• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.23 no.2
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• pp.277-285
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• 1993

This study was performed to evaluate the role of Waters' view and panoramic view for the interpretation of mucosal cyst of the maxillary sinus and to determine the radiographic features of that according to the sites and sizes. For this study, clinically 25 cases of mucosal cyst of the maxillary sinus were used, and experimentally with two dry skulls, rubber ball of 15mm in diameter for marked radiopacity, and two jelly balls of 8 and 20㎜ in diameter for the similar radiopacity to cyst were used. The 25 cases with 25 panoramic views and 15 Waters' views were first analyzed, and secondly, the radiographic features of artificial lesions attached to the each wall of the antrum on Waters' view and panoramic view were analyzed. The obtained results were as follows: At clinical analysis, 1. 4 cases of 13-14㎜, 4 cases of 15-19mm, 14 cases of 20-25㎜, 3 cases of over 30㎜ in dia- meter were found on panoramic views. And 24 cases of 25 cases showed no relationship with teeth, and only 1 case was associated with advanced periodontal disease 2. The majority of mucosal cysts appeared to arise the posterior portion of the floor of the sinus and were superimposed with the inominate line of zygoma and the horizontally linear image of hard palate on panoramic view. 3. Only 2 cases of 15 cases were identified on both films. At experimental analysis, 4. On Waters' view, the images of the artificial lesion of the anterior portion and midportion of the floor of the sinus were lessend in diameter compared with the real size. On panoramic views, the images of the lesion were more radiolucent with lessened diameter than images on Water' view. 5. The images of the lesion of the posterior wall and the posterior portion of the floor of sinus on panoramic view were well detected by the preeducated group but not or poorly detected by the non-preeducated observer group. 6. On Waters' view, both observer groups recognized that the cystic images of the posterior portion of the floor of the maxillary sinus were superimposed with the petrous portion of the skull.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.468-474
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• 2008

Purpose: Previous clinical investigations of sinus floor augmentation have demonstrated repneumatization of grafted sinus. The aim of this study is to evaluate and compare the height changes of sinus floor after grafting with deprotenized bovine bone mineral (DBBM) and beta tricalcium phosphate (TCP). Materials and methods: 34 sinuses in 28 patients were augmented with 100% DBBM or 100% TCP through lateral approaches. Sinusgraft height was measured before, immediately after, and 6 months after bone graft with panoramic radiography. Result: After 6 months, the decreases of graft heights were 14.53% for DBBM group and 15.15% for TCP group. There was no statistically significant difference. Discussion and Conclusion: Long-term stability of sinus-graft height represents an important factor for implant success. After the uses of DBBM and TCP for maxillary sinus floor augmentations, acceptable graft height maintenances were observed.

• Journal of Periodontal and Implant Science
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• v.46 no.1
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• pp.57-69
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• 2016

Purpose: The aim of this pilot study was to determine the osteoconductivity and dimensional stability of augmented sinuses using different ratios of biphasic calcium phosphate (BCP) in a rabbit sinus model. Methods: Each sinus of New Zealand white rabbits (2.5-3.5 kg) was assigned to one of two groups: BCP with a hydroxyapatite to ${\beta}$-tricalcium phosphate (HA:${\beta}$-TCP) ratio of 70:30 (group TCP30) and BCP with an HA:${\beta}$-TCP ratio of 30:70 (group TCP70). After preparing a window in the antral wall of a sinus, the Schneiderian membrane was elevated, and the applicable material was grafted. A fluorochrome calcein green was injected five days before euthanizing the animals at four months post-surgery. The specimens were analyzed histologically, histomorphometrically, and by using micro-computed tomography (micro-CT). Results: Micro-CT analysis revealed that the total augmented volume and the new bone volume did not differ significantly between the two groups whereas the resorption of materials was greater in the TCP70 group. The trabecular thickness, number, and separation also did not differ significantly between the two groups. Histomorphometrically, the areas of total augmentation, new bone, and residual material, as well as the ratio of new-bone-material contact did not differ significantly between the groups. Histologically, the residual particles were more scattered in the TCP70 group than in the TCP30 group. The fluorescence of the calcein green did not differ notably between the two groups. Conclusions: The osteoconductivity and dimensional stability of the two BCPs with different ratios tested in this study were comparable after four months of healing. Therefore, we conclude that both BCPs show promise as a bone substitute for sinus augmentation.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.151-164
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• 2007

