Maxillary sinus pathologies in dental implant candidates: CBCT-based prevalence and odontogenic risk factors.

BACKGROUND

This retrospective study aimed to assess the prevalence of maxillary sinus pathologies and their associations with odontogenic factors in dental implant candidates using cone beam computed tomography (CBCT). By identifying the most common sinus pathologies and their potential relationship with odontogenic conditions, this study provides insights into factors influencing preoperative planning for sinus augmentation and implant placement.

METHODS

1,000 CBCT scans (500 males, 500 females), representing 2,000 maxillary sinuses, were analyzed. Sinus pathologies were classified based on demographic variations and odontogenic factors, including periapical lesions without root canal treatment (RCT), periapical lesions with RCT, root canal-treated teeth without lesions, and edentulism. The distinction between unilateral and bilateral occurrences was also assessed. The associations between these factors and sinus pathologies were statistically evaluated.

RESULTS

Sinus pathologies were identified in 39.5% of sinuses, affecting 54.8% of patients. The most common finding was mucosal thickening (61%), followed by cysts/polyps (27.6%) and opacifications (11.4%). Males had a higher prevalence of cysts/polyps (p =.020), while mucosal thickening showed no significant gender difference. Odontogenic factors were present in 65.2% of pathological sinuses, particularly in mucosal thickening cases. Periapical lesions-whether untreated or treated with RCT-were significantly associated with sinus pathology (p <.0001 and p =.013), while root canal-treated teeth without lesions showed no association (p =.411). The rate of complete sinus opacification, which may impact sinus augmentation procedures, was 5%. Patients aged 41-60 exhibited a higher incidence of bilateral sinus pathology (p <.0001). Mucosal thickening was more frequently bilateral, whereas sinus cysts were predominantly unilateral (p =.003).

CONCLUSIONS

This study highlights the high prevalence of sinus pathologies in dental implant candidates and their significant association with odontogenic factors. These findings underscore the importance of thorough preoperative radiographic evaluation to optimize implant planning and reduce complications. Identifying these relationships may enhance clinical decision-making before sinus augmentation procedures. Further research incorporating clinical examinations and patient records is warranted to strengthen these findings.