CBCT Evaluation of Periapical Pathologies in Maxillary Posterior Teeth and Their Relationship with Maxillary Sinus Mucosal Thickening

Abstract

In modern dentistry, radiographic imaging is crucial for examining the connection between the maxillary sinus floor and the root apices of the maxillary posterior teeth, particularly when the periapical region is affected by pathology that could result in infectious, inflammatory, or traumatic changes in the maxillary sinus. This study aimed to investigate the prevalence of periapical pathologies in the maxillary posterior teeth and their relationship with maxillary sinus mucosal thickening by using cone-beam computed tomography scans. This retrospective study was conducted on 420 digitized CBCT images which were scanned in sagittal, axial, and coronal views. Out of 420 total images, 223 (53.1%) were of males and 197 (44.9%) were of females. The data were analyzed using SPSS version 28. A total of 2936 posterior maxillary teeth were tested for periapical pathology (PP), 1477 on the right side and 1459 on the left side. In terms of gender, there was no significant relationship between PP in maxillary posterior teeth on both sides and mucosal thickness of the maxillary sinus (p > 0.05). A significant relationship was found between PP in maxillary posterior teeth on both sides and maxillary sinus mucosal thickening (p < 0.05). This study concluded that the prevalence of periapical pathology in the maxillary posterior teeth was significantly associated with a rise in the incidence of maxillary sinus mucosal thickening. Moreover, the primary causative factor for the pathophysiology of the odontogenic maxillary sinus was the periapical pathology in both maxillary first molars.

Multilevel Modeling Analysis of Odontogenic Risk Factors and Nasal Septum Deviation Associated with Maxillary Sinus Mucosal Thickening: A Cone-Beam Computed Tomography Study

“…Radiographic imaging is crucial in identifying the odontogenic causes of ODS and complements clinical assessment findings [ 11 ]. CBCT has been preferred over traditional computed tomography (CT) due to its lower radiation exposure, cost-effectiveness as well as being a highly precise three-dimensional imaging technique [ 16 ]. Thus, it became a preferred non-invasive, quantitative method for examining both periodontal tissues and the maxillary sinus, thereby enhancing the probability of successful treatment outcomes [ 14 ].…”

Endo-Periodontal Lesions—An Overlooked Etiology of Odontogenic Sinusitis

“…However, given that both the EPOS and American Academy of Otolaryngology-Head and Neck Surgery guidelines require specific symptoms for the diagnosis of chronic sinusitis, the adjunctive support of endoscopy and computed tomography (CT) imaging may not be fully representative of the ODS population [6]. In addition, in the early stage of ODS, oral lesions cause inflammation of the sinus mucosa, and in the absence of obstruction of the maxillary sinus orifice, the majority of patients do not have obvious symptoms of sinusitis and are found to have thickening of the mucosa of the maxillary sinus upon cone-beam computed tomography (CBCT) examination, which should be called odontogenic maxillary sinusitis to be more precise and has been reported extensively by oral surgeons and radiologists [7][8][9][10][11][12]. The severity of mucosal thickening is directly proportional to the oral lesion, and by treating the oral lesion, the sinus mucosal thickening can be controlled or even normalized.…”