Objective: The sinus floor elevation procedures have been used to facilitate implant placement in the severely atrophic posterior maxilla. Many variables may have an influence on the outcomes of the sinus floor elevation in combination with implant treatment. The aim of this study was to analyze survival rate of implants placed in the edentulous maxillae of patients in whom sinus floor elevation was undertaken according to variables. Materials and Methods: It consisted of 96 patients(50 male and 46 female), ranging in age from 31 to 70 years(mean 49 years), who underwent sinus floor elevation procedure(94 implants in left side and 106 implants in right side) from 2001 to 2002. A total of 200 implants were placed in the grafted sinus(73 implants in lateral approach and 127 implants in crestal approach). All implants were restored by fixed prosthesis. All patients were healthy. Follow-up periods for implants were between 48 to 60 months. Results: The cumulative survival rate of implants was 91.5%. Gender, age and operation site did not have an influence on the survival rate. There was statistically significant differences for the implants which placed in less than 4 or 5 rom residual bone height, the survival rate was 60%, 81.4% respectively (p<0.05). There was no statistically significant difference of implants survival rate ac- cording to approach technique. The survival rate for 100% autogenous bone grafts was lower with respect to composite grafts containing autogenous bone and 100% substitutes. The survival rate for hydroxyapatite-coated implants was statistically significant lower than other textured group (p<0.05). Conclusion: Residual bone height, surface texture and graft materials have an influence on the survival rate. To use autogenous bone as a part of a composite bone replacement, implant texture which leads to more favorable implant-bone interface were necessary. To determine residual bone height for initial implant stability was important.

• The Journal of the Korean dental association
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• v.45 no.8 s.459
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• pp.491-499
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• 2007

Deproteinized bovine bone mineral has been widely used as graft material in sinus augmentation procedure. The efficacy of OCS-B(r)(Nibec Inc., Seoul, Korea) as a graft material for sinus augmentaion was evaluated in 10 patients. A total of 13 sinus augmentation procedures were performed, and an average of 6.3 months later 27 implants were placed into the augmentation sinuses. The biopsy specimens were examined histologically and hitomorphometrically. Radiographical evaluation was done also. The average distance form grafted sinus to implant apex at the final evaluation period was $5.7\pm3.1$mm. The average percentage of newly formed bone at an average of 6.3 months was $20.0\pm8.4%$. The degree of bone to graft material contact was $18.7\pm6.4%$. It was shown from both radiographic evaluation and histologic results that sinus augmentation can successfully be performed with $\OCS-B^textcircledR$.

• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.33-36
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• 2011

Background: In a frontal sinus reconstruction, the literature primarily recommends a surgical approach for definite treatment with the exception of for anterior wall fractures with no dislocation. Many studies have assessed a range of methods for the reduction of frontal sinus fractures. This paper presents a case, in whom the anterior wall of the frontal sinus was reconstructed using an outer table calvarial bone graft in an en bloc manner. Patient and methods: A 36-year-old male visited the emergency room with a heavy injury to the forehead. He was diagnosed with fractures of the anterior and posterior wall of the frontal sinus. The neurosurgeon removed the fractured area and repaired the meninges. Afterwards, cranialization was performed and the opening of the nasofrontal duct was obstructed. After fixing the removed bone to its original location, all fragments of fractured anterior wall were purged out and the anterior wall reconstructed using an en bloc calvarial bone graft. Results: In the post-operative 8 months period, there were no complications, the round contour of the forehead was expressed well and the patient was satisfied with the result. Conclusion: There are many methods for reconstructing the anterior wall of the frontal sinus. On the other hand, in cases of large fracture sites with many fractured bone fragments, en bloc harvesting of the outer table calvarial bone could be a better choice than making use of only plates and screws because this method shows a good results in terms of aesthetics with a low complication rate.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.204-211
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• 2018

