RESUMEN
This retrospective study aimed to analyze volumetric changes of the maxillary sinus after modified endoscopic-assisted sinus surgery (MESS) and to assess short-term treatment outcomes. The volumes of the total maxillary sinus, aeration, and sinus pathology were calculated using computed tomography data obtained prior to surgery and six months after surgery. Postoperative radiological improvement was assessed using the Lund-Mackay score. Bone regeneration around the bony window was evaluated during plate removal. A total of 32 patients were evaluated. Compared with before surgery, air and sinus pathology volumes improved significantly (air, increase by 6.0 cm3, p < 0.001; sinus pathology, decrease by 6.4 cm3, p < 0.001). However, there was no statistically significant change in the total maxillary sinus volume after surgery. The preoperative Lund-Mackay score was 2.9, decreasing to 0.4 six months after surgery (p < 0.001). The only predictors of postoperative aeration rate and Lund-Mackay score were preoperative sinus pathology volume (p = 0.049) and Lund-Mackay score (p = 0.015), respectively. The continuity between the bony window and surrounding sinus wall was restored in all patients. The results of this study suggest that MESS can be a successful, effective, and minimally invasive surgical treatment option for treating maxillary sinus diseases.
Asunto(s)
Endoscopía , Seno Maxilar , Humanos , Femenino , Masculino , Seno Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Persona de Mediana Edad , Endoscopía/métodos , Resultado del Tratamiento , Estudios Retrospectivos , Adulto , Anciano , Enfermedades de los Senos Paranasales/cirugía , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Imagenología TridimensionalRESUMEN
The authors present a case of maxillary sinus actinomycosis in a young adult woman.This is a rare condition whose unspecific clinical presentation makes its diagnosis challenging. In this case, the diagnosis was given by the identification of Actinomyces colonies in samples of infected tissue.Treatment consisted of a combined medical and surgical approach. Endoscopic sinus surgery was performed to remove diseased mucosa and to aerate the involved sinuses, followed by long-term antibiotic therapy. No recurrence of the disease was observed during follow-up.
Asunto(s)
Actinomicosis , Antibacterianos , Seno Maxilar , Humanos , Femenino , Actinomicosis/diagnóstico , Actinomicosis/tratamiento farmacológico , Actinomicosis/cirugía , Antibacterianos/uso terapéutico , Seno Maxilar/microbiología , Seno Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Actinomyces/aislamiento & purificación , Adulto , Endoscopía , Diagnóstico Diferencial , Tomografía Computarizada por Rayos X , Sinusitis Maxilar/diagnóstico , Sinusitis Maxilar/microbiología , Sinusitis Maxilar/cirugíaRESUMEN
BACKGROUND: Cholesterol granuloma is not a common entity in the paranasal sinuses. It is a foreign body reaction to the cholesterol crystal deposition. Mostly associated with chronic middle ear diseases. CASE PRESENTATION: This article reports a case of cholesterol granuloma in the maxillary sinus. A 23-year-old Asian man presented with cough, nasal obstruction, and postnasal discharge. On endoscopy, there was a mass protruding from the right maxillary ostium. On computed tomograpy imaging, there was a polypoidal mass in the right maxillary sinus. Endoscopic sinus surgery was performed, the cholesterol granuloma was removed from the right maxillary sinus, and the tissue was submitted for histopathological examination, which showed foreign body giant cell reaction to cholesterol crystals. CONCLUSION: Cholesterol granuloma of maxillary sinus is not common and often missed by clinicians. It is necessary to consider the cholesterol granuloma of maxillary sinus in the differential diagnosis sinonasal lesions. Histopathological analysis is required for confirmation and should be removed surgically. This case may help as a reference for clinician to approach these kinds of cases.
