Citation Information :
Shah A, Sharma S, Boruah S, Mukherjee A, Tyagi G, Singh A. Comparing Expansion of Maxillary Antrum between Periapical Surgery and Extraction of Permanent Maxillary First Molar in Pediatric Patients Using CBCT. J Contemp Dent Pract 2022; 23 (6):606-612.
Aim: To compare the expansion of maxillary antrum between periapical surgery and extraction of permanent maxillary first molar in pediatric patients using cone-beam computed tomography (CBCT).
Materials and methods: In this study, 136 participants in the age-group of 11–18 years were included. The participants were divided into two groups. Group A consisted of patients who underwent extraction of the permanent maxillary first molars. Group B consisted of patients who underwent endodontic microsurgery in the periapical area. Group A included 68 participants while group B also included 68 study subjects. The expansion of the maxillary antrum was obtained after evaluating the change in volume of maxillary antrum at 6 months and 24 months in relation to the volume of maxillary antrum at the time of the procedure (baseline). For calculating the volume of the maxillary antrum, three parameters were taken into consideration. These parameters were an anteroposterior (AP) dimension, mesiodistal dimension (MD), and superoinferior (SI) dimension. Cone-beam computed tomography was used for carrying out these measurements with the help of Dolphin software.
Results: An expansion of 675.27 ± 32 mm3 was observed in group A between baseline and 6 months of extraction, while the expansion of 765.47 ± 24 mm3 was observed between 6 months and 24 months of extraction. This intragroup difference was statistically significant (p = 0.001). On the other hand, an expansion of 652.28 ± 43 mm3 was observed in group B between baseline and 6 months after periapical surgery and expansion of 969.43 ± 12 mm3 was observed between 6 months and 24 months after periapical endodontic surgery. This intragroup difference was statistically significant. In the control group, an expansion of 152.11 ± 12.101 mm3 was observed between baseline and 6 months after procedures while an expansion of 347.01 ± 6.781 mm3 was observed between 6 months and 24 months of procedures. The intragroup difference was significant statistically.
Conclusion: In this study, expansion of maxillary antrum was observed in both extraction of the maxillary permanent first molar in pediatric patients and the periapical endodontic surgery, and the expansion of maxillary antrum was more in cases of periapical endodontic surgery; however, the difference was non-significant statistically.
Clinical significance: Maxillary antrum expansion is clinically important during maxillary permanent tooth extraction or endodontic periapical surgery in pediatric patients because the growth of maxillary bones is in the growing stage in these patients. There are certain limitations of conventional two-dimensional (2D) radiographic techniques such as shortening, elongation, and superimposition of images. Recently, three-dimensional technique (3D) such as CBCT has been introduced in which these disadvantages have been eliminated.
Anderhuber W, Weiglein A, Wolf G. Nasal cavities and paranasal sinuses in newborns and children. Acta Anat (Basel) 1992;144(2): 120–126. PMID: 1514369.
Kilic C, Kamburoglu K, Yuksel SP, et al. An assessment of the relationship between the maxillary antrum floor and the maxillary posterior teeth root tips using dental cone-beam computerized tomography. Eur J Dent 2010;4(4):462–467. PMCID: PMC2948741.
Karakas S, Kavakli A. Morphometric examination of the paranasal sinuses and mastoid air cells using computed tomography. Ann Saudi Med 2005;25(1):41–45. DOI: 10.5144/0256-4947.2005.41.
Tatum H Jr. Maxillary and antrum implant reconstructions. Dent Clin N Am 1986;30(2):207–229. PMID: 3516738.
Chanavaz M. Maxillary antrum: anatomy, physiology, surgery, and bone grafting related to implantology: eleven years of surgical experience. J Oral Implantol 1990;16(3):199–209. PMID: 2098563.
Kubilius M, Kubilius R, Gleiznys A. The preservation of alveolar bone ridge during tooth extraction. Stomatologija 2012;14(1):3–11. PMID: 22617329.
Ludlow JB, Davies–Ludlow LE, Brooks SL, et al. Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol 2006;35(4):219–226. DOI: 10.1259/dmfr/14340323.
Göçmen G, Borahan MO, Aktop S, et al. Effect of septal deviation, Concha Bullosa and Haller's Cell on maxillary antrum's inferior pneumatization; a retrospective study. Open Dent J 2015;9:282–286. DOI: 10.2174/1874210601509010282.
Sharma KS, Jahen M, Kumar A. Measurements of maxillary antrum volume and dimensions by computed tomography scan for gender determination. J Anat Soc India 2014;63(1):36–42. DOI: 10.1016/j.jasi. 2014.04.007.
Sharan A, Madjar D. Maxillary antrum pneumatization following extractions: a radiographic study. Int J Oral Maxillofac Implants 2008;23(1):48–56. PMID: 18416412.
