Morphometric analysis of sinus depth in the posterior maxilla and proposal of a novel classification
Identifieur interne : 000845 ( Pmc/Curation ); précédent : 000844; suivant : 000846Morphometric analysis of sinus depth in the posterior maxilla and proposal of a novel classification
Auteurs : Florian Wagner [Autriche] ; Gabriella Dvorak [Autriche] ; Stefan Nemec [Autriche] ; Peter Pietschmann [Autriche] ; Hannes Traxler [Autriche] ; Kurt Schicho [Autriche] ; Rudolf Seemann [Autriche]Source :
- Scientific Reports [ 2045-2322 ] ; 2017.
Abstract
The aim of this study was to analyse the posterior maxillary sinus based on its extension into the alveolar process and to provide a simple clinical classification. A retrospective cohort study was conducted in CT scans of 200 dentate and 200 edentulous patients (100 women and 100 men, respectively). After manual placement of 12 reference points morphometric analysis was performed and sinus depth, residual alveolar ridge height (RH) and the sinus opening angle were calculated. Sinuses were classified according to the quartiles of sinus depth: class I (above the hard palate), class II (0–6 mm below the hard palate) and class III (>6 mm below the hard palate). Sinus depth was found to be a reliable anatomical landmark and did not vary significantly between gender (p = 0.8940) or dentition groups (p = 0.9723). Alveolar height varied significantly between sinus classes (p < 2 × 10−16) and dentition groups (p < 2 × 10−16) but not between genders (p = 0.5178). The sinus opening angle was significantly different between sinus classes (p < 2.2 × 10−16) but not between gender or dentition groups. We propose a novel classification built upon the quartiles of sinus depth, dividing the sinuses into three classes. Our classification is the first one that represents the anatomy of the patient independent of gender and dentition.
Url:
DOI: 10.1038/srep45397
PubMed: 28338085
PubMed Central: 5364414
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<author><name sortKey="Dvorak, Gabriella" sort="Dvorak, Gabriella" uniqKey="Dvorak G" first="Gabriella" last="Dvorak">Gabriella Dvorak</name>
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<front><div type="abstract" xml:lang="en"><p>The aim of this study was to analyse the posterior maxillary sinus based on its extension into the alveolar process and to provide a simple clinical classification. A retrospective cohort study was conducted in CT scans of 200 dentate and 200 edentulous patients (100 women and 100 men, respectively). After manual placement of 12 reference points morphometric analysis was performed and sinus depth, residual alveolar ridge height (RH) and the sinus opening angle were calculated. Sinuses were classified according to the quartiles of sinus depth: class I (above the hard palate), class II (0–6 mm below the hard palate) and class III (>6 mm below the hard palate). Sinus depth was found to be a reliable anatomical landmark and did not vary significantly between gender (p = 0.8940) or dentition groups (p = 0.9723). Alveolar height varied significantly between sinus classes (p < 2 × 10<sup>−16</sup>
) and dentition groups (p < 2 × 10<sup>−16</sup>
) but not between genders (p = 0.5178). The sinus opening angle was significantly different between sinus classes (p < 2.2 × 10<sup>−16</sup>
) but not between gender or dentition groups. We propose a novel classification built upon the quartiles of sinus depth, dividing the sinuses into three classes. Our classification is the first one that represents the anatomy of the patient independent of gender and dentition.</p>
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<title-group><article-title>Morphometric analysis of sinus depth in the posterior maxilla and proposal of a novel classification</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Wagner</surname>
<given-names>Florian</given-names>
</name>
<xref ref-type="corresp" rid="c1">a</xref>
<xref ref-type="aff" rid="a1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dvorak</surname>
<given-names>Gabriella</given-names>
</name>
<xref ref-type="aff" rid="a2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nemec</surname>
<given-names>Stefan</given-names>
</name>
<xref ref-type="aff" rid="a3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pietschmann</surname>
<given-names>Peter</given-names>
</name>
<xref ref-type="aff" rid="a4">4</xref>
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<contrib contrib-type="author"><name><surname>Traxler</surname>
<given-names>Hannes</given-names>
</name>
<xref ref-type="aff" rid="a5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schicho</surname>
<given-names>Kurt</given-names>
</name>
<xref ref-type="aff" rid="a1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Seemann</surname>
<given-names>Rudolf</given-names>
</name>
<xref ref-type="aff" rid="a1">1</xref>
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<aff id="a1"><label>1</label>
<institution>University Clinic for Cranio- and Maxillofacial Surgery, Medical University of Vienna</institution>
,<country>Austria</country>
</aff>