Asunto(s)
Colesterol , Granuloma de Cuerpo Extraño , Seno Maxilar , Enfermedades de los Senos Paranasales , Tomografía Computarizada por Rayos X , Humanos , Masculino , Seno Maxilar/patología , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Granuloma de Cuerpo Extraño/cirugía , Granuloma de Cuerpo Extraño/diagnóstico , Granuloma de Cuerpo Extraño/patología , Granuloma de Cuerpo Extraño/diagnóstico por imagen , Adulto Joven , Enfermedades de los Senos Paranasales/cirugía , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Enfermedades de los Senos Paranasales/patología , Enfermedades de los Senos Paranasales/diagnóstico , Endoscopía , Diagnóstico Diferencial , Obstrucción Nasal/etiología , Obstrucción Nasal/cirugíaRESUMEN
BACKGROUND: The posterior maxilla presents challenges for implant insertion because of the poor bone quality as well as the loss of vertical bone height. Indirect transcrestal sinus lift techniques are advised when a few millimeters of additional height are needed. This study aimed to evaluate the clinical and radiographic outcomes of antral membrane balloon technique versus Densah burs for transcrestal maxillary sinus lifting with simultaneous implant placement. MATERIALS AND METHODS: This randomized clinical trial was conducted on 22 patients received 32 dental implants for replacement of missed maxillary posterior teeth after crestal maxillary sinus lifting. The patients were randomly divided into two groups. Group 1, patients underwent crestal sinus floor elevation with simultaneous implant placement using antral membrane balloon technique. Group 2, patients underwent crestal sinus floor elevation with simultaneous implant placement using Densah burs. Patients were evaluated clinically and radiographically using cone beam computed tomography (CBCT) at regular time intervals immediately, 6 months and 12 months after surgery. All clinical and radiographic parameters were statistically analyzed. RESULTS: All dental implants were successful for 12 months of follow up. Regarding implant primary stability, there was a statistical significant difference between the study groups in favor of Densah group (P = 0.004), while there was no significant difference after 6 months (P = 0.07). Radiographically, balloon group showed a statistically significant immediate postoperative vertical bone height (P < 0.0001), and significant reduction in vertical bone height after 6 months (P < 0.0001). Densah group showed significant increase in bone density (P ≤ 0.05). CONCLUSION: Both techniques demonstrated successful clinical and radiographic outcomes for crestal sinus lift. The antral membrane balloon group demonstrated better immediate postoperative vertical bone gain, while Densah burs had higher implant primary stability and bone density. TRIAL REGISTRATION: This study was registered in Clinical-Trials.gov PRS ( https://register. CLINICALTRIALS: gov ) under identification number NCT05922592 on 28/06/2023.
Asunto(s)
Tomografía Computarizada de Haz Cónico , Elevación del Piso del Seno Maxilar , Humanos , Elevación del Piso del Seno Maxilar/métodos , Masculino , Femenino , Persona de Mediana Edad , Implantación Dental Endoósea/métodos , Adulto , Resultado del Tratamiento , Seno Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Implantes Dentales , Maxilar/cirugía , Maxilar/diagnóstico por imagen , Estudios de SeguimientoRESUMEN
OBJECTIVE: Sinus membrane perforation is a common complication of sinus lift surgery. This review aimed to examine if anatomical factors such as the presence of septa and lateral wall thickness influence the risk of membrane perforation. METHODS: This study was registered on PROSPERO (CRD42023488259). PubMed, Embase, and Web of Science were searched for relevant studies published up to 26th June 2024. The outcome of interest was the risk of perforation based on presence of septa and lateral wall thickness. Random-effects meta-analysis was conducted with dichotomous data to obtain the odds ratio (OR) of perforation using Review Manager. RESULTS: Ten studies with 1865 patients undergoing 2168 "lateral" sinus lift procedures were included. The total incidence of Schneiderian membrane perforations was 19% (405 cases). Schneiderian membrane perforation was present in 169/425 cases (39.76%) with sinus septa and 184/1492 cases (12.33%) without septa. Meta-analysis showed that septa were significantly associated with an increased risk of perforation (OR: 4.03 95% CI: 1.77, 9.19) with high heterogeneity (I2 = 87%). The certainty of the evidence was very low. Data on lateral wall thickness and risk of perforation was too heterogeneous for a meta-analysis. Studies reported mixed results on the risk of perforation based on lateral wall thickness. CONCLUSIONS: Our results show, with very low-quality evidence, that the presence of septa significantly increases the risk of perforations during maxillary sinus lift surgery. Evidence on the association between lateral wall thickness and a risk of perforations during sinus lift surgery is conflicting, and no clear conclusions can be derived at this stage.
