Evaluation of maxillary sinus variations using cone beam computed tomography and their association with posterior dental pathologies

Abstract

Maxillary sinus anatomical variations and mucosal abnormalities are frequently encountered on dental cone-beam computed tomography, but their relationship with posterior dental pathologies requires careful radiographic assessment. This retrospective CBCT study evaluated 300 patients and 600 maxillary sinuses for septa, pneumatization, mucosal thickening, retention cysts, ostium obstruction, periapical lesions, periodontal bone loss, endodontic status and root proximity to the sinus floor. Mucosal thickening was observed in 196 sinuses (32.7%), sinus septa in 135 (22.5%), marked alveolar pneumatization in 118 (19.7%) and retention cyst/polyp like opacity in 52 (8.7%). Periapical lesions (adjusted OR=3.12, 95% CI=2.01-4.86, p<0.001), severe periodontal bone loss (adjusted OR=2.28, p=0.003) and direct root contact with the sinus floor (adjusted OR=2.06, p=0.011) were significantly associated with mucosal thickening. Thus, CBCT provides clinically relevant information on sinus anatomy and odontogenic risk indicators, supporting its careful interpretation before posterior maxillary dental procedures.