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Table of Contents   
ORIGINAL ARTICLE
Year : 2019  |  Volume : 9  |  Issue : 2  |  Page : 194-204
Evaluation of odontogenic maxillary sinusitis with cone beam computed tomography: A retrospective study with review of literature


1 Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
2 Consultant Prosthodontist, KIIT University, Bhubaneswar, Odisha, India

Date of Submission20-Dec-2018
Date of Acceptance21-Feb-2019
Date of Web Publication12-Apr-2019

Correspondence Address:
Dr. Atul Anand Bajoria
Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Patia, Bhubaneswar - 751 024, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jispcd.JISPCD_435_18

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   Abstract 

Aim and Objectives: The purpose of this study was to describe the radiographic characteristics of odontogenic maxillary sinusitis as seen on cone beam computed tomography (CBCT) scans and determine whether any tooth or any tooth root, was more frequently associated with this disease.
Materials and Methods: The present study included 500 CBCT images that included the entire maxillary sinus of both the sides in all the three planes. The modified classification of Abrahams and Glassberg was used to assess maxillary sinusitis of odontogenic origin. Furthermore, the proximity of the tooth root to the sinus floor, periapical pathology, and the septae within the maxillary sinus were also assessed.
Results: In the present study, 1000 hemimaxillas were analyzed. Majority of the cases (74.9%) the apex of either tooth was touching the floor of the sinus. While 16.9% were in close relationship to the sinus while 8.2% of the cases, the apices were present within the sinus. Furthermore, in the present study, 38 of the total cases had an odontogenic cause of maxillary sinusitis, whereas 273 of them had a nonodontogenic cause, 96 have an undetermined cause, and the rest 593 cases had healthy sinus.
Conclusion: The incidence of odontogenic sinusitis is likely under-reported in the available literature. The introduction of low-dose CBCT is particularly useful to establish a definitive diagnosis to augment in the treatment of chronic maxillary sinusitis of odontogenic origin.


Keywords: Cone beam computed tomography, maxillary sinusitis and periodontitis, odontogenic sinusitis


How to cite this article:
Bajoria AA, Sarkar S, Sinha P. Evaluation of odontogenic maxillary sinusitis with cone beam computed tomography: A retrospective study with review of literature. J Int Soc Prevent Communit Dent 2019;9:194-204

How to cite this URL:
Bajoria AA, Sarkar S, Sinha P. Evaluation of odontogenic maxillary sinusitis with cone beam computed tomography: A retrospective study with review of literature. J Int Soc Prevent Communit Dent [serial online] 2019 [cited 2019 Apr 25];9:194-204. Available from: http://www.jispcd.org/text.asp?2019/9/2/194/256007



   Introduction Top


Odontogenic pain originating from the maxillary sinus can pose a diagnostic challenge for the clinician. As the roots of the maxillary posterior teeth are close to the floor of the sinus, along with common innervation, there is a probable reason for pathosis of the sinus to cause dental symptoms.[1] It is believed that the breach of the Schneiderian membrane owing to microbial incursion in periapical infections,[2] periodontal disease or iatrogenic factors[3] increases the risk of maxillary sinusitis. The progress of a periapical lesion in maxillary posterior teeth can give rise to inflammatory changes in the mucosal lining of the maxillary sinus and subsequently, the development of sinusitis.[4] The extension of periapical inflammation into the maxillary sinus was first described in 1943 by Bauer.[5] This was a cadaveric study with microscopic evaluation of sections of human teeth, alveolus, and sinus. Periapical inflammation was found to be proficient for affecting the sinus mucosa with or without perforation of the cortical bone of the sinus floor.[5] Radiographic imaging has always played an imperative role in establishing the odontogenic etiology of (mostly chronic) maxillary sinusitis and complement results of the clinical examination.[6] The purpose of this retrospective study was to describe the radiographic characteristics of odontogenic maxillary sinusitis as seen on cone beam computed tomography (CBCT) scans and to determine whether any tooth or any tooth root, was more frequently associated with this disease.