Asunto(s)
Seno Maxilar , Humanos , Seno Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Elevación del Piso del Seno Maxilar/efectos adversos , Factores de Riesgo , Mucosa Nasal/lesionesRESUMEN
OBJECTIVE: The aim of this study was to propose a comprehensive maxillary sinus (MS) contour classification system based on the evaluation of anatomical characteristics from cone beam computed tomography (CBCT) examination and investigate the relationship between sinus contours and sinus floor elevation (SFE). METHODS: A total of 283 CBCT scans from patients who had single tooth loss in the posterior maxilla and underwent SFE were analyzed. The MS was classified at each tooth position. For buccal-palatal evaluation, the classification from Type A to E was narrow-taper, taper, ovoid, square, and irregular, respectively. For mesial-distal evaluation, the classification from Type 1 to 4 was flat, slope, concave, and septa, respectively. The major anatomical parameters evaluated were (1) residual bone height (RBH), (2) sinus width (SW), (3) maxillary sinus angle (MSA), (4) buccal dip angle (BDA), (5) palatonasal recess (PNR), and (6) sinus depth. RESULTS: Eleven groups of MS contour were classified after detailed calculation. Differences in the RBH, MSA, BDA, and SW among different groups were statistically significant. The narrow-taper and slope MS (A2) group had the highest RBH (8.66 ± 0.77 mm), largest BDA (79.9° ± 3.18°), smallest MSA (19.8° ± 2.01°), and narrowest SW (6.30 ± 1.23 mm). The lowest RBH was in the square and concave sinus (D3) group (5.11 ± 2.70 mm). The ovoid and concave sinus (C3) group had the smallest BDA (50.64 ± 8.73 mm) and largest MSA (74.11° ± 11.52°). The square and flat MS (D1) group had the widest SW (19.13 ± 3.69 mm). A strongly significant positive correlation was observed between the SW and MSA (r = 0.67) and a strongly negative correlation between the SW and BDA (r = - 0.65). The prevalence of PNR (mean angle: 104.06° ± 16.83°, mean height: 14.72 ± 11.78 mm) was 38% and frequently observed in the ovoid and slope MS (C2) group. CONCLUSION: Despite certain characteristics at different tooth sites, the same tooth position was categorized differently using different classification systems, indicating large anatomical variations in the MS. The classification system proposed herein allows for classification based on general characteristics at a single tooth site, aiming to help surgeons in improving presurgical evaluation.
Asunto(s)
Tomografía Computarizada de Haz Cónico , Seno Maxilar , Humanos , Estudios Transversales , Tomografía Computarizada de Haz Cónico/métodos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/anatomía & histología , Femenino , Masculino , Persona de Mediana Edad , Adulto , Anciano , Elevación del Piso del Seno Maxilar/métodos , Maxilar/diagnóstico por imagen , Maxilar/anatomía & histologíaRESUMEN
BACKGROUND: The anatomical proximity between the root apex of the maxillary posterior teeth and the maxillary sinus can lead to complications, including odontogenic maxillary sinusitis. While several studies have investigated similar variables in different populations, there is limited research on the Indonesian population. This study aimed to describe the anatomical position of the maxillary posterior teeth in relation to the floor of the maxillary sinus using CT scans. METHODS: A total of 122 patients (432 maxillary premolars and 1,282 maxillary molars) underwent CT scans to evaluate 1,711 roots. The vertical relationship between the root apex of the maxillary posterior teeth and the maxillary sinus was classified into three types: IS (inside sinus), CO (sinus contact), and OS (outside sinus). RESULTS: The IS type was predominantly found in the palatal roots of the first molars, accounting for 20% of the total roots in this type. The CO type was most frequently observed in the mesiobuccal roots of the second molars, representing 18% of the total roots in this type. The OS type was most commonly found in the first premolar, comprising 20% of the total roots in this type. CONCLUSIONS: The palatal roots of the first molars exhibited the highest frequency of proximity to the maxillary sinus. CT scans can effectively assess the relationship between the root apex of the posterior teeth and the maxillary sinus. CLINICAL RELEVANCE: Clinicians should consider this information comprehensively when planning treatments for maxillary molars.
Asunto(s)
Diente Premolar , Seno Maxilar , Diente Molar , Tomografía Computarizada por Rayos X , Humanos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/anatomía & histología , Femenino , Masculino , Indonesia , Diente Molar/anatomía & histología , Diente Molar/diagnóstico por imagen , Adulto , Persona de Mediana Edad , Diente Premolar/diagnóstico por imagen , Diente Premolar/anatomía & histología , Maxilar/diagnóstico por imagen , Maxilar/anatomía & histología , Anciano , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/anatomía & histología , Adulto JovenRESUMEN
The structural features of the paranasal sinuses play a key role in the development of pathological processes within them. The aim of our study was to examine the variations in the anatomical structure of the maxillary sinus based on Multispiral Computed Tomography (MSCT) data. MATERIAL AND METHODS: The study involved 400 individuals aged 18 to 44 years, both male and female. During the study, attention was given to the following topographical and structural indicators: linear dimensions of the maxillary sinus2. The position relative to the nasal cavity, which is also important for reconstructive surgeries and cosmetic procedures. For planning surgical interventions in plastic surgery, the location and prevalence in height of the sinuses were also parameters studied in this work; pneumatization features, which deserve special attention from both researchers and practicing physicians; the average volume, wall thickness, and density, measured as key structural indicators of the sinus. Additionally, these data can indirectly indicate potential risks of complications; the study also determined the dependence of the calculated indicators on gender and age. RESULTS AND DISCUSSION: The maximum average sinus volume was found in men aged 60-74 years and women aged 18-44 years. This measure was 19.05±2.33 x10â»6m³ and 19.3±2.9 x10â»6m³, respectively. The minimum average volume was observed in men aged 45-59 years, where it was 13.02±2.3 x10â»6m³. In the corresponding age group of women, the minimum average volume was slightly higher, at 11.9±2.1 x10â»6m³. In other groups studied, the average volume values were intermediate between the maximum and minimum values. CONCLUSIONS: The results of this study provide insights into the variations in the structure of the human maxillary sinus based on MSCT data. The average sinus volume indicators were calculated, with a maximum of 19.05±2.33 x10â»6m³ and a minimum of 11.9±2.1 x10â»6m³. Additionally, the study identified features of the topographical location of the maxillary sinuses in relation to the external nose.
