Evaluation of Health or Pathology of Bilateral Maxillary Sinuses in Patients Referred for Cone Beam Computed Tomography Using a Low-Dose Protocol

The aim of this study was to evaluate the health or pathology of bilateral maxillary sinuses using cone beam computed tomography (CBCT) with a low-dose protocol, and to analyze potential influencing factors. The study included only CBCT scans with complete visualization of bilateral maxillary sinuses. The scans were taken using a medium to large field of view and a low-dose protocol, as indicated by the manufacturer. CBCT images were analyzed with regard to the morphology of the sinus membrane and surrounding bone twice by one observer. Influencing factors such as age, sex, or status of the remaining dentition in the posterior maxilla, including periodontal and end odontic parameters, were evaluated. The study included 134 CBCT scans (268 maxillary sinuses). Using a low-dose protocol, intraobserver reliability of the measurements was almost perfect (kappa value range 0.875 to 1). More than half the sinuses evaluated (63.1%)did not show visible morphologic changes. The most frequently identified pathologic appearance was a flat shallow thickening of the sinus membrane of > 2 mm (47 positive findings [17.5%]). Only 15(5.6%) sinuses were associated with teeth with endodontic treatment and/or pathology, and 10(3.7%) with teeth exhibiting periodontal pathology. CBCT scans with a low-dose protocol can be recommended as a feasible adjunctive tool to evaluate health or pathology of the maxillary sinuses prior to surgical interventions such as sinus floor augmentation. Of all morphologic changes seen, only a small portion of the cases were considered to need further medical diagnosis/treatment.