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Cone-Beam Computed Tomography: An Accurate Diagnostic Tool in Dental Practice for Evaluation of Anatomic Variations in Maxillary Bone Septa

Maíra Fanha Souto, Milena Bortolotto Felippe, Thiago de Oliveira Gamba, Isadora Luana Flores, Sérgio Lúcio Pereira de Castro Lopes and Luiz Roberto Coutinho Manhães Junior

Background: Advanced knowledge of the shape and length of the maxillary sinus and its internal septa is useful for treatment planning of extraction, implant and sinus lift procedures.

Purpose: This study evaluates the prevalence, morphology, orientation, location, height, and length of bone septa in the maxillary sinus using cone-beam computed tomography (CBCT) images, for completely dentate versus partially or fully edentulous patients. Also, since dental extractions may induce formation of sinus septa, this study assesses the correlation between edentulism and prevalence of the maxillary sinus septa.

Material and methods: Four hundred forty-three CBCT images were selected to evaluate the prevalence of a septum in the maxillary sinus to perform an anatomic study of septum morphology. All images were evaluated by one an expert in oral radiology. The χ2 test was used to verify the relationship between the presence of septa and sex, age, and edentulism status. Variance analysis and the Tukey test showed a relationship between partial or full edentulism and the height and length of the maxillary sinus septum.

Results: A maxillary sinus septum was found in 50.1% of the study sample size. 69.8% of patients with a septum were partially edentulous. Gender did not correlation with septum prevalence. The length of the septum in the transverse orientation, and the location of the septum in the medial aspect of the sinus, both correlated with tooth loss.

Conclusions: Maxillary sinus bone septa are more prevalent in partly or fully edentulous populations. Given the diversity of septa morphology among patients, a detailed evaluation of each patient’s septa using CBCT is useful for customizing bone graft and implant placement treatment planning for each patient.