Asunto(s)
Seno Maxilar , Humanos , Masculino , Femenino , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/anatomía & histología , Adulto , Adolescente , Adulto Joven , Persona de Mediana Edad , Anciano , Cavidad Nasal/diagnóstico por imagen , Cavidad Nasal/anatomía & histología , Tomografía Computarizada MultidetectorRESUMEN
OBJECTIVE: To evaluate the histomorphometric and computerized microtomographic (Micro-CT) analysis of the regenerated bone tissue from maxillary sinus augmentation surgery, with and without using the collagen membrane on the external osteotomy window. MATERIALS AND METHODS: Twelve patients were selected for this prospective, controlled, and randomized study. The patients were submitted to bilateral maxillary sinus surgery in a split-mouth design. On the test side, the maxillary sinus augmentation procedure included using Geistlich Bio-Oss® and a Geistlich Bio-Gide® collagen membrane covering the lateral osteotomy window. On the control side, only Geistlich Bio-Oss® was used without the presence of the membrane. After 6 months, the surgeries for implant installation were performed. In this surgical phase, specimens of the regenerated tissue were collected for histological and Micro-CT analysis. RESULTS: In the histomorphometric evaluation, the mean (±SD) percentages of newly formed bone were 43.9% (±11.5) and 40.8% (±8.9) in the test and control groups, respectively. The corresponding values of the Micro-CT analysis were 36.6% (±3.4) and 37.2% (±4.7) in the test and control groups, respectively. There was no statistically significant difference between the test and control groups in the two methods. In addition, there was no statistically significant difference between the mean percentage of biomaterial remaining between the test and control groups. However, the mean percentage of newly formed bone was significantly higher and the mean percentage of remaining biomaterial was significantly lower in the histomorphometric analysis compared to the values obtained through microtomography. CONCLUSION: The additional use of collagen membranes in maxillary sinus surgery does not offer advantages in newly formed bone.
Asunto(s)
Regeneración Ósea , Colágeno , Elevación del Piso del Seno Maxilar , Microtomografía por Rayos X , Humanos , Elevación del Piso del Seno Maxilar/métodos , Masculino , Femenino , Estudios Prospectivos , Persona de Mediana Edad , Minerales , Membranas Artificiales , Sustitutos de Huesos/uso terapéutico , Adulto , Seno Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/patología , Implantación Dental Endoósea/métodosRESUMEN
Functional endoscopic sinus surgery consistently benefits from good anatomical knowledge and modern imaging techniques. Ethmoid air cells migrate in specific topographical sites near the ethmoid. Posterior ethmoid air cells that descend into the maxillary sinus (MS) are ethmomaxillary sinuses (EMSs) that into the superior nasal meatus. Few previous studies found EMSs in 0.68% to 16.48% of cases. An EMS differs from a Haller's infraorbital cell nearing the ethmoidal infundibulum. A posterior ethmoid air cell intercalated between the ethmoid, MS and sphenoidal sinus is a Sieur's cell, but it could also be regarded as an EMS. An EMS should be discriminated from a maxillary recess of the sphenoidal sinus. An EMS could determine Onodi's maxillary bulla into the MS. The false duplicate MS described by Zuckerkandl consists of a MS draining into the middle nasal meatus adjoined by an EMS draining into the superior nasal meatus. These are separated by the ethmomaxillary septum. The latter may be confused with an intrasinus septum of the MS if the drainage pathways are not adequately documented. Therefore, a case-by-case anatomic identification of the pneumatic spaces nearing the MS should be performed before surgical endoscopic approaches of the nose and sinuses.
