Diagnostic information of computed tomography of the upper jaw in patients required implant rehabilitation

Abstract

Introduction: Dental implantation in conditions of bone deficiency in the loss of lateral group of teeth of the upper jaw is impossible without the maxillary sinus floor augmentation. Preparation for surgical intervention requires a thorough assessment of the anatomical features of the sinus, relationship between the sinus and adjacent teeth, detection of foci of chronic infection of the Schneiderian membrane. In the complex of the objective methods of investigation, computed tomography is the most informative approach to study the state of the bone and soft tissue structure of the sinus. The aim of the paper is to evaluate the state of the bone structures and maxillary sinus membrane to determine the technique for selection the optimum alternative for management of patients, who required sinus lift, based on the computed tomography. Materials and methods: Computed tomographic examination of 206 patients with bounded and free-end edentulous spaces in the lateral area of the upper jaw was carried out over a period of 2010-2017 to evaluate the appropriateness of sinus lift approach and selection of its technique. The state of the bone tissue and presence of the auxiliary septa, intranasal structures, including ostiomeatal complex, presence of edema and exudates, lesions of the mucosa, as well as the state of ostium maxillaris has been estimated. Results: In the projection of the maxillary sinus the thickness of the bone tissue ranged within 1 mm to 10,5 mm; the density of bone tissues was of the D3-D4 type. Inflammatory events were detected in 60,1%, including: thickening of the mucous membrane on the right and on the left (40,6% and 41,1%, respectively), the total edema (8,6% and 9,7%, respectively). Bilateral thickening was found in 38,8%, and bilateral total edema in 28,0% of cases. Remnants of the filling material were found in 1,4% of sinuses on the right and in 2,8% on the left. Bone septum was visualized on the right in 18,8%, and in 17,4% on the left, bilateral in the 31,8%. Cystic masses were detected on the right in 4,2% of cases and in 6,2% on the left, bilateral in 16,7%. Conclusions: Computed tomographic examination provides thorough evaluation of the parameters of the bone tissues, state of mucous membrane and peculiarities of architectonics of maxillary sinuses at the pre-implantation stage.