{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T08:40:20Z","timestamp":1778575220962,"version":"3.51.4"},"reference-count":44,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T00:00:00Z","timestamp":1714176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The upper posterior teeth are typically regarded as being exclusively inferior to the maxillary sinus (MS). The expansion of the nasal fossa above the maxillary alveolar base (MAB) needs better investigation. The hypothesis was raised that the MAB in the upper premolar region, which is usually addressed by surgeons for the elevation of the antral floor, is not exclusively beneath the MS. Therefore, we aimed to document the possible upper relations of the MAB as antral, nasal, or both. Materials and Methods: A total of 145 CBCT scans were used to study four types of MAB: type 1\u2014antral; type 2\u2014antral with a palatal recess; type 3\u2014antral and nasal; type 4\u2014nasal. In type 2, the orthoradial width of the alveolar bone, the rectilinear width of the antral floor, and the maximum depth of the palatal recess were measured. For type 3, the MAB width and the straight widths of the antral and nasal segments of the MAB were measured. Results: Type 1 was found in 67.24%, type 2 in 13.45%, type 3 in 16.21%, and type 4 in 3.1% of the 290 MSs investigated. Palatal recesses were found in 11.72% of the MSs on the right side and 15.17% of the MSs on the left side. Types 1 and 2 exhibited strongly statistically significant bilateral symmetry (Pearson\u2019s Chi2 = 86.42, p &lt; 0.001). Type 3 correlated equally with contralateral types 1 and 3. The bilateral symmetry for types 1\u20133 was stronger in the males (Pearson\u2019s Chi2 = 47.83, p &lt; 0.001) than in the females (Pearson\u2019s Chi2 = 56.96, p &lt; 0.001). There were no statistically significant associations between sex and the unilateral anatomical type. Conclusions: The MAB in the upper second premolar area should not be considered to be exclusively antral during surgeries or in anatomical teaching.<\/jats:p>","DOI":"10.3390\/medicina60050726","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T07:04:14Z","timestamp":1714633454000},"page":"726","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Anatomical Possibilities of the Alveolar Bone at the Upper Second Premolar Level"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8646-6157","authenticated-orcid":false,"given":"Alexandru Nicolae","family":"Mure\u015fan","sequence":"first","affiliation":[{"name":"Division of Anatomy, Department 1, Faculty of Dentistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy, RO-020021 Bucharest, Romania"},{"name":"Research Department, \u201cDr. Carol Davila\u201d Central Military Emergency Hospital, RO-010825 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol Antonio","family":"Dandoczi","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Department 1, Faculty of Dentistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy, RO-020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4655-4574","authenticated-orcid":false,"given":"R\u0103zvan Costin","family":"Tudose","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Department 1, Faculty of Dentistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy, RO-020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4130-9402","authenticated-orcid":false,"given":"Sorin","family":"Hostiuc","sequence":"additional","affiliation":[{"name":"Division of Legal Medicine and Bioethics, Faculty of Dentistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy, RO-020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8723-0540","authenticated-orcid":false,"given":"Mugurel Constantin","family":"Rusu","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Department 1, Faculty of Dentistry, \u201cCarol Davila\u201d University of Medicine and Pharmacy, RO-020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1055\/s-0039-1697866","article-title":"An Assessment of the Relationship between the Maxillary Sinus Floor and the Maxillary Posterior Teeth Root Tips Using Dental Cone-beam Computerized Tomography","volume":"4","author":"Kilic","year":"2010","journal-title":"Eur. J. Dent."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"618","DOI":"10.5005\/jp-journals-10024-1589","article-title":"Assessment of the relationship between the maxillary sinus floor and maxillary posterior teeth roots using cone beam computed tomography","volume":"15","author":"Shokri","year":"2014","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1016\/j.joen.2015.08.011","article-title":"Proximity of Posterior Teeth to the Maxillary Sinus and Buccal Bone Thickness: A Biometric Assessment Using Cone-beam Computed Tomography","volume":"41","author":"Kang","year":"2015","journal-title":"J. Endod."},{"key":"ref_4","first-page":"485","article-title":"The maxillary sinus floor in the oral implantology","volume":"49","author":"Nimigean","year":"2008","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101677","DOI":"10.1016\/j.jormas.2023.101677","article-title":"Simultaneous sinus elevation and immediate implant placement without biomaterial: A technical note","volume":"125","author":"Guillou","year":"2024","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1111\/jcpe.13947","article-title":"Clinical outcomes and risk factor analysis of dental implants inserted with lateral maxillary sinus floor augmentation: A 3- to 8-year retrospective study","volume":"51","author":"Zhang","year":"2024","journal-title":"J. Clin. Periodontol."