Background: The sinus lift technique may be difficult to perform if an aberrant sinus anatomy is encountered during surgical exposure, such as when a septum is present on the sinus floor. The objective of this study was to determine the prevalence, size, location, and morphology of maxillary sinus septa in the atrophic/edentulous and non‐atrophic/dentate maxillary segments.Methods: The sample population consisted of 100 patients (41 women and 59 men, with a mean age of 50 years, ranging between 19 and 87 years) for whom treatment was being planned for implant‐supported restorations. Reformatted computerized tomograms (CT) from 200 sinuses were analyzed using imaging software.Results: The prevalence of one or more septa per sinus was found to be 26.5% (53/200), 31.76% (27/85), and 22.61% (26/115) in the overall study population and the atrophic/edentulous and the non‐atrophic/dentate maxillary segments, respectively. In the analysis of the anatomic location of the septa within the sinus, it was revealed that 15 (25.4%) were located in the anterior region, 30 (50.8%) in the middle region, and 14 (23.7%) in the posterior region. The measured heights of the septa varied among the different areas. The mean heights of the septa were 1.63 ± 2.44, 3.55 ± 2.58, and 5.46 ± 3.09 mm in the lateral, middle, and medial areas, respectively.Conclusions: It can be inferred that there is a wide anatomical variation in the prevalence, size, location, and morphology of maxillary sinus septa, irrespective of the degree of atrophy. Therefore, to prevent the likelihood of complications arising during sinus augmentation procedures, a thorough and extensive understanding of the anatomic structures inherent to the maxillary sinus is indispensable.

Sohn JY, et al. J Periodontal Implant Sci. 2010 Aug;40(4):180-187. https://doi.org/10.5051/jpis.2010.40.4.180

Background: Periodontal plastic surgery is used to fulfill the esthetic and functional demands of patients. The palatal masticatory mucosa is the main donor site for connective tissue, and the thickness of the graft tissue obtained is an important factor for the success of this technique. The aim of this study was to measure the thickness of masticatory mucosa in the posterior palatal area using computerized tomography (CT).Methods: The thickness measurements were performed on the images of 100 adult subjects who underwent CT on the maxilla for implant surgery. Twenty‐four standard measurement points were defined in the hard palate according to the gingival margin and the middle palatal suture. The radiographic measurements were used after calibration. The data were analyzed to determine the differences in the mucosal thickness according to gender, age, tooth position, and depth of the palatal vault.Results: The overall mean thickness of the palatal masticatory mucosa was 3.83 ± 0.58 mm (range: 2.29 to 6.25 mm). Females had significantly thinner mean masticatory mucosa (3.66 ± 0.52 mm) than males (3.95 ± 0.60 mm) (P <0.0001). The thickness of the palatal masticatory mucosa increased with age. The mean thickness according to tooth site was 3.46 mm (maxillary canine), 3.66 mm (first premolar), 3.81 mm (second premolar), 3.13 mm (first molar), 3.31 mm (the base of the interproximal papilla of the first and second molars), and 3.39 mm (second molar). There was an overall increase in the thickness of the palatal masticatory mucosa as the distance from the gingival margin to the middle palatine suture increased, with the exception of the Ca‐d (a point at 12 mm from the gingival margin of the canine) region. There was no significant difference in the thickness of the palatal masticatory mucosa between the groups with high or low palatal vaults.Conclusions: The palatal masticatory mucosa thickness increased from the canine to premolar region but decreased at the first molar region and increased again in the second molar region, with the thinnest area at the first molar region and the thickest at the second premolar region. The canine to premolar region seems to be the most appropriate donor site that contains a uniformly thick mucosa. CT can be considered an alternative method for the measurement of palatal soft tissue thickness.

Microneedles are emerging drug delivery methods for painless treatment. The current study tested dissolving microneedles containing lidocaine (Li-DMN) for use in local anesthesia. An Li-DMN patch was fabricated by centrifugal lithography with carboxymethyl cellulose as a structural polymer and assessed for physical properties by optical microscopy and a fracture force analyzer. The biocompatibility was evaluated by a histology section in vitro and by ear thickness in vivo. The efficacy of the Li-DMN patch was assessed by electrophysiological recordings in primary cultured sensory neurons in vitro and a von Frey test on rats’ hind paws in vivo. The physical properties of the microneedle showed enough rigidity for transdermal penetration. The maximal capacity of lidocaine-HCl in the Li-DMN patch was 331.20 ± 6.30 µg. The cytotoxicity of the dissolving microneedle to neuronal cells was negligible under an effective dose of lidocaine for 18 h. Electrophysiological recordings verified the inhibitory effect of the voltage-gated sodium channel current by the Li-DMN patch in vitro. A skin reaction to the edema test and histologic analysis of the rats’ ears after application of the Li-DMN patch were negligible. Also, the application of the Li-DMN patch reduced the nocifensive behavior of the rats almost immediately. In conclusion, the dissolving microneedle patch with carboxymethyl cellulose is a promising candidate method for the painless delivery of lidocaine-HCl.