• Imaging Science in Dentistry
• /
• v.40 no.2
• /
• pp.59-62
• /
• 2010

Purpose : To investigate and compare the prevalence, size, and location of maxillary sinus septa on panoramic and cone beam computed tomography (CBCT) images. Materials and Methods : Two hundred patients who had taken both panoramic and CBCT images were included. The location of maxillary sinus septa on the panoramic radiographs were recorded and confirmed on the CBCT images. Also the size of septa was measured on the reformatted CBCT images. Results : The prevalence of the patients who had maxillary sinus septa was 51.0% and they showed 179 septa totally. Among them 51.0% of the patients had one septum, 32.4% two septa, 13.7% three, and 2.9% four. The measured heights of the septa were $4.37{\pm}2.87\;mm$, $3.51{\pm}2.47\;mm$, and $3.04{\pm}2.37\;mm$ in the medial, middle, and lateral areas, respectively. It was revealed that 1.0% was located at canine region, 18.0% at first premolar, 25.0% at second premolar, 22.7% at first molar, 19.8% at second molar, and 14.0% at third molar region. Among 213 septa depicted by the panoramic radiographs, only 69.0% were confirmed at the CBCT images. Conclusion : Since various heights and courses of the septa can develop in all parts of the maxillary sinus, adequate assessment of the inner aspect of the maxillary sinus is essential to avoid complications during sinus augmentation procedures. CBCT scanning is the preferred radiographic method for detecting the presence of sinus septa.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.3
• /
• pp.319-324
• /
• 2008

Purpose: The aim of this study was to examine the incidence, location and morphology of antral septa using radiographic exam.(Panorama, CT) in the dentate/non-atrophic and edentulous/atrophic maxillary segments. Material & methods: 232 sinuses were subdivided into two groups(group1 : 175 sinuses were classified as complete & partial dentate maxillary segments, group2 : 57 sinuses were classified as complete edentulous maxillary segments) and were investigated for the incidence, location and morphology of maxillary sinus septa. Results: A total of 80 septa were observed in 232 maxillary sinuses, which corresponded to 30.65% of the sinuses(71 of 232). 67.5% of the total septa was observed in the complete & partial dentate groups, but 32.5% of the total septa was observed in the complete edentulous group. Upon analysis of the anatomical location of the septa, it was seen that 14 septa(17.5%) were located in the P1 area, 15 septa(18.7%) were located in the P2 area, 19 septa(23.8%) were located in the M1 area and 32 septa(40%) were located in the M2 area & dista area of M2. we found 45 septa in the apical lesion of teeth, Group 1. However the remaining 9 septa were found in the edentulous area. Conclusion: CT is a better method than panoramic radiography for detecting the presence of the maxillary sinus septa. Maxillary sinus septa are more commonly detected in complete edentulous maxillary segments than in complete & partial dentate maxillary segments. Also maxillary sinus septa are more commonly detected posteriorly than anteriorly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.41 no.1
• /
• pp.30-36
• /
• 2015

Objectives: The aim of this study is to determine the incidence, location, and orientation of maxillary sinus septa in formalin embalmed cadavers. Materials and Methods: The study was conducted on 210 cadaveric heads available in our department. After taking the mid-sagittal section the specimens were opened from the medial aspect and the sinus sinus septa, their anatomical plane, location and dimensions. Results: The mean linear distance between maxillary sinus floor and its anatomical ostium was $26.76{\pm}5.21mm$ and $26.91{\pm}4.96mm$ on right and left side, respectively. A total of 59 maxillary sinus septa (28.1%) were observed in 210 maxillary specimens. Septae were most common, 33 septa (55.9%), in the middle region (between first and second molar tooth) of the sinus cavity. The maxillary sinus membrane (Schneiderian membrane) adhered tightly to the maxillary sinus and over the septae. Significantly more maxillary sinus septa were observed in edentulous maxillae in comparison to the dentate upper jaw. Conclusion: Knowledge of location of maxillary sinus ostium is mandatory for the rhinologist for drainage of secretions in maxillary sinusitis. The morphological details of maxillary sinus septa, particularly their location and anatomical planes, will guide dentists in performance of safe implant surgeries. The maxillary antrum septa of category I and II may complicate the procedure of inversion of bone plate and elevation of sinus membrane during maxillary augmentation surgeries. The category III septa observed in the sagittal plane were embedded by one of the branches of the infraorbital nerve in it, and if accidentally cut will lead to infraorbital nerve palsy in maxillary sinus surgeries.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.33 no.5
• /
• pp.504-510
• /
• 2007

