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Clinical relevance: Tomographic analysis of the maxillary sinus and associated anatomical structures, such as the nasal cavity, is the most reliable resource for planning and carrying out implant-supported rehabilitation of the maxilla posterior region. That was a cross-sectional tomographic study of 58 totally edentulous adult patients, totaling 116 maxillary sinuses. The RadiAnt DICOM Viewer™ 2020.2 (64-bit) software was used to measure basal/alveolar widths and maxillary length, in addition to linear distances from the maxillary sinus and nasal cavity to calculate volumes. Results: There was no significant correlation between the maxillary sinus nasal cavity volumes (ρ=0.048 / p=0.609). The volume of the nasal cavity showed a significant difference between genders (p=0.007), bigger in males. Greater alveolar and basal maxillary widths correlated with greater maxillary sinus volume. Maxilla length was significantly correlated with nasal cavity volume (ρ=0.425 / p<0.001). Sinus membrane thickness was not significantly associated with maxillary sinus volume. There was no significant correlation between sinus thickness lateral wall and sinus membrane thickness.
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Measurements. Tomographic measures included linear measurements, in its greatest extension, of the maxillary sinus (lateral, anteroposterior and superior-inferior), maxilla basal/alveolar length and widths, and linear measurements of the nasal cavity (lateral-lateral, anteroposterior and upper-lower). Maxillary sinus. The right and left maxillary sinuses included in this study were measured from the anteroposterior, medial-lateral and skull-flow anatomical references. The measures were statistically categorized and correlated between their quartiles with the other variables. Maxillary sinus volume was calculated in cm3 through geometric calculation from linear tomographic measurements. The geometric equation used to calculate the volume of the maxillary sinus consisted of the multiplication between the linear measurements divided by 3. The linear measurements of the maxillary sinus were medial-lateral (M-L) - maximum distance between the inner portion of the lateral cortex and the inner portion of the medial cortex in the axial section; anteroposterior (A-P), represented by the maximum distance between the inner portion of the anterior cortex and the internal portion of the posterior cortex in the axial section; and height (H) - maximum distance between the lowest limit and the most superior limit of the maxillary sinus in the coronal section. Maxillary sinus lateral wall. The maxillary sinus lateral wall thickness measurements were performed from the images of the coronal tomographic sections on the right and left sides. Two reference points were selected in the lower-upper direction, with two height levels from the maxillary sinus floor (3 mm - H1 and 8 mm - H2) - region addressed for sinus floor lifting surgeries via the lateral window - having the zygomatic-alveolar crest as the anteroposterior anatomical reference. At both heights, a horizontal line was drawn up to the maxillary sinus lateral wall in order to form an angle of 90º and perform the measurement. Maxillary sinus membrane. The thickness of the maxillary sinus membrane (TMSM) was evaluated from the images of the coronal tomographic sections on the right and left sides of all patients at the same anatomical reference points used for measurements of the sinusal lateral wall thickness. Values greater than 3 mm were considered. Measurements were categorized into two groups: TMSM ≤3 mm and TMSM >3 mm. Maxillary length and width. To measure the length of the maxilla, the distance between the anterior nasal spine point (ANS) and the posterior nasal spine point (PNS) in the sagittal section was considered. To measure the basal width - at the level of the maxillary palatine process - the linear distance between the right and left points of the lower limit of the nasal cavity floor perpendicular to the median sagittal plane was selected, in the coronal section, having as an anatomical reference - posterior to the zygomatic-maxillary crest.