Anatomic variations and lesions of the maxillary sinus detected in cone beam computed tomography for dental implants

Objective To evaluate the presence of anatomic variations and lesions of the maxillary sinus in cone beam computed tomography (CBCT) of the maxilla required for dental implant planning. Material and methods This transversal prevalence study evaluated a sample of 500 consecutive CBCT exams. The inclusion criteria were CBCT exams of the maxilla required for dental implant planning. The CBCT exams were independently evaluated by two oral and maxillofacial radiologists who assessed the presence of anatomic variations and lesions of the maxillary sinus. As most of the CBCT exams did not allow the evaluation of the area close to the maxillary sinus roof, anatomic variations that take place at this site were not assessed. Results The anatomic variations detected were pneumatization (83.2%), antral septa (44.4%), hypoplasia (4.8%), and exostosis (2.6%). The identified lesions were mucosal thickening (=3 mm in 54.8% and >3 mm in 62.6%), polypoid lesions (21.4%), discontinuity of the sinus floor (17.4%), air-fluid level (4.4%), bone thickening of the maxillary sinus wall (3.8%), antroliths (3.2%), discontinuity of the sinus lateral wall (2.6%), sinus opacification (1.8%), and foreign body (1.6%). Conclusion Anatomic variations and lesions of the maxillary sinus were common findings in CBCT exams of the maxilla required for dental implant planning. As some of these conditions can modify dental implant planning and must require specialized treatment, its recognition is noteworthy in dental practice, and especially in implantology. The amount and significance of the anatomic variations and lesions detected in this study reinforces the importance of computed tomography in preoperative dental implant planning.