Association of Maxillary Sinus Reactions and Periapical Pathology in the Maxillary Posterior Teeth: Evaluation Using Cone Beam Computed Tomography

Abstract

This study aimed to investigate the association between maxillary sinus reactions and periradicular pathology in maxillary posterior teeth using cone-beam computed tomography. The maxillary posterior images of 395 teeth were examined for the presence of periradicular pathology, and the maxillary sinus disease. The proximity between the root apex and the cortical bone of the maxillary sinus using the linear measurement (mm) tool was used (RadiAnt, DICOM viewer, Poznan, Poland). The frequency found from maxillary sinus assessment was subjected to the Kolmogorov-Smirnov normality test, the Kruskal-Wallis test, the chi-square test with Bonferroni correction and a logistic regression analysis. A significance level of 5% was assumed. About 46.6% of the teeth showed a periapical pathology associated with an inflammatory reaction of the maxillary sinus. Among them, thickening of the maxillary sinus mucosa > 3 mm is the most common finding (59.3%). There was no difference between the types of maxillary sinus reactions and the variables studied (p >0.05). Periapical lesions on palatal roots were 2.17 times more likely to develop an inflammatory reaction than other roots (p < 0.05). Women were 2.04 times less likely to develop maxillary changes than men (p < 0.05). The distance between apex and floor and the presence or absence of endodontic treatment were not significantly associated with sinusitis. Periapical pathology could be related to maxillary inflammatory reaction of the sinus.

Key Words:
Cone beam computed tomography; Maxillary sinusitis; Periapical diseases