IMAGISTIC INVESTIGATIONS OF FRONTAL SINUS ARCHITECTURE AND PATHOLOGY – AN INTERDISCIPLINARY APPROACH TO PRACTICAL DENTISTRY

Abstract

In order to determine the effects of frontal sinus morphology on the morpho-functionality of the dento-maxillary apparatus and the therapeutic management of pathologies in the orthodontic or maxillofacial surgery area, paraclinical evaluation is extremely important. During time, radiography – a relatively old method, allowed complex explorations of the extreme cephalic area, providing details of cephalometric and facial indexes and information regarding the pneumatization and neuro- and viscera-cranium at the same time. Aim: This manuscript focuses on the correlation of elements related to craniofacial anomalies, in which frontal sinus malformations hold a particularly important place, with various dental anomalies which are particularly important aspects in optimizing the diagnostic and therapeutic protocol in both, orthodontic and orthognathic surgical approaches. Materials and methods: We set out to examine the frontal sinus, including a number of 112 patients, aged 4 to 78 years old, with malocclusions, the research being performed in the Radiology Clinic of Emergency Clinical Hospital “Sf. Spiridon” Iasi, during 2018-2020. We used in our research the landmarks represented by the frontal median septum and the upper orbital margin, on the basis of which we calculated the dimensions of the frontal sinus. The cases were as follows: 66 women (58,9%) and 46 men (41,1%), and age distribution was as follows: •4 – 9 years (20 cases – 17,9%); •10 – 19 years (22 cases – 19,6%); •20 – 45 years (31 cases – 27,7%); •46 – 60 years (19 cases – 17,0%); •over 60 years (20 cases – 17,9%). Results and discussions: The data obtained in our study are superimposable on those found in the literature, noting a frequency of absence of bilateral frontal sinus in 9,8% of cases, the elements of specificity belonging to the percentage of 6,1% for women and 15,2% for men, all cases being between 5-15 years. There are not significant differences between the planimetric measurements at patients with sinusitis compared with the others; instead, we found statistically significant differences between the planimetric measurements concerning the right sinus as well as the left sinus at the 3 classes of malocclusion – the patients in the I-st class have the smallest sinuses, the patients in the II-nd class have intermediary mesurements, while the patients in the III-rd class have the biggest measurements of the sinuses. Conclusions: In dental practice, cascading effects are extremely important, starting from frontal sinus malformations, which lead to different types of dento-dental anomalies, the implications being found in specific orthodontic therapy and orthognathic surgery.

Keywords

• frontal sinus; computer tomography; imaging in dentistry; malocclusion; oral complex rehabilitation;