   Materials and Methods Top


The present study included 500 CBCT images that included the entire maxillary sinus of both the sides in all the three planes. The source of data for the study was patients that reported to the department of oral medicine and radiology from January 2017 to 2018. The CBCT had been advised for the evaluation of teeth in the posterior region of maxilla for various diagnostic purposes. A prior ethical approval was obtained from the Institutional Ethical Committee (Letter No: KIIT/KIDS/IEC0345) before the start of the study. The CBCT scans were done using Hyperion X9 digital imaging system (Myray, Italy). The images were obtained at 70–75 kV, 8–10 mA, and 11–12.3 s exposure time. The field of view size was 11 mm × 8 mm with a 300-μm image resolution. For evaluation of the CBCT scans, a 21-inch LCD monitor's (HP L1910, Hewlett-Packard Development Co., Palo Alto, CA, USA) with 1280 × 1024 pixel was used. The NNT Imaging Software (v4.6) Windows edition (Myray, Italy) was used. Images were selected considering a high-level technical standard (i.e., appropriate sharpness, density, and contrast), clearly showing the maxillary posterior teeth apices and the sinuses floor. An assessment of the topographic relationship of each root to the maxillary sinus floor was conducted in CBCT images.

For the purpose of this study, diagnostic criteria for sinusitis diagnosis were developed based on published literature.[7] Based on these criteria, the maxillary sinusitis/pathology was divided into four categories [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6].
Figure 1: Line Diagram of the maxillary teeth with the floor of the maxillary sinus. (a) Modified classification of Abrahams and Glassberg for maxillary sinusitis. (b) Relation of the periapical pathology of teeth with that of the sinus floor. (c) Relation of the tooth apex with the floor of the sinus

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Figure 2: A multiplanar reformatted sagittal cone beam computed tomography image of healthy maxillary sinus with its compliment of teeth

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Figure 3: A multiplanar reformatted sagittal cone beam computed tomography image of odontogenic maxillary sinusitis with its compliment of teeth

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Figure 4: A multiplanar reformatted sagittal cone beam computed tomography image of nonodontogenic maxillary sinusitis with its compliment of teeth

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Figure 5: A multiplanar reformatted sagittal cone beam computed tomography image of undetermined maxillary sinusitis with its compliment of teeth

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Figure 6: (a) A multiplanar reformatted sagittal cone beam computed tomography image of an antrolith within the maxillary sinus. (b) A multiplanar reformatted sagittal cone beam computed tomography image of a mucous retention cyst within the maxillary sinus

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The relationship of the tooth apex to the floor of the maxillary sinus and periapical lesion to the floor of the maxillary sinus is depicted in [Figure 1].


   Results Top


In the present study, 1000 hemimaxillas were analyzed. A total of 500 participants including 314 males and 186 females participated in the study. All the participants in the present study were adults and were between the ages of 25–65 years. In the present study, descriptive statistics was used to summarize the features of odontogenic and nonodontogenic sinusitis. Statistical Package for the Social Sciences (SPSS; IBM, California, USA) version 20.0 was used to perform the statistical analysis. Student's t-test was used to assess the relation (P < 0.05 was considered to be statistically significant) between the odontogenic pathology and maxillary sinus infection.