Background and Objectives : Unilateral maxillary sinus lesions are relatively common but may occur in variety of causes. Therefore, accurate diagnosis and appropriate treatment are needed. The aim of this study is to review patients with unilateral maxillary sinus lesion who underwent surgical treatment and to analyze causes and characteristics of unilateral maxillary sinus lesions with literature review. Materials and Methods : A retrospective chart analysis was completed on 318 patients with unilateral maxillary sinus lesions who underwent surgical treatment from January, 2008 through May, 2018. Clinical history and data such as age, sex, symptoms of initial, radiologic and dental finding, operation type were collected from medical record. Results : Patients mean age was 50.7 years with slight male gender dominance. Most common type was sinusitis (42.7%), followed by odontogenic sinusitis (22.3%) and fungal ball (19.5%). In particular, the most common cause of odontogenic sinusitis was post dental surgery such as implant. Middle meatal antrostomy (90.9%) was accounted for a great part of surgery underwent to patients. Patients complained of post nasal discharge (62.9%), nasal obstruction (40.9%) and odor smell(35.2%) most commonly. Periapical lucency (35.8%) was the most common in CT finding followed by implant perforation (17.3%) and oroantral fistula (12.3%) in odontogenic sinusitis. Conclusions : Unilateral maxillary sinus lesions are relatively common, but they are increasing recently with dental procedures such as implant surgery, and serious adverse effects due to malignant tumors or improper treatment may occur, so accurate diagnosis and treatment are needed.

• Journal of Periodontal and Implant Science
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• v.49 no.1
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• pp.47-57
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• 2019

Purpose: This study was designed to observe the resorption pattern of biphasic calcium phosphate (BCP) used for maxillary sinus augmentation over a 3- to 6-year healing period, and to investigate factors affecting the resorption of BCP. Methods: A total of 47 implants placed in 27 sinuses of 22 patients were investigated. All patients had residual bone height less than 5 mm at baseline. The modified Caldwell-Luc approach was used to elevate the maxillary sinus membrane, and the sinus cavity was filled with BCP (70% hydroxyapatite and 30% ${\beta}$-tricalcium phosphate). Implant placement was done simultaneously or in a staged manner. Serial radiographic analysis was performed up to 6 years postoperatively. Results: During the follow-up period, no implant loss was reported. The mean reduced height of the augmented sinus (RHO) was $0.27{\pm}1.08mm$ at 36 months, and $0.89{\pm}1.39mm$ at 72 months postoperatively. Large amounts of graft material (P=0.021) and a long healing period (P=0.035) significantly influenced the amount of RHO. In particular, there was a significant relationship between a healing period longer than 40 months and RHO. Conclusions: BCP can achieve proper dimensional stability with minimal reduction of the graft height in a 3- to 6-year healing period after maxillary sinus augmentation. The healing period and the amount of graft material influenced the resorption of BCP.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.6
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• pp.411-426
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• 2021

Combining different procedures to reduce the number of surgical sessions and patient discomfort in implant placement and sinus floor elevation has been recommended, and evidence supports good outcomes. The aim of this study was to review the results of clinical studies on sinus floor elevation through extraction sockets and simultaneous immediate posterior implant placement. An electronic search was carried out in PubMed, Scopus, and Web of Science to find English articles published in or before August 2020. A manual search was also performed. Titles, abstracts, and the full-text of the retrieved articles were studied. Thirteen studies met our eligibility criteria: 6 retrospective case series, 3 case reports, 2 prospective cohort case-series, 1 prospective case series, and 1 randomized controlled trial. Overall, 306 implants were placed; 2 studies reported implant survival rates of 91.7% and 98.57%. The others either did not report the survival rate or reported 100% survival. Sinus floor elevation through a fresh extraction socket and simultaneous immediate implant placement appears to be a predictable modality with a high success rate. However, proper case selection and the expertise of the clinician play fundamental roles in the success of such complex procedures.

• Anatomy and Cell Biology
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• v.56 no.2
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• pp.179-184
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• 2023

The Functional endoscopic sinus surgery through transnasal approach is a common modality of treatment for disorders of the nasal cavity, paranasal air sinuses as well as cranial cavity. The olfactory fossa (OF) is located along the superior aspect of cribriform plate which varies in shape and depth. This variable measurement of the depth of OF is mostly responsible for greater risk of intracranial infiltration during endoscopic procedures in and around the nasal cavity. The morphology of frontal and ethmoid sinus (ES) vary from simple to complex. This cadaveric study is planned to improve the ability of the otolaryngologist, radiologist to understand the possible morphological variations and plan steps of less invasive "precision surgery" to have a safe and complication free procedures. A total of 37 human head regions were included in the study. For classification of OF, Modified Kero's classification was used. The size, shape and cells of frontal and ES were noted. We found, type II (60.8%) OF was more common followed by type I (29.7%) than type III (9.5%). The shape of frontal sinus was comma shaped (55.4%) followed by oval (18.9%) than irregular (16.2%). Most common two cells type of ES was seen in 50.0% of both anterior and posterior ES. Out of 74 ES, 8.1% of Onodi cells and 14.9% of agger nasi cells were seen.