Tolstunov L, Thai D, Arellano L. Implant-guided volumetric analysis of edentulous maxillary bone with cone-beam computerized tomography scan. Maxillary antrum pneumatization classification. J Oral Implantol 2012;38(4):377–390. DOI: 10.1563/AAID-JOI-D-11- 00212.
Schropp L, Wenzel A, Kostopoulos L, et al. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 2003;23(4):313–323. PMID: 12956475.
Al-Zahrani MS, Al-Ahmari MM, Al-Zahrani AA, et al. Prevalence and morphological variations of maxillary sinus septa in different age groups: a CBCT analysis. Ann Saudi Med 2020;40(3):200–206. DOI: 10.5144/0256-4947.2020.200.
Wehrbein H, Diedrich P. The initial morphological state in the basally pneumatized maxillary antrum–a radiological-histological study in man. Fortschr Kieferorthop 1992;53(5):254–262. In German. DOI: 10.1007/BF02325074.
Ariji Y, Kuroki T, Moriguchi S, et al. Age changes in the volume of the human maxillary antrum: a study using computed tomography. Dentomaxillofac Radiol 1994;2(3)3:163–168. DOI: 10.1259/dmfr.23.3. 7835518.
Harorh, A, Bocutoglu O. The comparison of vertical height and width of maxillary antrum by means of Waters’ view radiograms taken from dentate and edentulous cases. Ann Dent 1995;54(1–2):47–49. PMID: 8572547.
Ohba T, Langlais RP, Morımoto Y, et al. Maxillary antrum floor in edentulous and dentate patients. Indian J Dent Res 2001;12:121–125. PMID: 11808062.
Rushton VE, Horner K, Worthington HV. Screening panoramic radiology of adults in general dental practice: radiological findings. Br Dent J 2001;190(9):495–501. DOI: 10.1038/sj.bdj.4801014.
Goldman M, Pearson AH, Darzenta N. Endodontic success: who's reading the radiograph? Oral Surg Oral Med Oral Pathol 1972;33(3): 432–437. DOI: 10.1016/0030-4220(72)90473-2.
Farman AG. Image guidance: the present future of dental care. Pract Proced Aesthet Dent 2006;18(6):342–344. PMID: 16933530.
Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc 2006; 72(1):75–80. PMID: 16480609.
Ludlow JB, Davies–Ludlow LE, Brooks SL. Dosimetry of two extraoral direct digital imaging devices: NewTom cone-beam CT and Orthophos Plus DS panoramic unit. Dentomaxillofac Radiol 2003;32(4):229–234. DOI: 10.1259/dmfr/26310390.
Roberts JA, Drage NA, Davies J, et al. Effective dose from cone-beam CT examinations in dentistry. Br J Radiol 2009;82(973):35–40. DOI: 10.1259/bjr/31419627.
Shahbazian M, Xue D, Hu Y, et al. Spiral computed tomography based maxillary antrum imaging in relation to tooth loss, implant placement and potential grafting procedure. J Oral Maxillofac Res 2010;1(1):e7. DOI: 10.5037/jomr.2010.1107.
Kocak N, Alpoz E, Boyacıoglu H. Morphological Assessment of Maxillary Sinus Septa Variations with Cone-Beam Computed Tomography in a Turkish Population. Eur J Dent 2019;13(1):42–46. DOI: 10.1055/s-0039-1688541.
Xie Q, Soikkonen K, Wolf J, et al. Effect of head positioning in panoramic radiography on vertical measurements: an in vitro study. Dentomaxillofac Radiol 1996;25(2):61–66. DOI: 10.1259/dmfr.25.2.9446974.
Engstrom H, Chamberlain D, Kiger R, et al. Radiographic evaluation of the effect of initial periodontal therapy on thickness of the maxillary antrum mucosa. J Periodontol 1988;59(9):604–608. DOI: 10.1902/jop.19220.127.116.114.
Bartee BK. Extraction site reconstruction for alveolar ridge preservation. Part 2: membrane-assisted surgical technique. J Oral Implantol 2001;27:194–197. DOI: 10.1563/1548-1336(2001)027 2.3.CO;2.
Shah RA, Mitra DK, Rodrigues SV, et al. Implants in adolescents. J Indian Soc Periodontol 2013;17:546–548. DOI: 10.4103/0972-124X.118335.
Op Heij DG, Opdebeeck H, van Steenberghe D, et al. Age as compromising factor for implant insertion. Periodontol 2003;33:172–184. DOI: 10.1046/j.0906-6713.2003.03314.x.
Loubele M, Bogaerts R, Van Dijck E, et al. Comparison between effective radiation dose of CBCT and MSCT scanners for dentomaxillofacial applications. Eur J Radiol 2009;71(3):461–468. DOI: 10.1016/j.ejrad. 2008.06.002.