},{"key":"ref_7","first-page":"86","article-title":"The Causes of Dental Implant Migration into the Maxillary Sinus: A Case Series Study from 25 Years of Experience","volume":"25","author":"Mohammadi","year":"2024","journal-title":"J. Dent."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Ilie, A.C., Jianu, A.M., Rusu, M.C., and Muresan, A.N. (2022). Anatomical Changes in a Case with Asymmetrical Bilateral Maxillary Sinus Hypoplasia. Medicina, 58.","DOI":"10.3390\/medicina58050564"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.jare.2013.06.006","article-title":"Three-dimensional linear and volumetric analysis of maxillary sinus pneumatization","volume":"5","author":"Hamdy","year":"2014","journal-title":"J. Adv. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.ijom.2003.10.012","article-title":"Topographic anatomy of the inferior wall of the maxillary sinus in Koreans","volume":"33","author":"Kwak","year":"2004","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1111\/cid.13086","article-title":"Complications of sinus floor elevation procedure and management strategies: A systematic review","volume":"24","author":"Hsu","year":"2022","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_12","first-page":"e47941","article-title":"The Impact of Artificial Intelligence on Dental Implantology: A Narrative Review","volume":"15","author":"Altalhi","year":"2023","journal-title":"Cureus"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1007\/s00405-019-05383-y","article-title":"Three-dimensional evaluation of maxillary sinus volume in different age and sex groups using CBCT","volume":"276","author":"Colak","year":"2019","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"431","DOI":"10.5115\/acb.21.051","article-title":"Volumetric growth analysis of maxillary sinus using computed tomography scan segmentation: A pilot study of Indonesian population","volume":"54","author":"Sarilita","year":"2021","journal-title":"Anat. Cell Biol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jasi.2014.04.007","article-title":"Measurements of maxillary sinus volume and dimensions by computed tomography scan for gender determination","volume":"63","author":"Sharma","year":"2014","journal-title":"J. Anat. Soc. India"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1563\/AAID-JOI-D-11-00212","article-title":"Implant-guided volumetric analysis of edentulous maxillary bone with cone-beam computerized tomography scan. Maxillary sinus pneumatization classification","volume":"38","author":"Tolstunov","year":"2012","journal-title":"J. Oral. Implantol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Gu, Y., Sun, C., Wu, D., Zhu, Q., Leng, D., and Zhou, Y. (2018). Evaluation of the relationship between maxillary posterior teeth and the maxillary sinus floor using cone-beam computed tomography. BMC Oral Health, 18.","DOI":"10.1186\/s12903-018-0626-z"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1007\/s00276-014-1317-3","article-title":"Evaluation of the relationship between the maxillary posterior teeth and the sinus floor using cone-beam computed tomography","volume":"36","author":"Ok","year":"2014","journal-title":"Surg. Radiol. Anat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4103\/JCD.JCD_530_18","article-title":"Evaluation of the relationship between the maxillary sinus floor and the root apices of the maxillary posterior teeth using cone-beam computed tomographic scanning","volume":"22","author":"Razumova","year":"2019","journal-title":"J. Conserv. Dent."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1097\/ID.0b013e31827464fc","article-title":"Topographic analysis of maxillary premolars and molars and maxillary sinus using cone beam computed tomography","volume":"21","author":"Yoshimine","year":"2012","journal-title":"Implant Dent."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1259\/dmfr.25.1.9084281","article-title":"Computed tomographic indices for maxillary sinus size in comparison with the sinus volume","volume":"25","author":"Ariji","year":"1996","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1007\/s00784-018-2552-5","article-title":"Is the pneumatisation of the maxillary sinus following tooth loss a reality? A retrospective analysis using cone beam computed tomography and a customised software program","volume":"23","author":"Schriber","year":"2019","journal-title":"Clin. Oral Investig."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Haj Yahya, B., Bar-Hai, D., Samehov, D., Chaushu, G., and Hamzani, Y. (2021). Sinus Augmentation-Expect the Unexpected: Diagnostic Anatomical Study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10194293"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Albadani, M.M., Elayah, S.A., Al-Wesabi, M.A., Al-Aroomi, O.A., Al Qadasy, N.E., and Saleh, H. (2024). A graftless maxillary sinus lifting approach with simultaneous dental implant placement: A prospective clinical study. