Relationship Between Maxillary Sinus Pathologies and Maxillary Posterior Tooth Periapical Pathologies

Abstract

To determine the prevalence of odontogenic maxillary sinus pathologies and their relationship with periapical pathologies in the maxillary posterior teeth using cone-beam computed tomography (CBCT).

Maxillary posterior CBCT scans of consecutive patients aged 20-77 years were evaluated retrospectively. Patients with at least one maxillary posterior tooth were included. Patients with edentulous maxillae or having one or more maxillary implants were excluded. Finally, 461 CBCT images were evaluated. Demographic data, such as age and sex, and pathologic findings of the right and left maxillary sinuses and adjacent teeth were recorded. Statistical analyses were performed using the Chi square test and binary logistic regression.

The prevalence of right and left odontogenic maxillary sinusitis was 59.5 and 64 %, respectively. Maxillary sinus pathology was more common in males, and there was no relationship with age. Regarding the maxillary sinus pathology, 64 % had mucosal thickening, 19 % had partial opacification, 5 % had total opacification, and 12 % had polypoidal mucosal thickening. Right and left maxillary sinus pathologies were approximately twice as prevalent in patients with periapical pathology in at least one maxillary posterior tooth. Periapical pathologies in the right maxillary first molar and left maxillary first and second molars significantly increased the risk of maxillary sinus pathology with odds ratios of 2.53, 1.83, and 3.12, respectively.

Odontogenic maxillary sinus pathologies were present in > 50 % of the study population. Periapical pathologies in the maxillary first and second molar teeth significantly increased maxillary sinus pathologies.