Using cone beam computed tomography to detect the relationship between the periodontal bone loss and mucosal thickening of the maxillary sinus

Abstract

Background: Maxillary sinuses are covered by a 1 mm thick mucous membrane that when this
membrane becomes infl amed, the thickness may increase 10-15 times. The common causes of
odontogenic sinusitis are dental abscesses and periodontal disease. Computed tomography (CT) is
considered the gold standard for sinus diagnosis. Recently, cone beam computed tomography (CBCT)
has been introduced for dental and maxillofacial imaging, which has several advantages over traditional
CT, including lower radiation dose and chairside process. This study aims to fi nd the association between
mucosal thickening (MT) of the sinus and periodontal bone loss (PBL) and pulpoperiapical condition.
Materials and Methods: A total of 180 CBCT images were reviewed. PBL was assessed in six
points under each sinus at the mesial and distal sides of the upper second premolar and fi rst and
second molars by measuring the distance from the alveolar crest to the point 2 mm under the
cemento-enamel junction (CEJ). The MT was assessed at six points in the fl oor of the sinus precisely
over the mentioned points. To assess the possible role of pulpoperiapical condition on the sinus MT,
the existing teeth were classifi ed into fi ve groups due to the probable effect of each condition on
the pulp and peri-apex. The statistical association between MT of sinus and PBL and pulpoperiapical
condition was assessed using SPSS software (SPSS Inc., version 16.0, Chicago, IL, USA) and bivariate
correlation and binary linear regression statistical tests (P < 0.05).
Results: MT was observed in 39.4% of patients (mean = 4.68 ± 5.25 mm). PBL was seen in 33% of the
patients (mean = 1.87 ± 1.63 mm). Linear regression test showed that there is an association between
both PBL and pulpoperiapical condition and MT, but the effect of PBL was about 4 times stronger.
Conclusion: This study showed that MT of the maxillary sinus was common among patients with
PBL and MT of the maxillary sinus was signifi cantly associated with PBL.
Key Words: Maxillary sinus, mucosal thickening, periodontal bone loss