Analysis of correlation between maxillary molars and maxillary sinus mucosal thickening

doi:10.19439/j.sjos.2022.06.013

Abstract

Abstract: PURPOSE: To investigate the influence of maxillary molars on the thickening of maxillary sinus mucosa by cone-beam CT (CBCT). METHODS: A total of 72 patients with periodontitis were included in the study and 137 cases of maxillary sinus were evaluated using CBCT for the following parameters: location, tooth, maximal mucosal thickness, alveolar bone loss, vertical intrabony pockets and minimal residual bone height. The maxillary sinus mucosal thickness ≥2 mm was defined as mucosal thickening. The parameters that could influence the dimensions of the maxillary sinus membrane were assessed. The data were analyzed using univariate analysis and binary logistic regression by SPSS 25.0 software package. RESULTS: Mucosal thickening was present in 56.2% of 137 cases and increased in frequency as the alveolar bone loss of the corresponding molar progressed from mild (21.1%) to moderate (56.1%) to severe (69.2%), and the risk of maxillary sinus mucosal thickening increased by 6-7 times (moderate OR=7.13, 95%CI: 1.37-37.21; severe OR=6.29, 95%CI: 1.06-37.37). The severity of vertical intrabony pockets was correlated with the presence of mucosal thickness (no intrabony pockets 38.7%; type Ⅰ 63.4%; type Ⅱ 79.4%), with an increased risk of maxillary sinus mucosal thickening (type Ⅰ OR=3.72, 95%CI: 1.01-13.70; type Ⅱ OR=5.39, 95%CI: 1.15-25.30). The minimal residual bone height was negatively correlated with the presence of mucosal thickness(≤4 mm OR=99.00, 95%CI: 17.42-562.79). CONCLUSIONS: Alveolar bone loss, vertical intrabony pockets and the minimal residual bone height in maxillary molars were significantly associated with mucosal thickening of the maxillary sinus.

Key words: Cone-beam CT, Maxillary sinus, Mucosal thickening, Periodontitis

CLC Number:

R781.4

SONG Jue, LIU Hao-hao, LIU Jia-liang, CHEN Mei-hua. Analysis of correlation between maxillary molars and maxillary sinus mucosal thickening[J]. Shanghai Journal of Stomatology, 2022, 31(6): 638-642.

