Comparison of cone-beam computed tomography and panoramic radiography in the evaluation of maxillary sinus pathology related to maxillary posterior teeth: Do apical lesions increase the risk of maxillary sinus pathology?

Abstract

Purpose The aims of this study were first, to compare panoramic radiography with cone-beam computed tomography (CBCT) for evaluating topographic relationships, such as the classification of maxillary posterior teeth and their distance to the maxillary sinus floor; and second, to determine the relationship between maxillary sinus pathology and the presence of apical lesions. Materials and Methods In total, 285 paired CBCT and panoramic radiography records of patients (570 maxillary sinuses) were retrospectively analyzed. Both imaging modalities were used to determine the topographic relationship of the maxillary posterior teeth to the sinus floor. Mucosal thickening >2 mm was considered a pathological state. Data were analyzed using the chi-square, Wilcoxon, and Mann-Whitney U tests. Odds ratios (ORs) and confidence intervals (CIs) were calculated. Results The closest vertical distance measurements made between posterior maxillary teeth roots and the maxillary sinus on panoramic radiography and CBCT scans showed statistically significant differences from each other ( P <0.05). Compared to panoramic radiography, CBCT showed higher mean values for the distance between the maxillary sinus floor and maxillary posterior teeth roots. The CBCT images showed that at least 1 apical lesion adjacent to the right maxillary sinus increased the risk of maxillary sinus pathology by 2.37 times (OR, 2.37; 95% CI, 1.58-3.55, P <0.05). Conclusion Panoramic radiography might lead to unreliable diagnoses when evaluating the distance between the sinus floor and posterior roots of the maxillary teeth. Periapical lesions anatomically associated with maxillary sinuses were a risk factor for sinus mucosal thickening.

Single-visit nonsurgical endodontic treatment of maxillary sinusitis: A case series

“…[ 8 ] It has been also proved that it is common for dental professionals to underdiagnose MSEO while basing only on conventional two-dimensional intraoral periapical radiographs or orthopantomography. [ 7 12 13 14 ] CBCT provides information about root canal anatomy, especially missed canals, that is crucial in planning and prognosing the success rate of nonsurgical RCT.…”

Intrusion of maxillary molar roots into the maxillary sinus in a sample of the Egyptian population using cone beam computed tomography

“…The relation between the MSF and the root tips of the maxillary posterior teeth was categorized by many studies [8-21, 23, 24]. The classification used in the current study was previously documented by many authors in different studies [16][17][18][19][20][21]. It is represented in class 1: root tip is outside the sinus, class 2: root tip is against the sinus wall, and class 3: root tip is in the sinus.…”

“…Many studies used different scoring systems to categorize the sinus-root relation in different populations [8][9][10][11][12][13][14][15]. The simplest of all these systems consists of three classes, class 1: root tip is outside the sinus, class 2: root tip is against the sinus wall, and class 3: root tip is in the sinus [16][17][18][19][20][21]. The most popular classification was that introduced by Kwak et al [22] and it was widely implemented by researchers [23,24].…”

Comparison of panoramic radiography and cone-beam computed tomography for assessing radiographic signs indicating root protrusion into the maxillary sinus

“…The position of the roots relative to the sinus floor has several important clinical implications. 1 The close relationship of the maxillary posterior teeth and maxillary sinus floor may result in various complications. A periapical or periodontal infection of maxillary molars and premolars may spread to the maxillary sinus and cause odontogenic sinusitis.…”

“…The position of the roots relative to the sinus floor has several important clinical implications. 1 …”