CBCT imaging can be a valuable adjunct in radioanatomical and radiodiagnostic observations in the posterior maxilla. It may better visualize maxillary sinus involvement for posterior upper teeth than panoramic radiography.
Close proximity of the maxillary roots and the sinus floor makes a dental disease a probable cause of maxillary sinusitis. The aim of this study was to evaluate the ability of periapical radiography and cone beam computed tomography in defining the topographic relationship of maxillary teeth to the sinus floor and detecting apical periodontitis and other odontogenic causes of the maxillary sinusitis. Out of 145 dental records from subjects (mean age 52 years, range 20-75 years; 89 females) referred to the Oral Imaging Centre, KU Leuven, periapical and CBCT images of the posterior maxilla were selected for further analysis. Anatomical relationship of maxillary teeth to the sinus floor, apical periodontitis and other etiological causes of soft tissue thickening were assessed with both imaging modalities. The results of this study demonstrated that periapical radiographs are not adequate in observing the anatomical relationship between maxillary molars and the sinus floor. CBCT showed an intimate relationship of 1st and 2nd molar with the maxillary sinus in 50 and 45% of the cases, respectively. Periapical radiography could only spot approximately 40% of apical periodontitis on posterior maxillary teeth and 3% of all apical infections extending to the sinus, seen on CBCT.
Belgium SUMMARY This review aims to explore whether 3D imaging offers an added value in diagnosis of odontogenic sinusitis. Odontogenic maxillary sinusitis accounts for approximately 10-12% of maxillary sinusitis cases. Proper diagnosis of odontogenic sinusitis is based on a thorough dental and medical examination and crucial to ensure therapeutic efficacy. To establish the odontogenic cause of maxillary sinusitis, 2D and 3D imaging modalities may be considered, each presenting distinct advantages and drawbacks. The available research indicates that 2D imaging modalities may often mask the origin of odontogenic maxillary sinusitis. This limitation is particularly evident in the maxillary molar region, stressing the need for 3D cross-sectional imaging. The advent of low-dose cone beam computed tomography in dentistry may be particularly useful when odontogenic maxillary sinusitis is not responsive to therapy. Yet, it seems that more research is needed to validate its use in odontogenic maxillary sinusitis.
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