{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:49:39Z","timestamp":1765176579707,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>An antral pseudocyst (AP) is a common well-defined \u2018dome-shaped\u2019 faintly radiopaque lesion of the maxillary sinus, and usually does not require treatment in asymptomatic patients. However, when sinus floor augmentation is required to increase bone volume for implant installation, the elevation of the sinus mucosa might drive the AP against the ostium. This might cause its obstruction and, as possible consequence, sinusitis. The purpose of this study was to investigate the clinical and tomographic conditions of APs to identify a predictable cyst removal that might allow a safety sinus floor augmentation. A total of 52 maxillary sinuses in 46 patients (mean age 55.1 years) presenting AP were examined by cone beam computed tomographies (CBCTs). A two-stage approach was applied. At the first surgery, the cystic lesions were further inspected by an endoscope through the antrostomy, and histopathological diagnosis of the removed tissues was carried out. After the confirmation of decrease of the swelling of sinus membrane by CBCT, the sinus floor augmentation was performed, at least four months after cyst removal. The color and transparency of the 86 cystic lesions were classified into 4 types. The whitish transparent cysts were 34 (39.5%), the yellowish transparent cysts were 18 (20.9%), the dark purple transparent cysts were 8 (9.3%) and the milky-white opaque cysts were 26 (30.2%). The contents of the 60 (69.8%) transparent cysts were serous fluid, but those of milky-white cysts were composed of viscous or elastic soft tissues, and the aspiration of the contents was unsuccessful. The analysis of the preoperative CBCT did not provide certainty on the contents of the cystic lesions. All cystic lesions were diagnosed as AP, and an infection was identified in one AP, presenting marked infiltration of the inflammatory cells. Considering the difficulties of performing a correct diagnosis of the AP content by a CBCT analysis, the risk of failure of the surgery that creates severe afflictions to the patients, and the necessity of a histological evaluation of the cyst, a two-stage surgery appeared to be the most reliable procedure.<\/jats:p>","DOI":"10.3390\/dj9100122","type":"journal-article","created":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T16:43:55Z","timestamp":1634575435000},"page":"122","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A Reliable Surgical Procedure for Sinus Floor Augmentation with Antral Pseudocysts"],"prefix":"10.3390","volume":"9","author":[{"given":"Yasuhiro","family":"Nosaka","sequence":"first","affiliation":[{"name":"Department of Oral Implantology, Osaka Dental University, Osaka 540-0008, Japan"},{"name":"Nosaka Oral Surgery Clinic, Japan. 2F Chambre-Ashiya, 11-17, Nishiyama-cho, Ashiya 659-0083, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitomi","family":"Nosaka","sequence":"additional","affiliation":[{"name":"Nosaka Oral Surgery Clinic, Japan. 2F Chambre-Ashiya, 11-17, Nishiyama-cho, Ashiya 659-0083, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Oral Implantology, Osaka Dental University, Osaka 540-0008, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadasuke","family":"Tanioka","sequence":"additional","affiliation":[{"name":"Department of Oral Implantology, Osaka Dental University, Osaka 540-0008, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2804-1632","authenticated-orcid":false,"given":"Daniele","family":"Botticelli","sequence":"additional","affiliation":[{"name":"ARDEC Academy, 47923 Rimini, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Oral Implantology, Osaka Dental University, Osaka 540-0008, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"ref_1","first-page":"11","article-title":"Report of the Sinus Consensus Conference of 1996","volume":"13","author":"Jensen","year":"1998","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/j.1600-051X.2008.01272.x","article-title":"A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation","volume":"35","author":"Pjetursson","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/0030-4220(84)90080-X","article-title":"Pseudocysts and retention cysts of the maxillary sinus","volume":"58","author":"Gardner","year":"1984","journal-title":"Oral Surg. Oral Med. Oral Pathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1054\/bjom.1999.0160","article-title":"Mucus retention cyst of the maxillary sinus: The endoscopic approach","volume":"38","author":"Hadar","year":"2000","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/0030-4220(81)90118-3","article-title":"Mucosal antral cysts. Review of the literature and report of a radiographic survey","volume":"51","author":"Allard","year":"1981","journal-title":"Oral Surg. Oral Med. Oral Pathol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1902\/jop.2005.76.3.461","article-title":"Prevalence of maxillary sinus disease and abnormalities in patients scheduled for sinus lift procedures","volume":"76","author":"Beaumont","year":"2005","journal-title":"J. Periodontol."