Gingival Biotype and Its Relationship With the Maxillary Membrane and Lateral Wall Thickness

Evaluating the relationship between periodontal bone loss in maxillary posterior teeth and Schneiderian membrane thickness

BACKGROUND

To understand the potential impact of periodontal disease on maxillary sinus health, this study aimed to evaluate the relationship between periodontal bone loss and maxillary sinus membrane thickness using cone beam computed tomography (CBCT).

METHODS

Nine hundred thirty-nine maxillary posterior segment images from 527 subjects were retrospectively scanned via CBCT. A total of 826 premolar, 701 first molar and 817 s molar teeth were examined. The maxillary sinuses in each segment were divided into anterior, median and posterior regions according to the tooth roots they were associated with, and their membrane thicknesses were measured and categorized. The effects of age and gender on membrane thickness were evaluated. T tests and one-way ANOVA were used to analyze differences between groups, followed by post hoc Tukey tests for multiple comparisons. Additionally, correlation analyses were performed to investigate the relationships between the categorized membrane thicknesses and periodontal bone loss.

RESULTS

A significant positive correlation was found between maxillary sinus membrane thickness and periodontal bone loss in all three regions (p < 0.05). Periodontal bone loss was greater in regions with class IV membrane thickness (p < 0.001). Sinus membrane thickness and periodontal bone loss were greater in men and older people (p < 0.001).

CONCLUSIONS

This study found a relationship between maxillary sinus membrane thickness and bone loss due to periodontal disease in the maxillary posterior region. Considering the relationship between periodontal disease and sinus infections, it can be concluded that progressive and untreated periodontal disease may be associated with infections in close anatomical structures such as the maxillary sinus. These results may contribute to the development of clinical decisions and treatment plans in implantology practices.

Correlation between periodontal phenotype and sinus membrane thickness: A systematic review

AIM

To assess the correlation between the periodontal phenotype (PP) and sinus membrane thickness (SMT) in humans.

METHODS

This review was conducted according to the PRISMA guidelines. Two reviewers independently carried out electronic and manual literature searches of studies published in English, German, and Spanish, from 1970 to September 2022 in four electronic databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, in addition to gray literature. Studies that assessed the correlation between PP and SMT in adults (aged 18 years) were included. Methodological quality was evaluated using the Appraisal Tool for Cross-Sectional Studies (AXIS) for articles that met the eligibility criteria.

RESULTS

Six studies, including 510 patients, were considered for qualitative analysis. All included studies were cross-sectional, and the correlation between the PP and SMT was evaluated, finding a positive and high correlation in 83.3% of them, based on a value of ≥0.7. All the included studies were assessed with a high overall risk of bias.

CONCLUSIONS

Periodontal phenotype and sinus membrane thickness are likely correlated. Nevertheless, further standardized studies are required to draw definitive conclusions.

Association between smoking and Schneiderian membrane perforation during maxillary sinus floor augmentation: A systematic review and meta-analysis

OBJECTIVE

To estimate the association between smoking and Schneiderian membrane perforation in sinus floor augmentation.

MATERIALS AND METHODS

Searches were conducted in PubMed, Web of Science, Embase, and Cochrane Library. Data were extracted by two authors independently. The inclusion criteria were the (1) age of patients >18, (2) the number of participants >10, and (3) smoking and the patients of Schneiderian membrane perforation were accurately recorded. The risk of bias was assessed by the Newcastle-Ottawa scale (NOS). Statistics analyses were conducted using Reman5.4.1 and Stata (15.0). The association of Schneiderian membrane perforation with smoking habits during maxillary sinus floor elevation was expressed as odds ratios (ORs) with a 95% confidence interval (95% CIs). And the I2 statistic was used to estimate statistical heterogeneity. The funnel plot and Egger's tests were used to evaluate the reliability and stability of the results.

RESULTS

Of 1463 articles screened, nine studies were included in our systematic review, and eight were synthesized for meta-analysis. Eight were retrospective observational studies and one was a clinical trial, with a total of 1424 patients included. The nine studies were proved as high quality according to the NOS. There was no significant publication bias in the studies (p = 0.827). A random-effects model was used because of differences in the adopted methodologies (p = 0.39, I2  = 5%). During maxillary sinus augmentation, smoking and Schneiderian membrane perforation were associated (odds ratios, 1.58 [95% CI, 1.10-2.25]).

CONCLUSION

Smoking increased the risk of membrane perforation in maxillary sinus floor augmentation. Our evaluation was limited by the poor reporting of the number of cigarettes smoked per day (PROSPERO number was CRD42022306570).