<aff id="a2"><label>2</label>
<institution>Department of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna</institution>
, Sensengasse 2a, 1090 Vienna,<country>Austria</country>
</aff>
<aff id="a3"><label>3</label>
<institution>University Clinic for Radiology, Medical University of Vienna</institution>
, Waehringer Guertel 18-20, 1090 Vienna,<country>Austria</country>
</aff>
<aff id="a4"><label>4</label>
<institution>Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna</institution>
,<country>Austria</country>
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<aff id="a5"><label>5</label>
<institution>Department of Systematic Anatomy, Medical University of Vienna</institution>
, Währinger Strasse 13, 1090 Vienna,<country>Austria</country>
</aff>
</contrib-group>
<author-notes><corresp id="c1"><label>a</label>
<email>Florian.Wagner@meduniwien.ac.at</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>24</day>
<month>03</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection"><year>2017</year>
</pub-date>
<volume>7</volume>
<elocation-id>45397</elocation-id>
<history><date date-type="received"><day>19</day>
<month>12</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>22</day>
<month>02</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2017, The Author(s)</copyright-statement>
<copyright-year>2017</copyright-year>
<copyright-holder>The Author(s)</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><pmc-comment>author-paid</pmc-comment>
<license-p>This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
</license-p>
</license>
</permissions>
<abstract><p>The aim of this study was to analyse the posterior maxillary sinus based on its extension into the alveolar process and to provide a simple clinical classification. A retrospective cohort study was conducted in CT scans of 200 dentate and 200 edentulous patients (100 women and 100 men, respectively). After manual placement of 12 reference points morphometric analysis was performed and sinus depth, residual alveolar ridge height (RH) and the sinus opening angle were calculated. Sinuses were classified according to the quartiles of sinus depth: class I (above the hard palate), class II (0–6 mm below the hard palate) and class III (>6 mm below the hard palate). Sinus depth was found to be a reliable anatomical landmark and did not vary significantly between gender (p = 0.8940) or dentition groups (p = 0.9723). Alveolar height varied significantly between sinus classes (p < 2 × 10<sup>−16</sup>
) and dentition groups (p < 2 × 10<sup>−16</sup>
) but not between genders (p = 0.5178). The sinus opening angle was significantly different between sinus classes (p < 2.2 × 10<sup>−16</sup>
) but not between gender or dentition groups. We propose a novel classification built upon the quartiles of sinus depth, dividing the sinuses into three classes. Our classification is the first one that represents the anatomy of the patient independent of gender and dentition.</p>
</abstract>
</article-meta>
</front>
<floats-group><fig id="f1"><label>Figure 1</label>
<caption><title>Measurement Protocol: Placement of Landmarks P1–P12; Calculation of sinus depth (SD) and alveolar height (AH) are illustrated in the left sinus, calculation of the sinus opening angle (α) is shown in the right sinus.</title>
<p>The palatal plane is marked as horizontal black line between P7 and P12.</p>
</caption>
<graphic xlink:href="srep45397-f1"></graphic>
</fig>
<fig id="f2"><label>Figure 2</label>
<caption><title>Histogram of the sinus depth.</title>
<p>Vertical lines resemble the first and the third quartile used as class limits. The first quartile was 0 mm and the third quartile 6 mm. The first class has a sinus floor above the hard palate, the second class’ floor is 0 to 6 mm below and the third class is more than 6 mm below the hard palate. The first class resembles 25%, the second class 50% and the third class 25% of the patients.</p>
</caption>
<graphic xlink:href="srep45397-f2"></graphic>
</fig>
<fig id="f3"><label>Figure 3</label>
<caption><title>Three reference sinuses corresponding to the three newly defined sinus classes are displayed.</title>
</caption>
<graphic xlink:href="srep45397-f3"></graphic>
</fig>
<fig id="f4"><label>Figure 4</label>
<caption><title>Scatterplot of the sinus depth versus the alveolar height stratified by the dentition group.</title>
<p>Marginal boxplots for the groups restrict the information to either sinus depth or alveolar height. Sinus depth gradually increases with decreasing alveolar bone height. Dentition groups did significantly influence alveolar bone height but not sinus depth.</p>
</caption>
<graphic xlink:href="srep45397-f4"></graphic>
</fig>
<fig id="f5"><label>Figure 5</label>
<caption><title>Boxplot of sinus opening angle stratified by sinus class.</title>
<p>The mean opening angle was significantly different between the sinus classes: 113.9 ± 17.6 in class I, 101.2 ± 13.3 in class II and 90.1 ± 10.7 in class III.</p>
</caption>
<graphic xlink:href="srep45397-f5"></graphic>
</fig>
</floats-group>
</pmc>
</record>
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