In general, the apices of premolars and molars are in close proximity to the floor of the maxillary sinus. Majority of the cases (74.9%), the apex of either tooth was touching the floor of the sinus. A total of 16.9% of the cases had a close relationship to the sinus while 8.2% of the cases the apices were present within the sinus [Table 1]. In the present study, out of the 1000 maxillary sinus, 606 were healthy, 387 had sinusitis, six had mucous retention cyst, and only one participant had calcification within the maxillary sinus [Table 2]. On the other hand, out of the 1000 hemimaxillas, 671 cases had healthy teeth while 139 (out of 1000) had a history of extraction done of which 69 cases had healthy sinus whereas 70 of them had sinus pathology. Fifty-eight (out of 1000) had a history of root canal treatment done in which the ratio of healthy and diseased sinus was equal. Sixty (out of 1000) had periodontitis out of which only nine cases had healthy sinus, while the others had diseased sinus. Seventeen (out of 1000) had periapical pathology out of which only three had a healthy sinus while the rest 14 had diseased sinus. Forty-seven (out of 1000) had carious teeth with no periapical pathology out of which 21 had a healthy sinus whereas 26 had diseased sinus. Similarly, eight (out of 1000) had restorations done in the teeth out of which seven had healthy sinus whereas only one had a diseased sinus [Table 3].
Table 1: Relation of tooth apex with the floor of the maxillary sinus

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Table 2: Relationship between sinus pathology and odontogenic pathology

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Table 3: Relationship between odontogenic pathology and maxillary sinusitis

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Interestingly, majority of the cases having either periodontitis or periapical pathology had sinus pathology.

Majority of the cases 749 (out of 1000) the apices of the teeth were touching the sinus floor of which 294 had a sinus pathology whereas 455 were normal. Similarly, 82 (out of 1000) of the cases had the apices of the teeth within the sinus cavity of which 44 had sinus pathologies while 38 were healthy [Table 4].
Table 4: Relationship between the maxillary sinus pathology and the tooth apex relation to the floor of the sinus

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Out of the 1000 hemimaxillas, 361 had periapical pathology. In 270 (out of 361) cases, the periapical lesion was in close proximity to the sinus of which 125 had no sinus pathology while 145 had diseased sinus. In 54 (out of 361) cases, the periapical lesion was touching the floor of the maxillary sinus of which 18 had no sinus pathology while 36 had diseased sinus. Similarly, in 37 (out of 361) cases, the periapical lesion was present within the maxillary sinus of which only 10 had a healthy sinus while 27 had diseased sinus [Table 5].
Table 5: Relationship between the maxillary sinus pathology and the relation of the periapical pathology to the floor of the maxillary sinus

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   Discussion Top


An extensive search for various articles was done through Google Scholar, PubMed, Cochrane Library, and EMBASE. It included all articles published between the year 2000 and 2018. The keywords used were “odontogenic sinusitis,” “chronic maxillary sinusitis,” “sinusitis of dental origin,” “sinusitis of undetermined origin,” “chronic apical periodontitis,” “periapical pathology and sinusitis,” and “iatrogenic sinusitis.” All the articles including case reports, case series, review, retrospective, and prospective studies were sorted out to gather all descriptions regarding odontogenic cause of maxillary sinusitis, and the type of imaging modality used[8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20],[21],[22],[23],[24],[25],[26],[27],[28],[29],[30],[31] [Table 6]].
Table 6: Literature search of odontogenic sinusitis

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In the present study, the incidence of odontogenic-related sinusitis was more commonly seen in males than in females. This was in accordance with the study done by Vallo et al.[32] All the participants in the present study were above 12 years of age, as the maxillary sinus is not completely developed before the age of 12 years.[33] Two-dimensional (2D) imaging has a very limited diagnostic value in identifying maxillary sinusitis because the radiologic signs are nonspecific. Carious lesions and periapical radiolucencies can be appreciated in Intraoral Periapical Radiograph (IOPAR) because periapical radiograph has a higher spatial resolution.[34] However, such lesions must attain considerable size to be seen periapical radiograph.[35],[36] Whereas panoramic radiographs have a lower sensitivity than IOPAR in identifying periapical lesions.[37] 3D-computed tomography is considered to be the most acceptable method for visualization of nasal and paranasal sinuses. As it has a higher contrast resolution and eliminates, the superposition of anatomical structures.[38] Thus, 2D imaging is of little or no use for accurate morphometric assessment.[39] 3D-imaging overcomes the 2D limitations by providing multiplanar views with no magnifications, superimpositions, and distortions.[40] Panoramic studies have demonstrated the root-maxillary sinus relationship in 39%–57% of the cases.[41],[42] With due advancement in 3D imaging the prevalence of root apices protruding into the maxillary sinus ranges from 5% to 10%.[24],[39],[40]