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-03949-9"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/cid.12606","article-title":"New classification of maxillary sinus contours and its relation to sinus floor elevation surgery","volume":"20","author":"Niu","year":"2018","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e07927","DOI":"10.1016\/j.heliyon.2021.e07927","article-title":"Flapless Localised Management of Sinus Floor (LMSF) for trans-crestal sinus floor augmentation and simultaneous implant placement. A retrospective non-randomized study: 5-year of follow-up","volume":"7","author":"Bruschi","year":"2021","journal-title":"Heliyon"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"101432","DOI":"10.1016\/j.jormas.2023.101432","article-title":"Evaluation of maxillary palatal process pneumatization by cone-beam computed tomography","volume":"124","author":"Serindere","year":"2023","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1007\/s11282-021-00569-9","article-title":"Radioanatomic study of maxillary sinus palatal process pneumatization","volume":"38","author":"Gunacar","year":"2022","journal-title":"Oral Radiol"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1902\/jop.2012.120371","article-title":"Palatonasal Recess on Medial Wall of the Maxillary Sinus and Clinical Implications for Sinus Augmentation via Lateral Window Approach","volume":"84","author":"Chan","year":"2013","journal-title":"J. Periodontol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e279","DOI":"10.11607\/prd.3228","article-title":"Morphologic Patterns of the Atrophic Posterior Maxilla and Clinical Implications for Bone Regenerative Therapy","volume":"37","author":"Monje","year":"2017","journal-title":"Int. J. Periodont. Restorat. Dent."},{"key":"ref_31","first-page":"14815171","article-title":"Palatine recess of maxillary sinus masquerading as radiolucent lesion: Case report","volume":"3","author":"Omami","year":"2013","journal-title":"Libyan Dent. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"39","DOI":"10.21608\/adjalexu.2018.57621","article-title":"Palatal Versus Buccal Antral Approach for Maxillary Sinus Lifting and Implant Placement","volume":"43","author":"Khalil","year":"2018","journal-title":"Alex. Dent. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"254","DOI":"10.4103\/jisp.jisp_357_17","article-title":"Indications for palatal sinus lift: Case series","volume":"22","author":"Rahpeyma","year":"2018","journal-title":"J. Indian Soc. Periodontol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Jadach, R., Asa\u2019ad, F., Rasperini, G., and Osypko, K. (2024). Classifying Maxillary Sinuses of Polish Patients for Sinus Lift: A Pilot Study. Dent. J., 12.","DOI":"10.3390\/dj12020035"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/j.joms.2013.04.023","article-title":"Palatal sinus elevation revisited: A technical note","volume":"71","author":"Seemann","year":"2013","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"111","DOI":"10.11607\/prd.2545","article-title":"A Palatal Approach for a Sinus Augmentation Procedure","volume":"36","author":"Sarmiento","year":"2016","journal-title":"Int. J. Periodont. Restorat. Dent."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s40729-015-0018-y","article-title":"Palatal window osteotomy technique improves maxillary sinus augmentation in previously insufficient augmentation case","volume":"1","author":"Ueno","year":"2015","journal-title":"Int. J. Implant Dent."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/0278-2391(92)90411-R","article-title":"Nasal fossa and maxillary sinus grafting of implants from a palatal approach: Report of a case","volume":"50","author":"Jensen","year":"1992","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.bjoms.2015.05.009","article-title":"The nasal lift technique for augmentation of the maxillary ridge: Technical note","volume":"53","author":"Camargo","year":"2015","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_40","unstructured":"Misch, C.E., and Resnik, R. (2017). Misch\u2019s Avoiding Complications in Oral Implantology, Elsevier Health Sciences."},{"key":"ref_41","first-page":"132","article-title":"Three-dimensional radiograph revealing the big-nose variant before dental implant surgery in posterior maxilla: A rare case report","volume":"2","author":"Khoshhal","year":"2016","journal-title":"Int. J. Med. Res. Prof."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/cid.12877","article-title":"Long-term outcomes of the implants accidentally protruding into nasal cavity extended to posterior maxilla due to inferior meatus pneumatization","volume":"22","author":"Park","year":"2020","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s13005-023-00384-z","article-title":"Nasal cavity perforation by implant fixtures: Case series with emphasis on panoramic imaging of nasal cavity extending posteriorly","volume":"19","author":"Yeom","year":"2023","journal-title":"Head Face Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/clr.14063","article-title":"Convolutional neural network-based automated maxillary alveolar bone segmentation on cone-beam computed tomography images","volume":"34","author":"Fontenele","year":"2023","journal-title":"Clin. Oral Implant. Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/5\/726\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:34:45Z","timestamp":1760106885000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/5\/726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,27]]},"references-count":44,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["medicina60050726"],"URL":"https:\/\/doi.org\/10.3390\/medicina60050726","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,27]]}}}