Does Maxillary Sinus Pneumatization Occurs Post Extraction of Maxillary Molars and what is the effect of ridge preservation?
Maxillary sinus pneumatization has been proposed to occur after maxillary tooth extractions. Dimensional changes occurring in the alveolar crest after extraction have been extensively studied. However, the role of this pneumatization in the overall changes of the vertical bone height has not been investigated.
The aim of this retrospective study was to compare post-extraction spatial and dimensional changes in the maxillary sinus floor and alveolar crest for non-ridge preserved (Control) and ridge preserved (Test) sites with ABBM (Anorganic Bovine Bone Minerals).
Material and methods
46 Pre- and post-CBCTS of 46 individuals who had maxillary molar tooth extraction were analyzed using Simplant 17.0 software. Pre- and post-operative CBCTS were aligned and then superimposed using coincident reference lines. Measurements were made in the mesio-buccal (MB), disto-buccal (DB) and palatal (P) root for the total vertical height, alveolar crest height and maxillary sinus floor height. The following measurements of root anatomical factors were performed; the distance of the root apex to the sinus floor, width of root at 2 mm from the apex, and inclination of the root in relation to the sinus floor.
In non-ridge preserved sites, the results revealed that the mean total vertical height changes (VHC) were 3.90, 3.52, and 2.83 mm. Sinus floor height changes (SC) were 0.67, 0.37 and 0.38 mm and the mean crest height changes (CHC) were 3.31, 3.49 and 2.40 mm in the sites of MB, DB and P roots, respectively. No statistical significant correlations were found between the root anatomical factors and sinus floor height change.
In ridge preserved sites, the total mean vertical height changes (VHC) were 1.25, 1.58 and 1.28 mm. Sinus floor mean height changes (SC) were 0.65, 0.54, 0.46 mm and the mean crestal height changes (CHC) were 0.40, 0.74 and 0.80 mm in the sites of MB, DB and P roots, respectively. No statistical significant correlations were found between the root anatomical factors and sinus floor height change.
Minimal sinus pneumatization was observed following extraction of maxillary molars in ridge-preserved and non-preserved sites. Extensive alveolar crestal dimensional changes were observed in non-ridge preserved sites, and this is consistent with published reports. Ridge preservation using bovine derived xenograft (ABBM) can lead to stable alveolar bone outcomes by minimizing crestal bone resorption.