In the present study, when the tip of tooth root was in contact with the floor of maxillary sinus, the incidence of mucosal thickening was lower than when the tip of root exceeded and protruded within the floor of the maxillary sinus. This finding was in accordance with the study done by Lu et al.[11] There is histological evidence of a thin cortical bone surrounding the maxillary sinus with perforation present in 14%–28% of the cases.[41] Due to this perforation or absence of thin layers of cortical bone, the periodontal tissues are in direct contact with the maxillary sinus mucosa. The knowledge of which is essential for planning dental treatment. Many researchers have found out that an odontogenic irritation may be potentially influenced by the proximity between roots of the teeth with periapical lesions and floor of sinus.[32],[43],[44] CBCT increases the accuracy of detecting periapical lesions when compared to conventional imaging modalities.[36],[45]

However, the interpretation of CBCT must be carried out cautiously as incipient and chronic periapical lesions detected by a CBCT examination might present low potential for identifying sinus inflammatory signs and symptoms. CBCT is far superior to multislice CT in terms of image resolutions, as thinner sections can be achieved. Apart from that CBCT equipment have reduced radiation exposures and a low equipment cost when compared to multi-slice CT.[10]

Some studies have shown that the root of the 2nd maxillary molar is closest to sinus.[36],[46] It was found out that Mesio-Buccal root of maxillary 2nd molar is on average 0.67 mm closer to the sinus than the palatal root of maxillary 1st molar.[39] This finding was consistent with the present study as well. On the contrary, it is the palatal root of the maxillary 1st molar that is most commonly associated with maxillary sinusitis as it is the first permanent maxillary molar to erupt into the oral cavity.[8],[47]

Distinguishing a healthy and a diseased sinus radiographically is not so problematic keeping into consideration its shape, loci, and lobulations. Because the sinus it is air-filled, the sinus appears radiolucent and has clearly defined margins.[4] In case of diseased sinus; a clinician may easily identify clouding (opacifications), mucosal thickening and or accumulation of fluid.[48] Previous studies have suggested the thickness of the mucosal lining of the sinus to be in the range from 2 to 6 mm.[32],[47],[49],[50],[51],[52] However, the study done by Maillet et al., the average amount of mucosal thickening was 7.4 mm.[9] The current investigation was a retrospective study of existing scans only and did not include patient symptoms, or the reasons for the referral for CBCT scans. Maillet et al. in their study found 75% prevalence of maxillary sinusitis associated with dental conditions.[9] According to previous studies, there is a definitive odontogenic cause for diseased maxillary sinus of which apical periodontitis accounts for 83% of all cases. Furthermore, the prevalence of other sinus disorders such as mucosal thickening, mucous retention cyst, and odontogenic maxillary sinusitis ranges from 8% to 29%, 2%–36%, and 10%–86%, respectively.[53],[54],[55],[56]

In a study done by Cha et al. they found various abnormalities of maxillary sinus such as acute sinusitis with a prevalence of 7.5%, retention cyst with a prevalence of 3.5% and polypoid mucosal thickening in 2.3% of the cases, respectively.[57] In addition, in previous studies, the prevalence of flat mucosal thickening of the maxillary sinus ranged from 23.7% to 38.1%, polypoid mucosal thickening ranged from 6.5% to 19.4%, acute maxillary sinusitis 3.6%, partial opacification of maxillary sinus 12%, and total opacification of maxillary sinus 7%, respectively.[58],[59] Several authors have reported that around 10%–12% of the total maxillary sinus pathology has an odontogenic cause.[4],[50],[60] In the present study, 51.8% of the participants had odontogenic sinusitis, whereas 65.4% of the total participants had a diseased maxillary sinus along with periapical lesions. This was in accordance with the previously computed tomography studies that demonstrated around 71%–86% of sinus infections have an odontogenic cause.[47]