Purpose: The purpose of this study was to determine the incidence of antral septa and the accuracy of panoramic radiograph in identifying maxillary sinus septa. In addition, when panoramic radiograph led to a false diagnosis of more than majority, we analyzed findings of the panoramic radiograph. Patients and methods: This study included 180 patients who were radiographically examined before the surgery was done using both panoramic and computerized tomographic radiographs(CT scan), Samsung Medical Center from April 2003 to March 2006, and examined the incidence of antral septa, the false diagnosis rate of panoramic radiograph, and radiographic characters in case of false diagnosis. Only those bone lamellae were considered as septa that showed a height of at least 3.0mm. It was thus possible to exclude the alveolar recess. One oral and maxillofacial surgeon(OMFS) determined the presence or absence of sinus septa in CT scan, and five OMFS determined the presence or absence of sinus septa in panoramic radiograph. Results: The septa were observed in 81 of 360 sinuses(22.5%). All septa were oriented in a buccopalatal plane. More or less greater prevalence was observed in the second molar region(38.2%) but no predominant location was found. Panoramic radiograph led to false diagnosed septa in 361 of 1800 cases(20.1%). In case of false diagnosis of more than majority, superimposed image on zygomatic process was 44.1%, faint image in the region not related to sinus lifting 26.5%, faint image in the region related to sinus lifting 17.6%, and misconception for superimposed image 11.8% Conclusion: In this study we could get clinico-anatomical information of septum in the maxillary sinus. Compared to CT scan, panoramic radiograph can not clearly differentiate the sinus septa, but we consider that panoramic radiograph may improve its usefulness if we take additional modified panoramic radiograph and clinical exam.

• Imaging Science in Dentistry
• /
• v.47 no.4
• /
• pp.261-267
• /
• 2017

Purpose: Analyzing different patterns of maxillary sinus septa in cone-beam computed tomography (CBCT) images and predicting maxillary sinus membrane perforations. Materials and Methods: In this cross-sectional study, CBCT images of 222 patients ranging from 20 to 81 years old were evaluated. One hundred fifty-two patients (93 females and 59 males) who had maxillary sinus septa in axial views were included in this study. Cross-sectional images were used to determine classifications of sinus septa and the risk of membrane perforation using a method modified from Al-Faraje et al. Variables of sex, age, and dental status were considered. Chi-squared and Kruskal-Wallis tests were used for data analysis(P<.05). Results: In this study, 265 maxillary sinus septal patterns were found. The mean age of the patients was $44.1{\pm}14.7$ years old. The Class I and VII-div II patterns had the greatest and least prevalence, respectively. Furthermore, there was a significant relationship between the location of septa and the frequency of membrane perforation risk (P<.05). In this study, the relationship of different patterns of septa with dental status did not differ significantly (P>0.05). Conclusion: A higher prevalence of moderate risk of membrane perforation in the molar region relative to the premolar region was observed. Furthermore, maxillary sinus septa occur most frequently in the molar region, demonstrating the importance of paying attention to this region during sinus lift surgery. This study did not show any relationship between tooth loss and the presence of septa.

• Journal of Periodontal and Implant Science
• /
• v.40 no.2
• /
• pp.56-60
• /
• 2010

Purpose: The sinus lift procedure requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the location and prevalence of maxillary sinus septa using computed tomography (CT). Methods: This study was based on the analysis of CT images for posterior maxilla which were obtained from patients who visited Chonbuk National University Dental Hospital during the period of June 2007 to December 2008. With the exclusion of cases presenting any pathological changes, 236 maxillary sinuses in 204 patients were retrospectively analyzed. The average age of the patients was 50.9. The cases were divided into two groups, an atrophy/edentulous segment and a non-atrophy/dentate segment, and maxillary sinus septa of less than 2.5 mm were not taken in-to consideration. The location of septa was also divided for analysis into 3 regions: the anterior (1st and 2nd premolar), middle (1st and 2nd molar) and posterior (behind 2ndmolar) regions. Results: In 54 (20.9%) of the 204 patients there were pathologic findings, and those patients were excluded from the analysis. Sinus septa were present in 58 (24.6%) of the 236 maxillary sinuses and in 55 (27%) of the 204 total patients. In the atrophy/ edentulous ridge group (148 maxillary sinuses), 41 cases (27.7%) were found, and 17 cases (19.3%) were found in the non-atrophy/ dentulous ridge group (88 maxillary sinuses). In terms of location, septa were found in 18 cases (27.3%) in the anterior, in 33 cases (50%) in the middle and in 15 cases (22.7%) in the posterior regions. Conclusions: In the posterior maxilla, regardless of type of ridge (atrophy/edentulous or non-atrophy/dentate), the anatomical variation of sinus septa is diverse in its prevalence and location. Thus, accurate information on the maxillary sinus of thepatient is essential and should be clearly understood by the surgeon to prevent possible complications during sinus lifting.