Asunto(s)
Endoscopía , Senos Etmoidales , Seno Maxilar , Humanos , Seno Maxilar/anatomía & histología , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Senos Etmoidales/diagnóstico por imagen , Senos Etmoidales/cirugía , Senos Etmoidales/anatomía & histología , Endoscopía/métodos , Tomografía Computarizada por Rayos X , Masculino , FemeninoRESUMEN
OBJECTIVES: To assess the performance of deep learning (DL) in the detection, classification, and segmentation of maxillary sinus diseases. METHODS: An electronic search was conducted by two reviewers on databases including PubMed, Scopus, Cochrane, and IEEE. All English papers published no later than February 7, 2024, were evaluated. Studies related to DL for diagnosing maxillary sinus diseases were also searched in journals manually. RESULTS: Fourteen of 1167 studies were eligible according to the inclusion criteria. All studies trained DL models based on radiographic images. Six studies applied to detection tasks, one focused on classification, two segmented lesions, and five studies made a combination of two types of DL models. The accuracy of the DL algorithms ranged from 75.7% to 99.7%, and the area under curves (AUC) varied between 0.7 and 0.997. CONCLUSION: DL can accurately deal with the tasks of diagnosing maxillary sinus diseases. Students, residents, and dentists could be assisted by DL algorithms to diagnose and make rational decisions on implant treatment related to maxillary sinuses.
Asunto(s)
Aprendizaje Profundo , Seno Maxilar , Enfermedades de los Senos Paranasales , Humanos , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Seno Maxilar/diagnóstico por imagen , AlgoritmosRESUMEN
OBJECTIVE: The study aimed to investigate the sinus membrane thickness (SMT) adjacent to healthy endodontically-treated maxillary molars with or without protruded apical foramen into the sinus cavity using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Images of 207 non-smoker patients aged 18-40 were retrospectively analyzed, 140 were endodontically treated, and 136 were without endodontic treatment. Patients with any sinus pathology, teeth that have symptoms, or poor root filling were excluded. Study groups consisted of Group EM-I (endodontically treated and protruded apical foramen), Group EM-C (endodontically treated and contacted apical foramen), and similarly without endodontic treatment; Group M-I and Group M-C. SMT upon the mesial, distal, and palatal roots was measured. One-way ANOVA and Student's t-tests were performed. RESULTS: Group EM-I had the thickest sinus membrane compared to other groups (p = 0.013). SMT values were 2.37-2.60 mm in Group EM-I, and 1.34-1.58 mm in other groups. Thickening (> 2 mm) percentages were 33.45% in Group EM-I and between 4.25 and 8.25% in other groups. No statistical difference was detected between first and second molars and genders (p > 0.05). CONCLUSION: When the apical foramen protruded into the sinus cavity, the conventional root canal treatment caused a minimal (between 2.37 mm and 2.60 mm) sinus membrane thickening with a rate of 33.45% based upon CBCT examinations.
Asunto(s)
Tomografía Computarizada de Haz Cónico , Seno Maxilar , Diente Molar , Humanos , Masculino , Femenino , Diente Molar/diagnóstico por imagen , Estudios Retrospectivos , Adulto , Adolescente , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/anatomía & histología , Diente no Vital/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Tratamiento del Conducto RadicularRESUMEN
During the early growth phase, every individual is involved in a prolonged series of developmental processes in the maxillofacial region. Formation of cysts associated with such three-dimensional growth of the maxillofacial skeleton as well as deciduous and permanent tooth development. The origin of cystic jaw lesions may be odontogenic or non-odontogenic, developmental, or inflammatory and they are epithelial-lined or non-epithelial-lined cysts in nature. These cysts are considered to be aggressive cysts when they tend to grow rapidly and can cause significant damage to the surrounding bone and tissues if left untreated. Aggressive cystic lesion of the jaw needs special attention in order to prevent recurrences or even worsen and widespread disease. The management of the maxillary sinus requires individualisation based on its clinical and histopathological characteristics. Here, we report a case of an aggressive odontogenic cyst in a 30s-aged female patient in the left maxillary sinus with the literature review.
