Associations between Maxillary Sinus Mucosal Thickening and Apical Periodontitis Using Cone-Beam Computed Tomography Scanning: A Retrospective Study

Introduction: This study evaluated the pathologic and spatial associations between apical periodontitis of the maxillary premolars/molars and the maxillary sinus mucosal thickening using cone-beam computed tomography (CBCT) scanning. Methods: CBCT images of 372 patients with 508 exposed maxillary sinuses were inspected retrospectively. Clinical features such as sex and age of the patients and pathologic findings of the maxillary sinus and adjacent teeth were recorded, graded, and analyzed. Results: Maxillary sinus mucosal thickening was found in 180 (48.4%) patients and 235 (46.2%) sinuses. The prevalence of maxillary sinus mucosal thickening increased dramatically as the severity of apical periodontitis increased (from 41.5% in those without periodontal disease to 100%). However, the nature of the spatial relationship between the maxillary sinus floor and the infected root tips or between the sinus floor and periapical lesions did not appear to have an effect on the prevalence of maxillary sinus mucosal thickening. Patients over 60 years of age had the highest prevalence of maxillary sinus mucosal thickening. Conclusions: A retrospective inspection of CBCT images revealed that the prevalence and severity of maxillary sinus mucosal thickening were positively associated with the degree of apical periodontitis. CBCT imaging is applicable for the evaluation of the maxillary sinuses and adjacent teeth. (J Endod 2012;38:1069-1074)