2 compared to the second premolar level.

    Conclusions:

    • A significant anteroposterior gradient in nasal fossa pneumatization exists over the maxillary alveolar base.
    • Maxillary sinus dominates exclusively in 97.6% of M2 sides, enabling predictable standard sinus floor elevation.
    • Invariable bilaterality of the 'Big Nose' pattern at M2 supports symmetrical surgical planning.