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Underwood's septa - Wikipedia

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<div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color:dimgray; color: white">Underwood's septa</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Gray862.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7b/Gray862.png/250px-Gray862.png" decoding="async" width="250" height="198" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7b/Gray862.png/375px-Gray862.png 1.5x, //upload.wikimedia.org/wikipedia/commons/7/7b/Gray862.png 2x" data-file-width="500" data-file-height="395" /></a></span><div class="infobox-caption">Specimen from a child eight years, eight months, and one day old. Lateral view of frontal, ethmoidal and maxillary sinus areas, the lateral portion of each having been removed by sagittal cuts. ("Maxillary septa" labeled at center left.)</div></td></tr><tr><td colspan="2" class="infobox-below"><a href="/wiki/Anatomical_terminology" title="Anatomical terminology">Anatomical terminology</a><div style="text-align: right;"><small class="noprint">&#91;<a href="https://www.wikidata.org/wiki/Q7883898" class="extiw" title="d:Q7883898">edit on Wikidata</a>]</small></div></td></tr></tbody></table> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:UnderwoodCollage.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/6/69/UnderwoodCollage.jpg/250px-UnderwoodCollage.jpg" decoding="async" width="250" height="487" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/6/69/UnderwoodCollage.jpg/375px-UnderwoodCollage.jpg 1.5x, //upload.wikimedia.org/wikipedia/en/6/69/UnderwoodCollage.jpg 2x" data-file-width="379" data-file-height="738" /></a><figcaption>A short <a href="/wiki/Underwood%27s_septum" class="mw-redirect" title="Underwood&#39;s septum">Underwood's septum</a> on the floor of the left <a href="/wiki/Maxillary_sinus" title="Maxillary sinus">maxillary sinus</a>, depicted in a regular dental x-ray film (top), a photograph taken during a sinus augmentation procedure (middle) and in a <a href="/wiki/Cone_beam_computed_tomography" title="Cone beam computed tomography">cone beam CT scan</a> taken for preoperative evaluation (bottom).</figcaption></figure> <p>In <a href="/wiki/Anatomy" title="Anatomy">anatomy</a>, <b>Underwood's septa</b> (or <b>maxillary sinus septa</b>, singular <i><b>septum</b></i>)<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> are fin-shaped projections of <a href="/wiki/Bone" title="Bone">bone</a> that may exist in the <a href="/wiki/Maxillary_sinus" title="Maxillary sinus">maxillary sinus</a>, first described in 1910 by Arthur S. Underwood, an anatomist at <a href="/wiki/King%27s_College_London" title="King&#39;s College London">King's College</a> in <a href="/wiki/London" title="London">London</a>.<sup id="cite_ref-UNDER_3-0" class="reference"><a href="#cite_note-UNDER-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> The presence of septa at or near the floor of the sinus are of interest to the <a href="/wiki/Dentist" title="Dentist">dental clinician</a> when proposing or performing <a href="/wiki/Sinus_lift" title="Sinus lift">sinus floor elevation procedures</a> because of an increased likelihood of <a href="/wiki/Surgical_complication" class="mw-redirect" title="Surgical complication">surgical complications</a>, such as tearing of the <a href="/wiki/Schneiderian_membrane" title="Schneiderian membrane">Schneiderian membrane</a>.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> </p><p>The <a href="/wiki/Prevalence" title="Prevalence">prevalence</a> of Underwood's septa in relation to the floor of the maxillary sinus has been reported at nearly 32%.<sup id="cite_ref-ULM_5-0" class="reference"><a href="#cite_note-ULM-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Location_of_septa_in_the_sinus">Location of septa in the sinus</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Underwood%27s_septa&amp;action=edit&amp;section=1" title="Edit section: Location of septa in the sinus"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Underwood divided the maxillary sinus into three regions relating to zones of distinct tooth eruption activity: anterior (corresponding to the premolars), middle (corresponding to the first molar) and posterior (corresponding to the second molar). Thus, he asserted, these septa always arise between teeth and never opposite the middle of a tooth.<sup id="cite_ref-UNDER_3-1" class="reference"><a href="#cite_note-UNDER-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> </p><p>Different studies reveal a different predisposition for the presence of septa based on sinus region: </p> <ul><li>Anterior: Ulm, et al.,<sup id="cite_ref-ULM_5-1" class="reference"><a href="#cite_note-ULM-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> Krennmair et al.<sup id="cite_ref-KRENNMAIR_6-0" class="reference"><a href="#cite_note-KRENNMAIR-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup></li> <li>Middle: Velásquez-Plata et al.,<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> Kim et al.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> and González-Santana et al.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup></li> <li>Posterior: Underwood<sup id="cite_ref-UNDER_3-2" class="reference"><a href="#cite_note-UNDER-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Primary_vs._secondary_septa">Primary vs. secondary septa</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Underwood%27s_septa&amp;action=edit&amp;section=2" title="Edit section: Primary vs. secondary septa"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Recent studies have classified two types of maxillary sinus septa: primary and secondary. <i>Primary septa</i> are those initially described by Underwood and that form as a result of the floor of the sinus sinking along with the roots of <a href="/wiki/Tooth_eruption" title="Tooth eruption">erupting teeth</a>; these primary septa are thus generally found in the sinus corresponding to the space between teeth, as explained by Underwood. Conversely, <i>secondary septa</i> form as a result of irregular pneumatization of the sinus following loss of maxillary posterior teeth.<sup id="cite_ref-KRENNMAIR_6-1" class="reference"><a href="#cite_note-KRENNMAIR-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> <i>Sinus pneumatization</i> is a poorly understood phenomenon that results in an increased volume of the maxillary sinus, generally following maxillary posterior tooth loss, at the expense of the bone which used to house the roots of the maxillary posterior teeth. </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Underwood%27s_septa&amp;action=edit&amp;section=3" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output 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href="#cite_ref-1">^</a></b></span> <span class="reference-text">Maestre-Ferrín L, et al. <u><a rel="nofollow" class="external text" href="http://www.medicinaoral.com/pubmed/medoralv15_i2_p383.pdf">Maxillary sinus septa: a systematic review</a></u>. <i>Med Oral Patol Oral Cir Bucal</i> 2010;<b>15</b>(2):e383–6. <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output 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