Relationship Between Vertical Facial Pattern and Maxillary Sinus Floor Lifting Surgery
Resumo
Abstract
Rehabilitation with implants in the posterior region of the maxilla is a great challenge due to resorption of the alveolar process and pneumatization of the maxillary sinus. We aimed to verify whether there was a relationship between the vertical facial pattern and dimensions and alterations present in the maxillary sinuses through multislice computed tomography and to evaluate its implications for the placement of implants in the posterior region of the maxilla. In this cross-sectional study, tomography examinations were performed in 60 total or partial dentate patients with little interference in occlusion, totaling 120 maxillary sinuses. The RadiAnt DICOM Viewer™ 2020.2 (64-bit) software was used to measure the linear distances of the maxillary sinus, pneumatization extension, and determination of the vertical facial pattern. There was no significant correlation between the maxillary sinus volume and facial pattern (p > 0.05) or between the facial pattern and sinusoidal membrane thickness. There was a significant correlation between the facial pattern and extension of pneumatization (p < 0.035) and between the facial pattern and presence of a septum (p = 0.012). The facial pattern also showed a significant correlation with the sinusoidal wall thickness (p < 0.01 for height H1 and p = 0.012 for height H2). There were also positive correlations among age, pneumatization, and breast volume (p < 0.05). The dolichofacial pattern showed greater pneumatization than the mesofacial pattern. The mesofacial pattern showed a lower prevalence of the presence of a septum; thus, the facial pattern may have the lowest risk of intraoperative complications.
Keywords: Multidetector Computed Tomography. Maxillary Sinus. Intraoperative Complications.
Resumo
A reabilitação com implantes na região posterior da maxila é um dos grandes desafios da especialidade devido à reabsorção do processo alveolar e pneumatização do seio maxilar. Este estudo objetivou verificar se existe relação entre o padrão facial vertical e as dimensões e alterações presentes nos seios maxilares através da tomografia computadorizada multidetectores e avaliar suas implicações para a instalação de implantes na região posterior de maxila. Foram avaliados, nesse estudo transversal, exames tomográficos de 60 pacientes dentados totais ou parciais com pouca interferência na oclusão, totalizando 120 seios maxilares. Utilizou-se o software RadiAnt DICOM Viewer 2020.2 (64-bit)™ para mensurações das distâncias lineares do seio maxilar, extensão da pneumatização e determinação do padrão facial vertical. Não houve correlação significativa entre os volumes do seio maxilar e o padrão facial (p>0,05), assim como entre o padrão facial e a espessura da membrana do seio. Houve correlação significativa entre o padrão facial e a extensão da pneumatização (p<0,035) e entre o padrão facial e a presença de septo (p=0,012). O padrão facial também apresentou correlação significativa com a espessura da parede do seio p <0,01 para altura H1 e p=0,012 para altura H2. Houve ainda uma correlação positiva entre idade, pneumatização e volume do seio (p<0,05). O padrão dolicofacial apresentou uma maior pneumatização quando comparado ao mesofacial. O padrão mesofacial apresentou uma menor presença de septo, levando a crer que é o padrão facial com menor risco de complicações transoperatórias.
Palavras-chave: Tomografia Computadorizada Multidetectores. Seio Maxilar. Complicações Intraoperatórias.
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