Gs Sivaraman, Sarvathikari Ramasamy, Amhr Alkandari Ahamed, Nawaz M Khaja Khalid, L Jayasharmila, Sureshbabu Shanmathy, Arthanari Abirami, Ramalingam Karthikeyan
Department of Oral Medicine and Radiology, Vivekanandha Dental College for Women, Namakkal, IND.
Department of Oral Medicine and Radiology, Annamalai University, Cuddalore, IND.
Cureus. 2024 Sep 8;16(9):e68929. doi: 10.7759/cureus.68929. eCollection 2024 Sep.
Background Cone-beam computed tomography (CBCT), a cross-sectional imaging technique, is valuable for clinical diagnosis and creating effective treatment plans. CBCT can precisely examine the connection between the maxillary sinuses and the maxillary root apices. Oral radiologists must be aware of all potential incidental findings and should be diligent in thoroughly identifying and assessing possible underlying diseases. Aim To determine the prevalence of incidental maxillary sinus pathologies and their relationship to dental diseases. Materials and methods In the present retrospective study, CBCT scans from 300 subjects (encompassing 600 right and left maxillary sinuses), aged 18 to 70, were gathered from various CBCT centers to represent the Tamil Nadu population. The CBCT images were analyzed using proprietary software, which provided both a panoramic reconstruction view and multiplanar reformation modules, including axial, sagittal, and coronal slices. The entire sample size was classified as follows: Group 1, age groups of 18 to 25 years; Group 2, age groups of 26 to 35 years; Group 3, age groups of 36 to 45 years; Group 4, age groups of 46 to 55 years; Group 5, age groups of 56 to 65 years; Group 6, age groups of 66 to 70 years. The prevalence of incidental maxillary sinus findings was analyzed, and their relationship with periapical abscess, periapical granuloma, periapical cyst, and breach was assessed. Results There was a prevalence of 52.05% of cases that had incidental maxillary sinus findings. Among them, 53.43% were males and 50.65% were females. Maxillary sinus pathologies were more common in individuals between 46 and 55 years, i.e., Group 4. In 300 datasets, the frequency of incidental maxillary sinus findings on the right is 21.33%, on the left is 24%, in both is 6.67%, and absent in 48% of the cases. Mucosal thickening was observed in 30% of cases with a periapical abscess, 19.52% with a periapical granuloma, 25% with a periapical cyst, and 51.79% with a breach. Polypoidal mucosal thickening was present in 32.50% of cases with a periapical abscess, 13.79% with a periapical granuloma, 50% with a periapical cyst, and 23.21% with a breach. Opacification occurred in 37.50% of cases with a periapical abscess, 20.69% with a periapical granuloma, 25% with a periapical cyst, and 25% with a breach. Conclusion Dental professionals should have a bird's-eye view in treating chronic odontogenic infections close to the maxillary sinus. Early diagnosis and prompt treatment of odontogenic infections help prevent maxillary sinus pathologies.
背景 锥形束计算机断层扫描（CBCT）是一种断层成像技术，对临床诊断和制定有效的治疗方案具有重要价值。CBCT 能够精确检查上颌窦与上颌根尖之间的联系。口腔放射科医生必须了解所有潜在的偶然发现，并应勤勉地全面识别和评估可能的潜在疾病。目的 确定上颌窦偶然病变的患病率及其与牙病的关系。材料与方法 在本回顾性研究中，从各个 CBCT 中心收集了 300 名年龄在 18 至 70 岁之间的受试者（包括 600 个左右上颌窦）的 CBCT 扫描数据，以代表泰米尔纳德邦人群。使用专有软件对 CBCT 图像进行分析，该软件提供全景重建视图和多平面重建模块，包括轴向、矢状和冠状切片。整个样本按以下方式分类：第 1 组，18 至 25 岁年龄组；第 2 组，26 至 35 岁年龄组；第 3 组，36 至 45 岁年龄组；第 4 组，46 至 55 岁年龄组；第 5 组，56 至 65 岁年龄组；第 6 组，66 至 70 岁年龄组。分析上颌窦偶然发现的患病率，并评估其与根尖脓肿、根尖肉芽肿、根尖囊肿和穿孔的关系。结果 有 52.05%的病例存在上颌窦偶然发现。其中，男性占 53.43%，女性占 50.65%。上颌窦病变在 46 至 55 岁的个体（即第 4 组）中更为常见。在 300 个数据集中，右侧上颌窦偶然发现的频率为 21.33%，左侧为 24%，双侧为 6.67%，48%的病例未发现。根尖脓肿病例中 30%观察到黏膜增厚，根尖肉芽肿病例中 19.52%观察到黏膜增厚，根尖囊肿病例中 25%观察到黏膜增厚，穿孔病例中 51.79%观察到黏膜增厚。根尖脓肿病例中 32.50%出现息肉样黏膜增厚，根尖肉芽肿病例中 13.79%出现息肉样黏膜增厚，根尖囊肿病例中 50%出现息肉样黏膜增厚，穿孔病例中 23.21%出现息肉样黏膜增厚。根尖脓肿病例中 37.50%出现混浊，根尖肉芽肿病例中 20.69%出现混浊，根尖囊肿病例中 25%出现混浊，穿孔病例中 25%出现混浊。结论 牙科专业人员在治疗靠近上颌窦的慢性牙源性感染时应具备全面的视野。牙源性感染的早期诊断和及时治疗有助于预防上颌窦病变。