},{"key":"ref_7","first-page":"110","article-title":"ENT assessment in the integrated management of candidate for (maxillary) sinus lift","volume":"28","author":"Pignataro","year":"2008","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/0030-4220(76)90251-6","article-title":"A clinical study of cysts arising from mucosa of the maxillary sinus","volume":"41","author":"Gothberg","year":"1976","journal-title":"Oral Surg. Oral Med. Oral Pathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/039463200802100129","article-title":"Sinus augmentation procedure of the jaw sinus in patients with mucocele","volume":"21","author":"Perfetti","year":"2008","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.tripleo.2006.03.008","article-title":"Maxillary sinus augmentation in the presence of antral pseudocyst: A clinical approach","volume":"103","author":"Mardinger","year":"2007","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s40902-016-0081-1","article-title":"Clinical evaluation of sinus bone graft in patients with mucous retention cyst","volume":"38","author":"Kim","year":"2016","journal-title":"Maxillofac. Plast. Reconstr. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1016\/j.ijom.2015.07.009","article-title":"Sinus grafting and simultaneous removal of large antral pseudocysts of the maxillary sinus with a micro-invasive intraoral access","volume":"44","author":"Chiapasco","year":"2015","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2856","DOI":"10.1016\/j.joms.2010.05.091","article-title":"Maxillary sinus augmentation following removal of a maxillary sinus pseudocyst after a shortened healing period","volume":"68","author":"Lin","year":"2010","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_14","first-page":"26","article-title":"Complications of postoperative swelling of the maxillary sinus membrane after sinus floor augmentation","volume":"1","author":"Nosaka","year":"2015","journal-title":"J. Oral Sci. Rehabil."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e12362","DOI":"10.1111\/jicd.12362","article-title":"Influence of the position of the antrostomy in sinus floor elevation assessed with cone-beam computed tomography: A randomized clinical trial","volume":"9","author":"Kawakami","year":"2018","journal-title":"J. Investig. Clin. Dent."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"223","DOI":"10.11607\/jomi.7112","article-title":"Influence of the height of the antrostomy in sinus floor elevation assessed by cone beam computed tomography- a randomized clinical trial","volume":"34","author":"Kawakami","year":"2019","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s40729-019-0183-5","article-title":"Tomographic evaluation of the influence of the placement of a collagen membrane subjacent to the sinus mucosa during maxillary sinus floor augmentation: A randomized clinical trial","volume":"5","author":"Hirota","year":"2019","journal-title":"Int. J. Implant. Dent."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"350","DOI":"10.11607\/jomi.7843","article-title":"Tomographic assessment on the influence on dimensional variations of the use of a collagen membrane to protect the antrostomy after maxillary sinus floor augmentation. A randomized clinical trial","volume":"35","author":"Imai","year":"2020","journal-title":"Int. J. Oral Maxillofac. Implants."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s40729-020-00233-7","article-title":"Involvement of the maxillary sinus ostium (MSO) in the edematous processes after sinus floor augmentation: A cone-beam computed tomographic study","volume":"6","author":"Sakuma","year":"2020","journal-title":"Int. J. Implant Dent."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kato, S., Omori, Y., Kanayama, M., Hirota, A., Ferri, M., Apaza Alccayhuaman, K.A., and Botticelli, D. (2021). Sinus Mucosa Thickness Changes and Ostium Involvement After Maxillary Sinus Floor Elevation in Sinus with Septa. A Cone Beam Computed Tomography Study. Dent. J., 9.","DOI":"10.3390\/dj9080082"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.aanat.2019.07.003","article-title":"Anatomical analyses for maxillary sinus floor augmentation with a lateral approach: A cone beam computed tomography study","volume":"226","author":"Kawakami","year":"2019","journal-title":"Ann. Anat."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Omori, Y., Nakajima, Y., Imai, H., Yonezawa, D., Ferri, M., Apaza Alccayhuaman, K.A., and Botticelli, D. (2021). Influence of Anatomical Parameters on the Dimensions of the Subantral Space and Sinus Mucosa Thickening after Sinus Floor Elevation. A Retrospective Cone Beam Computed Tomography Study. Dent. J., 9.","DOI":"10.3390\/dj9070076"}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/9\/10\/122\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:17:04Z","timestamp":1760167024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/9\/10\/122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,18]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["dj9100122"],"URL":"https:\/\/doi.org\/10.3390\/dj9100122","relation":{},"ISSN":["2304-6767"],"issn-type":[{"type":"electronic","value":"2304-6767"}],"subject":[],"published":{"date-parts":[[2021,10,18]]}}}