• Journal of Periodontal and Implant Science
• /
• v.36 no.1
• /
• pp.147-154
• /
• 2006

Surgical intervention in the posterior maxillary region requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the incidence, location of maxillary sinus septa by using radiographic (panoramic radiography and computed tomography) findings and comparison of panoramic radography with CT in antral anatomical variation. This study was based on data from 70 sinuses in partial dentate maxilla. The sample consisted of 61 patients(25 women and 36 men, with ages ranging between 19 and 77 years and a mean age of $49.4{\pm}11.3$ years) who were being treatment-planned to receive implant-supported restorations. First, the panoramic images were examined for the presence of antral septa by radiologist and examiner who don't know about CT findings. And incidence of antral septa was evaluated using an axial plane of CT image. The incidence of septa was compared between panoramic radiography and CT. The accuracy of the incidence was compared between radiologists and dentists. A total of 20 septa were found in 70 sinuses on CT image and the prevalence of one or more septa per sinus was found to be 28.6%. The assumed incidence of septa on panoramic radiography was $27.6%{\pm}2.2%$ in radiologist and $31.9%{\pm}5.8%$ in dentists. Erroneous diagnosis rate was 11.42% in radiologist and 15.96% in dentists. 40% of antral septa were located in the anterior(premolar) region, 30% of septa were located in the middle(first molar) and posterior(second molar) region separately. Prior to implant placement, it seems appropriate to consider panoramic radiography as a standard radiographic examination and periapical radiographs may be used to complete the findings in regions not sharply depicted in the panoramic radiograph. And cross-sectional imaging should be used in sites with severe bone loss and close proximity of the maxillary sinus.

• Applied Microscopy
• /
• v.24 no.1
• /
• pp.59-76
• /
• 1994

Fine structure of the distal femoral epiphysis of growing mouse was studied by electron microscopy. The first morphological evidence of developing secondary center of ossification in the distal femoral epiphysis was found at newborn mouse. Ossification center was in the form of multiple foci of calcification and its cells were represented by remnant of degenerated cells within large lacunae that were separated by mineralized cartilaginous septa. Endochondral ossification beneath the articular cartilage proceeded in a less orderly manner than metaphyseal endochondral ossification. Columns of hypertrophied chondrocytes were not distinctly parallel to intercellular mineralized septa in all direction. Hypertrophied chondrocytes in the inner zone of the epiphseal center of ossification showed disintegrated. Resorption of mineralized cartilaginous septa was undertaken by perivascular cells and multinucleated chondroclasts. Resorption of the calcified cartilage was restricted to the region of ruffled border of the chondroclast. Growth along the metaphyseal side of the epiphyseal center of ossification was different from that along the articular surface. As the secondary center expanded toward the metaphyseal side, many vascular buds penetrated unmineralized cartilaginous septa and invaded viable chondrocytes. Many hypertrophied chondrocytes bodering the metaphyseal side of bone center remained viable after they became embedded in mineralized cartilaginous septa. This result suggested that the hypertrophied.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.54.1-54.3
• /
• 2019

Background: The presence of septa increases the risk of Schneiderian membrane perforation during sinus lift procedure, and therefore, the chance of graft failure increases. We present a safe method of managing septa and, in particular, overcoming small and palatally located septa. Methods: After the elevation of the flap and the creation of a small bony window positioned anterior to the septum, the Schneiderian membrane is lifted carefully. A thin and narrow osteotome is then placed at the indentation created at the base of the septum, and mobilization of the septum is achieved by gentle malleting. The membrane is again carefully lifted up behind the septum. Results: There was one small membrane perforation case in all 16 cases, and none of these patients showed postoperative complications such as implant failure, infection, or maxillary sinusitis. Conclusions: This technique is useful for overcoming the problem of maxillary sinus septa hindering the sinus floor elevation procedure, leading to fewer complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.1
• /
• pp.36-42
• /
• 2011

Introduction: The current study examined the morphological characteristics of maxillary sinus septum by computed tomography (CT). Materials and Methods: Two hundred and four patients (408 maxillary sinuses) who visited dental clinic were evaluated. CT were examined. The height of the septum measured from the sinus floor to the apex of the septum more than 3 mm was defined as "sinus septum". Results: The prevalence of sinus septa was 21.3% (87/408), and 31.4% (64/204) of patients had more than 1 sinus septum. Females showed higher and thinner sinus septa than males. The anatomic location of the septa were distributed in the 2nd molar region (43.7%), 1st molar region (31.0%), 2nd premolar region (21.8%) and 1st premolar region (3.5%). In 57 patients with chronic disease, there was no significant difference between sinus disease and the presence of sinus septa. The loss of remaining teeth and teeth adjacent to the sinus septum area was not related to the presence of sinus septa. Older subjects showed a reduced height and length of the septum, and a thicker septum. Conclusion: These results show that the maxillary sinus septum undergoes atrophy with age.