Relationship between maxillary sinuses’ shapes and their contacts with upper jaw teeth roots according to computer tomography

Abstract

Background. Rhinosinusitis, affecting both maxillary and other sinuses, is a multidisciplinary issue which otolaryngologists, dentists, neurologists and ophthalmologists are constantly dealing with. There is a remarkable diagnostic value of anthropometric indicators of maxillary sinuses of people of different genders, using CT scan images of mature age patients. Purpose – establish a relationship between the shape of the maxillary sinuses and possible contacts of the tooth roots of the maxillary dental arch in healthy mature men and women. Materials and methods. The study was performed based on the results of 102 CBCT with normal maxillary sinuses variations in adults in the frontal and sagittal plane. The examinations were performed on Point 3D Combi 500 cone-beam tomograph. The paper belongs to the «description of case series» category whis is a type of study recognized by evidence based medicine and does not claim statistical significance of the results. Results and discussion. When examining the computer tomograms of men and women in the study group, it has been found out how the shape of the maxillary sinuses (MS) affects the contact of the tooth roots with the cortical plate and the mucous membrane of the maxillary sinuses. Six main shapes of the MS are defined: trapezoidal, square, round, oval, rectangular and triangular. In the frontal plane of CBCT, the most frequent contact with the MS cortical plate is observed in the triangular and rectangular shape of the MS, that is: in the MS rectangular shape it is in contact with the 15th, 25th tooth root in 13 people (56.5% of cases) and in the triangular shape – with the 15th, 25th tooth root in 17 people (56.5% of cases). Analyzing CBCT in the sagittal plane, the most frequent contact with the cortical plate of the left MS is observed in the MS triangular shape, namely – the sinus is in contact with the 25th tooth root in 38 people (59.4% of cases). In the sagittal plane of CBCT, the contact with the tooth roots was rarely observed in the MS square and round shape. In the MS square shape, the 13th and 14th tooth roots do not come into contact with its cortical plate, and, with the mucous membrane, there is no contact of all the roots of the teeth except the 16th, in 1 person only. Conclusions. The results of the study have made it possible to trace a number of patterns of influence of the maxillary sinus shape on the tooth roots contacting it. The contact of the MS cortical plate is most often observed with 16th and 26th tooth roots, while the MS mucous membrane – with 17th and 27th tooth roots of the upper jaw. It was found that in any shape of sinus in the frontal plane, no contact of the 13th, 23rd and 24th tooth roots of the maxillary dental arch with the mucous membrane of the maxillary sinus was detected. In the CBCT frontal plane, it has been found that the most frequent contact with the MS cortical plate is observed in triangular, trapezoidal and rectangular form of the MS, and the rarest one – in oval, square and round form of MS. The study has established that in the sagittal plane of CBCT the most frequent contact with the MS cortical plate is observed in the MS triangular shape, and the rarest – in the round one.