INTRODUCTION: Implant placement in the posterior maxilla can be challenging due to the pneumatization of the maxillary sinus and inadequate vertical bone height. The aim of this study was to compare the volumetric change in maxillary sinuses associated with extractions and ridge preservation versus those that have undergone extraction only.
METHODS: This retrospective study utilized cone beam computed tomography (CBCT) from archived dental records of patients who had extractions of posterior maxillary teeth. Only patients with both pre- and post- extraction CBCT were included. Data included the date the radiographs were taken, date of extraction or extraction with graft placement, and tooth extracted. Pre- and Post- extraction DICOM files were opened in InVivo v5.3 software (Anatomage) for image manipulation. After the volumes of the sinuses were isolated utilizing a series of volumetric rendering views and trimming instruments in InVivo v5.3, the volume calculation tool was utilized to assess the size of the sinuses. Means, standard error of the mean (SEM), and unpaired t tests between the grafted and non-grafted sites were compared.
RESULTS: 39 patients with 55 sinuses were available for review. A total of 36 extraction sites with ridge preservation and 26 without ridge preservation were included in the final data set. Sinuses associated with extraction sites receiving graft material showed a mean increase of 0.16 ± 0.15cc, whereas sinuses associated with non-grafted extraction sites showed a mean sinus increase of 0.66 ±0.61cc (mean difference of 0.50 cc). The mean change in sinus volume associated with extracted single first or second premolars with ridge preservation was 0.03cc whereas the mean change in sinus volume associated with single non-grafted premolar extractions sites was 0.36cc (difference of 0.33cc). The difference between the groups was 0.33cc. The mean change in sinus volume associated with single extracted molars that received ridge preservation was 0.15cc whereas the mean change in sinus volume associated with single extracted molar sites without ridge preservation was 0.95cc (mean difference of 0.80cc). In split mouth cases, the mean change in grafted sites was 0.29cc compared to 1.21cc (mean difference 0.92cc). Tooth position in the arch was directly related to the amount of post-extraction sinus pneumatization.
CONCLUSIONS: Mean volumetric change of the maxillary sinus is significantly greater in non-grafted maxillary posterior tooth extraction sites. Maxillary sinus volume and topography may be maintained by the grafting of maxillary posterior tooth extraction sites. Ridge preservation may be advantageous in preserving the vertical alveolar ridge dimension both intraorally and intra-antrally.
|Advisor:||Powell, Charles A.|
|Commitee:||Chandrasekaran, Sangeetha, Font, Kerri, Johnson, Lonnie, Potter, Brad J.|
|School:||University of Colorado at Denver|
|Department:||Health Information Technology|
|School Location:||United States -- Colorado|
|Source:||MAI 55/04M(E), Masters Abstracts International|
|Keywords:||Cbct, Extraction, Maxillary sinus, Ridge preservation, Sinus pneumatization, Socket graft|
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