O objetivo deste estudo foi realizar uma análise retrospectiva de imagens tomográficas dos seios maxilares, para avaliar a presença de espessamento e/ou alterações na mucosa sinusal, enfatizando a importância de um diagnóstico preciso no planejamento da cirurgia reconstrutiva dos seios maxilares. Material e métodos: entre agosto de 2010 e julho de 2019, foram examinadas as imagens tomográficas de 211 pacientes (94 homens e 117 mulheres), totalizando 355 seios maxilares divididos em cinco grupos, de acordo com a presença e espessura da mucosa sinusal. Resultados: 232 seios maxilares não apresentaram imagem de espessamento da mucosa sinusal e 123 seios (35%) apresentaram espessamentos que foram classificados de acordo com a medida apresentada. Em 57 seios, o espessamento foi associado a elementos dentários; em 66 seios, o espessamento não foi associado aos demais dentes. Conclusão: uma avaliação criteriosa durante o exame pré-operatório de pacientes com indicação de procedimentos cirúrgicos no seio maxilar é extremamente relevante. Durante o presente estudo, verificou-se que 35% dos seios maxilares examinados apresentavam lesões pré-existentes, sendo que alguns não apresentavam sinais e sintomas.

Bone morphogenetic protein (rhBMP-2) is a powerful osteo-inductive growth factor widely used in bone reconstruction and both the vehicle used to administer it and the scaffold substrate could determine its success in clinical situations. The aim was to analyse the clinical behaviour of dental implants placed in single alveolar ridges with a horizontal deficiency in the maxillary anterior region that were reconstructed horizontally with rhBMP-2 and porous hydroxyapatite (HA). Inclusion criteria were both males and females, between the ages of 18 and 29 with single tooth loss of one upper incisor. Cone Beam Computed Tomography (CBCT) was used to take measurements prior to bone augmentation and again prior to the implant insertion. Surgery was carried out under local anaesthetic. In the primary procedure. bone substitute was introduced using porous HA and rhBMP-2; after 4 to 5 months, dental implant surgery was carried out and the implant placed; after 3 months of consolidation the provisional prosthesis was placed and then a definitive restoration was placed. Variables were analysed using the t-test with a p-value of < 0.05 in order to assess statistical significance. Thirteen subjects were included (6 females and 7 males). Bone augmentation resulted in a bone gain of 4.15mm (p=0.023), which was shown to be statistically significant. All of the grafts placed were successful and 13 implants were placed, using torques between 30 and 70N, without complications. For the final prostheses, 11 vere screw retained and 2 were cemented in place. The horizontal bone augmentation using HA and rhBMP-2 is an efficient technique for single bone defects in the anterior maxillary area; clinical trials on a larger scale are needed to confirm these results.