Several studies have reported a great variability in the prevalence of incidental findings in the maxillary sinus of asymptomatic subjects when multiplanar images are used. Multislice CT scan studies have found abnormalities in the maxillary sinus in 30% of the cases.[61],[62] Whereas, CBCT studies have found abnormalities in maxillary sinus in 24.6% to 56.3% of the cases.[57],[58],[59] In the present study, the prevalence of abnormalities in the maxillary sinus was 39.4% which was in accordance with the previous studies. However, a study done by Rege et al. the prevalence was as high as 68.3%.[12] The discrepancy could be due to the sampling criteria selected for the study, the study design, variations in image interpretation, diagnostic criteria for maxillary sinusitis, and the influence of the climate in different geographical areas.[63],[64]


   Conclusion Top


The incidence of odontogenic sinusitis is likely under-reported in the available literature. Radiographic analysis plays a pivotal role in the diagnosis of odontogenic sinusitis. It has been established in the published literature that 2D-imaging modalities may obscure the origin of odontogenic maxillary sinusitis. The introduction of low-dose CBCT is particularly useful to establish a definitive diagnosis to augment in the treatment of chronic maxillary sinusitis of odontogenic origin.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Radman WP. The maxillary sinus; Revisited by an endodontist. J Endod 1983;9:382-3.  Back to cited text no. 1
    
2.
Watzek G, Bernhart T, Ulm C. Complications of sinus perforations and their management in endodontics. Dent Clin North Am 1997;41:563-83.  Back to cited text no. 2
    
3.
Low KM, Dula K, Bürgin W, von Arx T. Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. J Endod 2008;34:557-62.  Back to cited text no. 3
    
4.
Maloney PL, Doku HC. Maxillary sinusitis of odontogenic origin. J Can Dent Assoc (Tor) 1968;34:591-603.  Back to cited text no. 4
    
5.
Bauer W. Maxillary sinusitis of dental origin. Am J Orthod Oral Surg 1943;29:133-513.  Back to cited text no. 5
    
6.
Bogaerts P, Hanssens JF, Siquet JP. Healing of maxillary sinusitis of odontogenic origin following conservative endodontic retreatment: Case reports. Acta Otorhinolaryngol Belg 2003;57:91-7.  Back to cited text no. 6
    
7.
Abrahams JJ, Glassberg RM. Dental disease: A frequently unrecognized cause of maxillary sinus abnormalities? AJR Am J Roentgenol 1996;166:1219-23.  Back to cited text no. 7
    
8.
Arias-Irimia O, Barona-Dorado C, Santos-Marino JA, Martínez-Rodriguez N, Martínez-González JM. Meta-analysis of the etiology of odontogenic maxillary sinusitis. Med Oral Patol Oral Cir Bucal 2010;15:e70-3.  Back to cited text no. 8
    
9.
Maillet M, Bowles WR, McClanahan SL, John MT, Ahmad M. Cone-beam computed tomography evaluation of maxillary sinusitis. J Endod 2011;37:753-7.  Back to cited text no. 9
    
10.
Brüllmann DD, Schmidtmann I, Hornstein S, Schulze RK. Correlation of cone beam computed tomography (CBCT) findings in the maxillary sinus with dental diagnoses: A retrospective cross-sectional study. Clin Oral Investig 2012;16:1023-9.  Back to cited text no. 10
    
11.
Lu Y, Liu Z, Zhang L, Zhou X, Zheng Q, Duan X, et al. Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: A retrospective study. J Endod 2012;38:1069-74.  Back to cited text no. 11
    
12.
Rege IC, Sousa TO, Leles CR, Mendonça EF. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health 2012;12:30.  Back to cited text no. 12
    
13.
Shanbhag S, Karnik P, Shirke P, Shanbhag V. Association between periapical lesions and maxillary sinus mucosal thickening: A retrospective cone-beam computed tomographic study. J Endod 2013;39:853-7.  Back to cited text no. 13
    