Asunto(s)
Seno Maxilar , Quistes Odontogénicos , Humanos , Quistes Odontogénicos/cirugía , Quistes Odontogénicos/diagnóstico por imagen , Femenino , Seno Maxilar/patología , Seno Maxilar/diagnóstico por imagen , Adulto , Enfermedades Maxilares/cirugía , Enfermedades Maxilares/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Radiografía PanorámicaRESUMEN
Objective:To build a VGG-based computer-aided diagnostic model for chronic sinusitis and evaluate its efficacy. Methods:â A total of 5 000 frames of diagnosed sinus CT images were collected. The normal group consisted of 1 000 framesï¼250 frames each of maxillary sinus, frontal sinus, septal sinus, and pterygoid sinusï¼, while the abnormal group consisted of 4 000 framesï¼1 000 frames each of maxillary sinusitis, frontal sinusitis, septal sinusitis, and pterygoid sinusitisï¼. â¡The models were trained and simulated to obtain five classification models for the normal group, the pteroid sinusitis group, the frontal sinusitis group, the septal sinusitis group and the maxillary sinusitis group, respectively. The classification efficacy of the models was evaluated objectively in six dimensions: accuracy, precision, sensitivity, specificity, interpretation time and area under the ROC curveï¼AUCï¼. â¢Two hundred randomly selected images were read by the model with three groups of physiciansï¼low, middle and high seniorityï¼ to constitute a comparative experiment. The efficacy of the model was objectively evaluated using the aforementioned evaluation indexes in conjunction with clinical analysis. Results:â Simulation experiment: The overall recognition accuracy of the model is 83.94%, with a precision of 89.52%, sensitivity of 83.94%, specificity of 95.99%, and the average interpretation time of each frame is 0.2 s. The AUC for sphenoid sinusitis was 0.865ï¼95%CI 0.849-0.881ï¼, for frontal sinusitis was 0.924ï¼0.991-0.936ï¼, for ethmoidoid sinusitis was 0.895ï¼0.880-0.909ï¼, and for maxillary sinusitis was 0.974ï¼0.967-0.982ï¼. â¡Comparison experiment: In terms of recognition accuracy, the model was 84.52%, while the low-seniority physicians group was 78.50%, the middle-seniority physicians group was 80.50%, and the seniority physicians group was 83.50%; In terms of recognition accuracy, the model was 85.67%, the low seniority physicians group was 79.72%, the middle seniority physicians group was 82.67%, and the high seniority physicians group was 83.66%. In terms of recognition sensitivity, the model was 84.52%, the low seniority group was 78.50%, the middle seniority group was 80.50%, and the high seniority group was 83.50%. In terms of recognition specificity, the model was 96.58%, the low-seniority physicians group was 94.63%, the middle-seniority physicians group was 95.13%, and the seniority physicians group was 95.88%. In terms of time consumption, the average image per frame of the model is 0.20 s, the average image per frame of the low-seniority physicians group is 2.35 s, the average image per frame of the middle-seniority physicians group is 1.98 s, and the average image per frame of the senior physicians group is 2.19 s. Conclusion:This study demonstrates the potential of a deep learning-based artificial intelligence diagnostic model for chronic sinusitis to classify and diagnose chronic sinusitis; the deep learning-based artificial intelligence diagnosis model for chronic sinusitis has good classification performance and high diagnostic efficacy.
Asunto(s)
Sinusitis , Tomografía Computarizada por Rayos X , Humanos , Enfermedad Crónica , Tomografía Computarizada por Rayos X/métodos , Sinusitis/clasificación , Sinusitis/diagnóstico por imagen , Diagnóstico por Computador/métodos , Sensibilidad y Especificidad , Sinusitis Maxilar/diagnóstico por imagen , Sinusitis Maxilar/clasificación , Seno Maxilar/diagnóstico por imagen , Curva ROCRESUMEN
The aim of this study is to examine the frequency of maxillary sinus pathologies and their relationship with each other using cone beam computed tomography (CBCT) and to make a new grade according to the number of affected walls. 1000 maxillary sinuses of 500 patients with CBCT images were included in the study. Anatomical variations and pathological formations of the maxillary sinuses were examined. Images were evaluated for the presence of flat, polypoidal, partial and generalized mucosal thickening, partial and total opacification, polyps and mucous retention cysts. Maxillary sinus pathologies were graded according to the number of walls affected. In the examined CBCT images, no pathology was found in 54.2% of the maxillary sinuses, while pathology was observed in 45.8%. The most common sinus pathologies were mucous retention cyst (12.3%) and polypoidal thickening (12.2%). While pneumatization, ostium obstruction, and the presence of sinus-related roots were associated with sinus pathology, no relationship was found with nasal septum deviation and the presence of septa. Before dental implant and sinus surgery applications, the presence of sinus pathologies and their relationship with anatomical variations can be evaluated with CBCT, a three-dimensional technique, and complications such as sinus membrane perforation, infection, failure to break the bone window due to the presence of antral septa, graft loss and oroantral fistula formation can be reduced.
