BACKGROUND AND AIM: Implant planning in the posterior maxilla is traditionally centered around the maxillary sinus; however, the nasal floor may represent the primary cortical contact in some cases. This study aimed to determine the prevalence of nasal dominance, equal relationship, and sinus dominance patterns using CBCT and to demonstrate the clinical significance of nasal dominance through an illustrative case report. MATERIALS AND METHODS: A total of 1993 CBCT images were retrospectively screened. After exclusion criteria, 1133 patients (525 male, 608 female; mean age 37.8 years) were included. Right and left maxillary first molar regions were independently evaluated on coronal CBCT sections, yielding 2266 sites classified as sinus dominance, nasal dominance, or equal relationship. RESULTS: Sinus dominance was the predominant pattern (93.3%), followed by equal relationship (5.2%) and nasal dominance (1.5%). Nasal dominance was approximately four times more frequent in females than males. An illustrative case treated via crestal nasal floor elevation demonstrated stable osseointegration at 70 months. CONCLUSION: Nasal dominance is a rare but clinically significant variant that may fundamentally alter the surgical approach in posterior maxillary implant planning. CBCT evaluation is essential for its identification. Demographic associations observed in this study should be interpreted cautiously given the limited case numbers.
Kaygisiz et al. (Fri,) studied this question.