14.
Dobele I, Kise L, Apse P, Kragis G, Bigestans A. Radiographic assessment of findings in the maxillary sinus using cone-beam computed tomography. Stomatologija 2013;15:119-22.  Back to cited text no. 14
    
15.
Pokorny A, Tataryn R. Clinical and radiologic findings in a case series of maxillary sinusitis of dental origin. Int Forum Allergy Rhinol 2013;3:973-9.  Back to cited text no. 15
    
16.
Shiki K, Tanaka T, Kito S, Wakasugi-Sato N, Matsumoto-Takeda S, Oda M, et al. The significance of cone beam computed tomography for the visualization of anatomical variations and lesions in the maxillary sinus for patients hoping to have dental implant-supported maxillary restorations in a private dental office in Japan. Head Face Med 2014;10:20.  Back to cited text no. 16
    
17.
Saibene AM, Pipolo GC, Lozza P, Maccari A, Portaleone SM, Scotti A, et al. Redefining boundaries in odontogenic sinusitis: A retrospective evaluation of extramaxillary involvement in 315 patients. Int Forum Allergy Rhinol 2014;4:1020-3.  Back to cited text no. 17
    
18.
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 Oral Maxillofac Surg 2014;72:2454-60.  Back to cited text no. 18
    
19.
von Arx T, Fodich I, Bornstein MM. Proximity of premolar roots to maxillary sinus: A radiographic survey using cone-beam computed tomography. J Endod 2014;40:1541-8.  Back to cited text no. 19
    
20.
Matsumoto Y, Ikeda T, Yokoi H, Kohno N. Association between odontogenic infections and unilateral sinus opacification. Auris Nasus Larynx 2015;42:288-93.  Back to cited text no. 20
    
21.
Malina-Altzinger J, Damerau G, Grätz KW, Stadlinger PD. Evaluation of the maxillary sinus in panoramic radiography – A comparative study. Int J Implant Dent 2015;1:17.  Back to cited text no. 21
    
22.
Shahbazian M, Vandewoude C, Wyatt J, Jacobs R. Comparative assessment of periapical radiography and CBCT imaging for radiodiagnostics in the posterior maxilla. Odontology 2015;103:97-104.  Back to cited text no. 22
    
23.
Tian XM, Qian L, Xin XZ, Wei B, Gong Y. An analysis of the proximity of maxillary posterior teeth to the maxillary sinus using cone-beam computed tomography. J Endod 2016;42:371-7.  Back to cited text no. 23
    
24.
Roque-Torres GD, Ramirez-Sotelo LR, Vaz SL, Bóscolo SM, Bóscolo FN. Association between maxillary sinus pathologies and healthy teeth. Braz J Otorhinolaryngol 2016;82:33-8.  Back to cited text no. 24
    
25.
Schreindorfer K, Kiss Á, Marada G. Maxillary sinusitis as a diagnostical adverse finding of the dental cone-beam computed tomography study. Orv Hetil 2017;158:1747-53.  Back to cited text no. 25
    
26.
Zirk M, Dreiseidler T, Pohl M, Rothamel D, Buller J, Peters F, et al. Odontogenic sinusitis maxillaris: A retrospective study of 121 cases with surgical intervention. J Craniomaxillofac Surg 2017;45:520-5.  Back to cited text no. 26
    
27.
Ata-Ali J, Diago-Vilalta JV, Melo M, Bagán L, Soldini MC, Di-Nardo C, 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. Med Oral Patol Oral Cir Bucal 2017;22:e400-9.  Back to cited text no. 27
    
28.
Dau M, Marciak P, Al-Nawas B, Staedt H, Alshiri A, Frerich B, et al. Evaluation of symptomatic maxillary sinus pathologies using panoramic radiography and cone beam computed tomography-influence of professional training. Int J Implant Dent 2017;3:13.  Back to cited text no. 28
    