Asunto(s)
Tomografía Computarizada de Haz Cónico , Seno Maxilar , Humanos , Tomografía Computarizada de Haz Cónico/métodos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/patología , Femenino , Masculino , Persona de Mediana Edad , Adulto , Estudios Retrospectivos , Anciano , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Enfermedades de los Senos Paranasales/patología , Anciano de 80 o más Años , Adolescente , Adulto JovenRESUMEN
PURPOSE: To critically appraise and summarize the potential of linear and/or volumetric dimensions of the maxillary sinuses obtained with cone-beam and multi-slice computed tomography. METHODS: A bibliographic search was conducted in seven databases in August 2023. Cross-sectional retrospective studies using linear and volumetric measurements of the maxillary sinuses obtained with cone-beam and multi-slice computed tomography for sex estimation and presenting numerical estimation data were included. Narrative or systematic reviews, letters to the editor, case reports, laboratory studies in animals, and experimental studies were excluded. The critical appraisal and certainty of evidence were assessed using the guidelines described by Fowkes and Fulton and GRADE, respectively. RESULTS: A total of 656 studies were found, 32 of which were included. A total of 3631 individuals were analyzed and the overall sex estimation rate ranged from 54.9 % to 95 %. When compared with isolated measurements, combined linear measurements of the right and left maxillary sinuses, such as width, length, and height, provided a higher rate of sex estimation (54.9-95 %). In most of the studies (62.5 %), all measurements were higher in men than in women. Multiple methodological problems were found in the studies, especially distorting influences in 84.4 % of the answers. The certainty of evidence varied from very low to low. CONCLUSIONS: The combination of height, width, and length measurements of the right and left maxillary sinuses from cone-beam and multi-slice computed tomography can be useful in the estimation of sex of humans. Further primary studies are needed to increase the certainty of evidence. PROSPERO REGISTER: CRD42020161922.
Asunto(s)
Tomografía Computarizada de Haz Cónico , Seno Maxilar , Tomografía Computarizada Multidetector , Determinación del Sexo por el Esqueleto , Humanos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/anatomía & histología , Determinación del Sexo por el Esqueleto/métodos , Antropología Forense/métodosRESUMEN
BACKGROUND Odontogenic keratocyst (OKC) is a common odontogenic cyst, and it occurs more frequently in the mandible, with the posterior region of the dental arch, the angle, or the ramus being the most commonly affected sites. Odontogenic keratocyst occurring within the maxillary sinus is extremely rare, accounting for only about 1% of cases. CASE REPORT A 20-year-old female patient without any clinical symptoms underwent an oral examination, during which a dense dental shadow was identified within the maxillary sinus, surrounded by a low-density shadow. Physical examination revealed absence of the left maxillary third molar, with intact mucosa. The patient reported no history of tooth extraction. X-ray and cone-beam computed tomography revealed a high-density image within the left maxillary sinus, resembling a tooth and surrounded by a soft-tissue shadow, which exhibited a greater density in comparison to conventional odontogenic cysts. The initial diagnosis was odontogenic keratocyst in the maxillary sinus with an ectopic maxillary third molar. Surgical enucleation of the cyst and extraction of the impacted tooth were carried out utilizing the Caldwell-Luc approach. Histopathological analysis confirmed the presence of OKC. No significant recurrence was noted during the 6 months of follow-up. CONCLUSIONS Odontogenic keratocysts in the maxillary sinus with ectopic third molar are rare and may not have any symptoms in the early stage. Surgery can be performed using the Caroler-Luke approach to achieve ideal treatment results. In view of the high recurrence rate of OKC, close follow-up should be conducted after surgery.
Asunto(s)
Seno Maxilar , Tercer Molar , Quistes Odontogénicos , Humanos , Quistes Odontogénicos/cirugía , Quistes Odontogénicos/diagnóstico por imagen , Femenino , Tercer Molar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/patología , Adulto Joven , Tomografía Computarizada de Haz Cónico , Enfermedades de los Senos Paranasales/cirugía , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Extracción DentalRESUMEN
OBJECTIVES: We aimed to investigate the relationship between the presence of the accessory maxillary ostium (AMO) with mucosal thickening (MT) and maxillary sinus cysts (MSCs). STUDY DESIGN: This single-center retrospective study included patients who underwent paranasal sinus computed tomography (CT) between November 2022 and February 2023. We excluded patients with natural maxillary ostium (NMO) occlusion. Two radiologists evaluated the presence of AMOs, MT, and MSCs in CT images and measured their dimensions using a three-dimensional volumetric analysis program. RESULTS: We included 125 patients (mean age: 36.47 ± 16.0 years; male/female: 67/58). In total, 65 patients (52%) had single or multiple AMOs. No significant relationship was found between the presence of an AMO and the presence of MT on either side (P ≥ .306). There was a statistically significant difference between the presence of an AMO and MSC on the right side (P = .002), but not on the left side (P = .477). The diameter of the AMO and the distance from the AMO to the maxillary sinus floor were not correlated with mucosal thickness or MSC volume, but the distance from the AMO to the sinus floor had a small positive correlation with total maxillary sinus volume. CONCLUSIONS: The presence of an AMO and its increased diameter may not contribute to ipsilateral maxillary sinusitis in patients whose unilateral or bilateral NMOs are not occluded.