References

[1] 王兴. 第四次中国口腔健康流行病学调查报告 [M]. 北京: 人民卫生出版社, 2017.
[2] Lu Y, Liu Z, Zhang L, et al.Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study[J]. J Endod, 2012, 38(8): 1069-1074.
[3] Wuokko-Landén A, Blomgren K, Suomalainen A, et al.Odontogenic causes complicating the chronic rhinosinusitis diagnosis[J]. Clin Oral Investig, 2021, 25(3): 947-955.
[4] Maspero C, Farronato M, Bellincioni F, et al.Three-dimensional evaluation of maxillary sinus changes in growing subjects: a retrospective cross-sectional study[J]. Materials (Basel), 2020, 13(4): 1007-1022.
[5] Block MS, Dastoury K.Prevalence of sinus membrane thickening and association with unhealthy teeth: a retrospective review of 831 consecutive patients with 1 662 cone-beam scans[J]. J Oral Maxillofac Surg, 2014, 72(12): 2454-2460.
[6] Phothikhun S, Suphanantachat S, Chuenchompoonut V, et al.Cone-beam computed tomographic evidence of the association between periodontal bone loss and mucosal thickening of the maxillary sinus[J]. J Periodontol, 2012, 83(5): 557-564.
[7] Bajoria AA, Sarkar S, Sinha P.Evaluation of odontogenic maxillary sinusitis with cone beam computed tomography: a retrospective study with review of literature[J]. J Int Soc Prev Community Dent, 2019, 9(2): 194-204.
[8] Eggmann F, Connert T, Bühler J, et al.Do periapical and periodontal pathologies affect Schneiderian membrane appearance? systematic review of studies using cone-beam computed tomography[J]. Clin Oral Investig, 2017, 21(5): 1611-1630.
[9] Guo ZZ, Liu Y, Qin L, et al.Longitudinal response of membrane thickness and ostium patency following sinus floor elevation: a prospective cohort study[J]. Clin Oral Implants Res, 2016, 27(6): 724-729.
[10] Yilmaz HG, Tözüm TF.Are gingival phenotype, residual ridge height, and membrane thickness critical for the perforation of maxillary sinus?[J]. J Periodontol, 2012, 83(4): 420-425.
[11] Iwata E, Hasegawa T, Kobayashi M, et al.Can CT predict the development of oroantral fistula in patients undergoing maxillary third molar removal?[J]. Oral Maxillofac Surg, 2021, 25(1): 7-17.
[12] Simuntis R, Kubilius R, Padervinskis E, et al.Clinical efficacy of main radiological diagnostic methods for odontogenic maxillary sinusitis[J]. Eur Arch Otorhinolaryngol, 2017, 274(10): 3651-3658.
[13] Craig JR, Cheema AJ, Dunn RT, et al.Extrasinus complications from odontogenic sinusitis: a systematic review[J]. Otolaryngol Head Neck Surg, 2022, 166(4): 623-632.
[14] Zhang B, Wei Y, Cao J, et al.Association between the dimensions of the maxillary sinus membrane and molar periodontal status: a retrospective CBCT study[J]. J Periodontol, 2020, 91(11): 1429-1435.
[15] Goller-Bulut D, Sekerci AE, Köse E, et al.Cone beam computed tomographic analysis of maxillary premolars and molars to detect the relationship between periapical and marginal bone loss and mucosal thickness of maxillary sinus[J]. Med Oral Patol Oral Cir Bucal, 2015, 20(5): e572-e579.
[16] Bornstein MM, Wasmer J, Sendi P, et al.Characteristics and dimensions of the Schneiderian membrane and apical bone in maxillary molars referred for apical surgery: a comparative radiographic analysis using limited cone beam computed tomography[J]. J Endod, 2012, 38(1): 51-57.
[17] Peñarrocha-Oltra S, Soto-Peñaloza D, Bagán-Debón L, et al.Association between maxillary sinus pathology and odontogenic lesions in patients evaluated by cone beam computed tomography: a systematic review and meta-analysis[J]. Med Oral Patol Oral Cir Bucal, 2020, 25(1): e34-e48.
[18] Nurchis MC, Pascucci D, Lopez MA, et al.Epidemiology of odontogenic sinusitis: an old, underestimated disease, even today. a narrative literature review[J]. J Biol Regul Homeost Agents, 2020, 34(5 Suppl. 3): 195-200.
[19] Ren S, Zhao H, Liu J, et al.Significance of maxillary sinus mucosal thickening in patients with periodontal disease[J]. Int Dent J, 2015, 65(6): 303-310.
[20] Eke PI, Dye BA, Wei L, et al.Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012[J]. J Periodontol, 2015, 86(5): 611-622.
[21] Nascimento EH, Pontual ML, Pontual AA, et al.Association between odontogenic conditions and maxillary sinus disease: a study using cone-beam computed tomography[J]. J Endod, 2016, 42(10): 1509-1515.
[22] Arias-Irimia O, Barona-Dorado C, Santos-Marino JA, et al.Meta-analysis of the etiology of odontogenic maxillary sinusitis[J]. Med Oral Patol Oral Cir Bucal, 2010, 15(1): e70-e73.
[23] Yenigun A, Fazliogullari Z, Gun C, et al.The effect of the presence of the accessory maxillary ostium on the maxillary sinus[J]. Eur Arch Otorhinolaryngol, 2016, 273(12): 4315-4319.
[24] Taghiloo H, Halimi Z.The frequencies of different types of nasal septum deviation and their effect on increasing the thickness of maxillary sinus mucosa[J]. J Dent Res Dent Clin Dent Prospects, 2019, 13(3): 208-214.
[25] Rancitelli D, Borgonovo AE, Cicciù M, et al.Maxillary sinus septa and anatomic correlation with the schneiderian membrane[J]. J Craniofac Surg, 2015, 26(4): 1394-1398.
[26] Maina IW, Patel NN, Cohen NA.Understanding the role of biofilms and superantigens in chronic rhinosinusitis[J]. Curr Otorhinolaryngol Rep, 2018, 6(3): 253-262.
[27] Workman AD, Granquist EJ, Adappa ND.Odontogenic sinusitis: developments in diagnosis, microbiology, and treatment[J]. Curr Opin Otolaryngol Head Neck Surg, 2018, 26(1): 27-33.
[28] Ata-Ali J, Diago-Vilalta JV, Melo M, et al.What is the frequency of anatomical variations and pathological findings in maxillary sinuses among patients subjected to maxillofacial cone beam computed tomography? a systematic review[J]. Med Oral Patol Oral Cir Bucal, 2017, 22(4): e400-e409.