Association between odontogenic factors and maxillary sinus mucosal characteristics: a retrospective CBCT study

Objectives The aim of this study was to investigate the effects of various dental and maxillary sinus (MS) variables on mucosal characteristics (MC), including maxillary sinus mucosal thickness (MT) and mucosal appearance (MA), using cone-beam computed tomography (CBCT) imaging. Materials and methods CBCT images of the MS (n=249) were reviewed from a total of 16439 patients who had undergone CBCT examinations for various dentomaxillofacial issues, leading to the identification and confirmation of odontogenic maxillary sinusitis (OMS). The MT and the distances between the maxillary sinus floor (MSF) and both the root apex and periapical lesion (PALs) were measured. The MA and situations of adjacent teeth were recorded. The relationships between these odontogenic factors and MC (including MT and MA) were evaluated. The data were analyzed using analysis of variance, χ2-test, and logistic regression. Results A total of 249 CBCT images exhibited OMS with specific mucosal characteristics. MT was significantly correlated with gender, tooth type, the distance between the root apex and the MSF, and the distance between the PALs and the MSF, whereas MA was significantly associated with all these above factors except gender. (P＜0.05). A logistic regression model showed that the severity of MT hyperplasia was significantly associated with male sex (OR: 2.441, 95% CI: 1.225 ~ 4.863, P< 0.05). The distance between the MSF and PALs or root apex in contact with the MSF (type 2) showed a significant relation with MT > 10 mm. (PALs: OR = 0.161 and 0.089, P < 0.05; root apex: OR = 0.212, P < 0.005). Conclusions Multiple factors, including gender, periapical infection, and the distance between the MSF and PALs/root apex, may have a precursor effect on the occurrence of MT and MA in the maxillary sinus. The severity of MT was significantly associated with male sex and the distance between the MSF and PALs/root apex. Odontogenic diseases represent significant risk factors for the development of maxillary sinus infections and should therefore be carefully considered by both dental and medical professionals in the comprehensive assessment and management of maxillary sinus lesions. Therefore, communication between dental surgeons and an otolaryngology specialist is important for the timely diagnosis and treatment of MT of dental origin. Clinical relevance The maxillary sinuses are notably affected by a range of odontogenic factors—such as patient gender, the proximity of the maxillary sinus floor (MSF) to the root apex or periapical lesion (PAL), and the type of tooth involved—all of which may play a contributory role in alterations of mucosal thickening (MT) and maxillary sinus anatomy (MA).