29.
Vestin Fredriksson M, Öhman A, Flygare L, Tano K. When maxillary sinusitis does not heal: Findings on CBCT scans of the sinuses with a particular focus on the occurrence of odontogenic causes of maxillary sinusitis. Laryngoscope Investig Otolaryngol 2017;2:442-6.  Back to cited text no. 29
    
30.
Aksoy U, Orhan K. Association between odontogenic conditions and maxillary sinus mucosal thickening: A retrospective CBCT study. Clin Oral Investig 2019;23:123-31.  Back to cited text no. 30
    
31.
Little RE, Long CM, Loehrl TA, Poetker DM. Odontogenic sinusitis: A review of the current literature. Laryngoscope Investig Otolaryngol 2018;3:110-4.  Back to cited text no. 31
    
32.
Vallo J, Suominen-Taipale L, Huumonen S, Soikkonen K, Norblad A. Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: Results from the health 2000 health examination survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e80-7.  Back to cited text no. 32
    
33.
Diament MJ, Senac MO Jr., Gilsanz V, Baker S, Gillespie T, Larsson S, et al. Prevalence of incidental paranasal sinuses opacification in pediatric patients: A CT study. J Comput Assist Tomogr 1987;11:426-31.  Back to cited text no. 33
    
34.
Boeddinghaus R, Whyte A. Current concepts in maxillofacial imaging. Eur J Radiol 2008;66:396-418.  Back to cited text no. 34
    
35.
Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: II 1961. J Endod 2003;29:707-12.  Back to cited text no. 35
    
36.
Van Assche N, Jacobs R, Coucke W, van Steenberghe D, Quirynen M. Radiographic detection of artificial intra-bony defects in the edentulous area. Clin Oral Implants Res 2009;20:273-9.  Back to cited text no. 36
    
37.
Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 2008;34:273-9.  Back to cited text no. 37
    
38.
White S, Pharaoh M. Advanced imaging modalities. Oral Radiology: Principles and Interpretation. 6th ed., Ch. 13. St. Louis: Mosby; 2009. p. 207-24.  Back to cited text no. 38
    
39.
Eberhardt JA, Torabinejad M, Christiansen EL. A computed tomographic study of the distances between the maxillary sinusfloor and the apices of the maxillary posterior teeth. Oral SurgOral Med Oral Pathol 1992;73:345-6.  Back to cited text no. 39
    
40.
Kilic C, Kamburoglu K, Yuksel SP, Ozen T. An assessment of the relationship between the maxillary sinus floor and the maxillary posterior teeth root tips using dental cone-beam computerized tomography. Eur J Dent 2010;4:462-7.  Back to cited text no. 40
    
41.
Sharan A, Madjar D, Hashomer T. Correlation between maxillary sinus floor topography and related root position of posterior teeth using panoramic and cross-sectional computed tomography imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:375-81.  Back to cited text no. 41
    
42.
Wehrbein H, Diedrich P. The initial morphological state in the basally pneumatized maxillary sinus – A radiological-histological study in man. Fortschr Kieferorthop 1992;53:254-62.  Back to cited text no. 42
    
43.
Mehra P, Jeong D. Maxillary sinusitis of odontogenic origin. Curr Allergy Asthma Rep 2009;9:238-43.  Back to cited text no. 43
    
44.
Hauman CH, Chandler NP, Tong DC. Endodontic implications of the maxillary sinus: A review. Int Endod J 2002;35:127-41.  Back to cited text no. 44
    
45.
Lofthag-Hansen S, Huumonen S, Gröndahl K, Gröndahl HG. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:114-9.  Back to cited text no. 45
    
46.
Nogi T, Kanazawa E. Morphometry of the maxillary sinus and the relationship between the sinus base and the tooth roots. J Oral Sci 2001;27:227-34.  Back to cited text no. 46
    
