Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Radiographic evaluation before surgical extraction of impacted third molar to reduce the maxillary sinus related complication

  • Mi Hyun Seo (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Buyanbileg Sodnom-Ish (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Mi Young Eo (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Hoon Myoung (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Soung Min Kim (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University)
  • Received : 2023.01.08
  • Accepted : 2023.02.18
  • Published : 2023.08.31
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Abstract

Objectives: Surgical extraction of maxillary third molars is routine in departments devoted to oral and maxillofacial surgery. Because maxillary third molars are anatomically adjacent to the maxillary sinus, complications such as oroantral fistula and maxillary sinusitis can occur. Here we explore the factors that can cause radiographic postoperative swelling of the maxillary sinus mucosa after surgical extraction. Materials and Methods: This retrospective study reviewed the clinical records and radiographs of patients who underwent maxillary third-molar extraction. Preoperative panoramas, Waters views, and cone-beam computed tomography were performed for all patients. The patients were divided into two groups; those with and those without swelling of the sinus mucosa swelling or air-fluid level in a postoperative Waters view. We analyzed the age and sex of patients, vertical position, angulation, number of roots, and relation to the maxillary sinus between groups. Statistical analysis used logistic regression and P<0.05 was considered statistically significant. Results: A total of 91 patients with 153 maxillary third molars were enrolled in the study. Variables significantly related to swelling of the maxillary sinus mucosa after surgical extraction were the age and the distance between the palatal cementoenamel junction (CEJ) and the maxillary sinus floor (P<0.05). Results of the analysis show that the relationship between the CEJ and sinus floor was likely to affect postoperative swelling of the maxillary sinus mucosa. Conclusion: Maxillary third molars are anatomically adjacent to the maxillary sinus and require careful handling when the maxillary sinus is pneumatized to the CEJ of teeth.

Keywords

Acknowledgement

This research was supported by grant No. 08-2021-0013 from the SNUDH Research Fund and the Basic Science Research Program administered through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2021R1I1A1A01058939).

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