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Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study.
Clinical Oral Investigations 2019 January
OBJECTIVES: This study aimed to assess the maxillary sinus mucosal thickening and to associate them with odontogenic conditions using cone-beam computed tomographic (CBCT) images.
MATERIALS AND METHODS: CBCT images of 294 patients (143 female, 151 males; age range 18-78 years) with 588 maxillary sinuses were evaluated retrospectively. The anatomic relationship between maxillary sinuses and teeth was determined and classified. The presence of root canal fillings and the periapical lesions of these teeth was also recorded. Sinus mucosal thickenings were classified as grade 1 (normal) (< 2 mm), grade 2 (moderate) (2-10 mm), and grade 3 (severe) (> 10 mm). Alveolar bone loss was measured on all maxillary premolar/M teeth.
RESULTS: More than 2-mm mucosal thickening (grade 2 and grade 3) in either one or both maxillary sinuses was found in 172 (58.5%) of the patients. The prevalence of mucosal thickening (> 2 mm) for maxillary sinuses with and without any periapical lesions was 42.1 and 53.6%, respectively (p < 0.05). The prevalence of mucosal thickening increased in patients with periodontal alveolar bone loss (p < 0.05). There was a significant correlation between mucosal thickening with age, gender and missing teeth (p < 0.05).
CONCLUSIONS: Multiple conditions, including periapical infection, root canal treatment, and close relationship maxillary teeth and sinus, may have a precursor effect on the occurrence of mucosal thickening in the maxillary sinus. Periodontal status and its role as a risk factor in triggering maxillary sinus infections should be also considered by not only dental professionals but also the medical professionals to plan for the treatment of maxillary sinus lesions.
CLINICAL RELEVANCE: Maxillary sinuses are significantly influenced by various odontogenic conditions, including periodontal bone loss, periapical lesions, and missing teeth, which may result in thickening of the maxillary sinus mucosa.
MATERIALS AND METHODS: CBCT images of 294 patients (143 female, 151 males; age range 18-78 years) with 588 maxillary sinuses were evaluated retrospectively. The anatomic relationship between maxillary sinuses and teeth was determined and classified. The presence of root canal fillings and the periapical lesions of these teeth was also recorded. Sinus mucosal thickenings were classified as grade 1 (normal) (< 2 mm), grade 2 (moderate) (2-10 mm), and grade 3 (severe) (> 10 mm). Alveolar bone loss was measured on all maxillary premolar/M teeth.
RESULTS: More than 2-mm mucosal thickening (grade 2 and grade 3) in either one or both maxillary sinuses was found in 172 (58.5%) of the patients. The prevalence of mucosal thickening (> 2 mm) for maxillary sinuses with and without any periapical lesions was 42.1 and 53.6%, respectively (p < 0.05). The prevalence of mucosal thickening increased in patients with periodontal alveolar bone loss (p < 0.05). There was a significant correlation between mucosal thickening with age, gender and missing teeth (p < 0.05).
CONCLUSIONS: Multiple conditions, including periapical infection, root canal treatment, and close relationship maxillary teeth and sinus, may have a precursor effect on the occurrence of mucosal thickening in the maxillary sinus. Periodontal status and its role as a risk factor in triggering maxillary sinus infections should be also considered by not only dental professionals but also the medical professionals to plan for the treatment of maxillary sinus lesions.
CLINICAL RELEVANCE: Maxillary sinuses are significantly influenced by various odontogenic conditions, including periodontal bone loss, periapical lesions, and missing teeth, which may result in thickening of the maxillary sinus mucosa.
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