47.
Obayashi N, Ariji Y, Goto M, Izumi M, Naitoh M, Kurita K, et al. Spread of odontogenic infection originating in the maxillary teeth: Computerized tomographic assessment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:223-31.  Back to cited text no. 47
    
48.
Thunthy KH. Diseases of the maxillary sinus. Gen Dent 1998;46:160-5.  Back to cited text no. 48
    
49.
Carmeli G, Artzi Z, Kozlovsky A, Segev Y, Landsberg R. Antral computerized tomography pre-operative evaluation: Relationship between mucosal thickening and maxillary sinus function. Clin Oral Implants Res 2011;22:78-82.  Back to cited text no. 49
    
50.
Mehra P, Murad H. Maxillary sinus disease of odontogenic origin. Otolaryngol Clin North Am 2004;37:347-64.  Back to cited text no. 50
    
51.
Lim WK, Ram B, Fasulakis S, Kane KJ. Incidental magnetic resonance image sinus abnormalities in asymptomatic Australian children. J Laryngol Otol 2003;117:969-72.  Back to cited text no. 51
    
52.
Gordts F, Clement PA, Destryker A, Desprechins B, Kaufman L. Prevalence of sinusitis signs on MRI in a non-ENT paediatric population. Rhinology 1997;35:154-7.  Back to cited text no. 52
    
53.
Melén I, Lindahl L, Andréasson L, Rundcrantz H. Chronic maxillary sinusitis. Definition, diagnosis and relation to dental infections and nasal polyposis. Acta Otolaryngol 1986;101:320-7.  Back to cited text no. 53
    
54.
Engström H, Chamberlain D, Kiger R, Egelberg J. Radiographic evaluation of the effect of initial periodontal therapy on thickness of the maxillary sinus mucosa. J Periodontol 1988;59:604-8.  Back to cited text no. 54
    
55.
Bhattacharyya N. Do maxillary sinus retention cysts reflect obstructive sinus phenomena? Arch Otolaryngol Head Neck Surg 2000;126:1369-71.  Back to cited text no. 55
    
56.
Mathew AL, Pai KM, Sholapurkar AA. Maxillary sinus findings in the elderly: A panoramic radiographic study. J Contemp Dent Pract 2009;10:E041-8.  Back to cited text no. 56
    
57.
Cha JY, Mah J, Sinclair P. Incidental findings in the maxillofacial area with 3-dimensional cone-beam imaging. Am J Orthod Dentofacial Orthop 2007;132:7-14.  Back to cited text no. 57
    
58.
Pazera P, Bornstein MM, Pazera A, Sendi P, Katsaros C. Incidental maxillary sinus findings in orthodontic patients: A radiographic analysis using cone-beam computed tomography (CBCT). Orthod Craniofac Res 2011;14:17-24.  Back to cited text no. 58
    
59.
Ritter L, Lutz J, Neugebauer J, Scheer M, Dreiseidler T, Zinser MJ, et al. Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:634-40.  Back to cited text no. 59
    
60.
Brook I. Sinusitis of odontogenic origin. Otolaryngol Head Neck Surg 2006;135:349-55.  Back to cited text no. 60
    
61.
Diament MJ, Senac MO, Gilsanz V, Baker S, Gillespie T, Larsson S. Prevalence of incidental paranasal sinuses opacification in pediatric patients: a CT study. J Comput Assist Tomogr 1987;11:426-31.  Back to cited text no. 61
    
62.
Havas TE, Motbey JA, Gullane PJ. Prevalence of incidental abnormalities on computed tomographic scans of the paranasal sinuses. Arch Otolaryngol Head Neck Surg 1988;114:856-9.  Back to cited text no. 62
    
63.
Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 1991;101:56-64.  Back to cited text no. 63
    
64.
Rodrigues CD, Freire GF, Silva LB, Fonseca da Silveira MM, Estrela C. Prevalence and risk factors of mucous retention cysts in a Brazilian population. Dentomaxillofac Radiol 2009;38:480-3.  Back to cited text no. 64
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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