Asunto(s)
Imagenología Tridimensional , Seno Maxilar , Enfermedades de los Senos Paranasales , Tomografía Computarizada por Rayos X , Humanos , Femenino , Masculino , Estudios Retrospectivos , Adulto , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/patología , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Enfermedades de los Senos Paranasales/patología , Quistes/diagnóstico por imagen , Quistes/patología , Persona de Mediana Edad , Mucosa Nasal/diagnóstico por imagen , Mucosa Nasal/patologíaRESUMEN
PURPOSE: The aim of the present study was to compare the histomorphometrically evaluated new bone formation (NB), the radiographically measured graft stability, and the clinical implant outcome for maxillary sinus augmentation grafted with deproteinized bovine bone mineral (DBBM) with either small (Bio-Oss-S, Geistlich) or large (Bio-Oss-L, Geistlich) particles. MATERIALS AND METHODS: Using a split-mouth study design, bilateral maxillary sinus augmentation was performed in 13 patients either with Bio-Oss-S particles (0.25 to 1 mm) or Bio-Oss-L particles (1 to 2 mm). After a healing period of 6 months, bone biopsies were axially retrieved in the molar region for histologic/histomorphometric analysis of NB, including subsequent staged implant placement. To determine graft stability, the maxillary sinus augmentation vertical graft heights were radiographically measured immediately after sinus augmentation, at implant placement, and at the 2- and 4-year post-augmentation follow-ups. In addition, the clinical implant-prosthodontic outcome (survival/ success/marginal bone loss) was assessed at 1 and 3 years post-loading. RESULTS: A total of 22 sinuses from 11 patients with split-mouth evaluation were ultimately available for data and statistical analysis. Histomorphometric analysis of the axially retrieved bone biopsies revealed the presence of NB (S: 25.5% ± 7.0% vs L: 23.6% ± 11.9%; P = .640), residual graft particles (S: 19.6% ± 9.2% vs L: 17.5% ± 6.3%; P = .365) as well as connective tissue (S: 54.9% ± 9.2% vs L: 58.9% ± 12.5%; P = .283), without significant differences between the use of small (Bio-Oss-S) and large (Bio-Oss-L) particles. However, there was significantly (P = .021) higher bone-to-graft contact (BGC) for the small-particle graft sites (27.9% ± 14.8%) compared to the large-particle graft sites (19.9% ± 12.9%), representing a significantly higher osteoconductivity. Both particle sizes showed significant (P < .01) vertical graft height reduction over time (4 years) of about 10%, with predominant graft reduction in the time period between sinus augmentation and implant placement compared to any follow-up periods after implant placement. At the 3-year post-loading implant evaluation, all implants and prostheses survived (100%), and the peri-implant marginal bone loss (S: 0.52 ± 0.19 mm; L: 0.48 ± 0.15 mm) as well as the peri-implant health conditions (S: 87.5%, L:81.2%) did not differ between implants inserted with the two different xenograft particles used. CONCLUSIONS: The use of small and large bovine xenograft particles for maxillary sinus augmentation provides for comparable bone formation, ensuring stable graft dimensions combined with high implant success and healthy peri-implant conditions. However, small particle size resulted in a higher BGC, providing for higher osteoconductivity than with the larger particle size.
Asunto(s)
Sustitutos de Huesos , Implantación Dental Endoósea , Minerales , Tamaño de la Partícula , Elevación del Piso del Seno Maxilar , Humanos , Elevación del Piso del Seno Maxilar/métodos , Persona de Mediana Edad , Minerales/uso terapéutico , Masculino , Femenino , Sustitutos de Huesos/uso terapéutico , Bovinos , Implantación Dental Endoósea/métodos , Animales , Resultado del Tratamiento , Adulto , Seno Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Anciano , Osteogénesis/fisiología , BiopsiaRESUMEN
BACKGROUND: Panoramic radiography (PR) is available to determine the contact relationship between maxillary molar teeth (MMT) and the maxillary sinus floor (MSF). However, as PRs do not provide clear and detailed anatomical information, advanced imaging methods can be used. AIM: The aim of this study was to evaluate the diagnostic performance of deep learning (DL) applications that assess the relationship of the MSF to the first maxillary molar teeth (fMMT) and second maxillary molar teeth (sMMT) on PRs with data confirmed by cone beam computed tomography (CBCT). METHODS: A total of 2162 fMMT and sMMT were included in this retrospective study. The contact relationship of teeth with MSF was compared among DL methods. RESULTS: DL methods, such as GoogLeNet, VGG16, VGG19, DarkNet19, and DarkNet53, were used to evaluate the contact relationship between MMT and MSF, and 85.89% accuracy was achieved by majority voting. In addition, 88.72%, 81.19%, 89.39%, and 83.14% accuracy rates were obtained in right fMMT, right sMMT, left fMMT, and left sMMT, respectively. CONCLUSION: DL models showed high accuracy values in detecting the relationship of fMMT and sMMT with MSF.