Association between maxillary sinus pathologies and healthy teeth

Abstract

Dental roots in the maxillary sinus are almost twice as likely to be associated with diseased sinuses than normal sinuses. Healthy teeth whose roots are inside the maxillary sinus may induce an inflammatory response in the sinus membrane. It is suspected that dental procedures may exacerbate the condition.

Maxillary sinus diseases – diagnosis and differential diagnosis

“…The floor of the maxillary sinus extends into the alveolar process between the roots of adjacent teeth, creating elevations and depressions called ''extensions,'' with narrow cortical areas (3). It has been radiographically demonstrated that most of the roots projecting into the maxillary sinus are in fact surrounded by a thin layer of cortical bone, with perforations present in 14-28% of cases.…”

“…It has been radiographically demonstrated that most of the roots projecting into the maxillary sinus are in fact surrounded by a thin layer of cortical bone, with perforations present in 14-28% of cases. Under normal conditions, the relationship between the tooth and the floor of the maxillary sinus consists of either a thin layer of compact bone that provides support to the apical periodontal ligament fibers, to which it firmly adheres, or there is a direct relationship with the maxillary sinus mucosa (3). The bony wall, separating the maxillary sinus from teeth roots, varies from full absence, when teeth roots are covered only by mucous membrane, to a wall of 12 mm (4).…”

“…However, in recent publications, up to 30-40% of chronic maxillary sinusitis cases are attributed to a dental cause (4). Intimate anatomical relation of the upper teeth to the maxillary sinus promotes the development of periapical or periodontal odontogenic infection into the maxillary sinus (3,4). Hence, Eberhardt conducted a study with CT in which he measured the distances between the maxillary sinus floor and the tips of the posterior maxillary molars, finding that the tips of the molars were generally closer to the sinus than the premolars, especially the mesiobuccal root of the second upper molar.…”

“…In other studies using CT, similar results were obtained regarding the distance between the roots and the sinus, and it was found that a small percentage of patients had roots that extended into the walls of the sinus (8). It has been demonstrated that, in cases of apical periodontitis, when the tip of the tooth root was in contact with the floor of the maxillary sinus, the incidence of mucosal thickening was lower than when the tip of the root exceeded the floor of the maxillary sinus, so the closer the tooth apex is to the floor of the maxillary sinus, the greater the impact on antral tissue (3). Of the odontogenic sinus diseases, apical periodontitis and periodontal disease account for 83% of all cases having dental origin (3).…”

“…It has been demonstrated that, in cases of apical periodontitis, when the tip of the tooth root was in contact with the floor of the maxillary sinus, the incidence of mucosal thickening was lower than when the tip of the root exceeded the floor of the maxillary sinus, so the closer the tooth apex is to the floor of the maxillary sinus, the greater the impact on antral tissue (3). Of the odontogenic sinus diseases, apical periodontitis and periodontal disease account for 83% of all cases having dental origin (3). In a metaanalysis made by Arias-Irimia the most common cause of odontogenic maxillary sinusitis were iatrogenic causes.…”