Abstract
Background: The detailed relationship between apical periodontitis and maxillary sinus mucosal thickening is still unknown. The aim of this study was to evaluate the association between maxillary posterior teeth periapical odontogenic lesions and maxillary sinus mucosal (MSM) thickening by using volumetric 3D CT analysis. Methods: A total of 83 subjects with apical periodontitis around maxillary posterior teeth and maxillary sinus mucosal thickening were selected. 3D models of maxillary sinus mucosa and apical lesions were reconstructed from CT, and their volume, mean diameter were calculated. Results: Mean MSM thickening was 8.81 ± 12.59 mm with an average volume of 5092.58 ± 7435.38 mm3. Men had higher MSM thickening than women. Mean diameter of apical lesion was 5.94 ± 2.68 mm; average volume was 200.5 ± 197.29 mm3. Mean distance between MSM and apical lesion was 1.83 ± 2.07 mm. Mucosal volume was the highest in the S1 and D1 configuration and the lowest in R3. Reducing the distance between apical lesion and MSM by each millimetre, the volume of MSM increases by 759.99 mm3. Conclusions: Volumetric CT analysis is a circumstantial method to evaluate the association between maxillary posterior teeth apical periodontitis and MSM thickening. This relationship is not related to the size of the apical lesion but depends on their anatomical position and the distance from the maxillary sinus mucosa.
Highlights
Apical periodontitis (AP) is an inflammation and destruction of periapical tissues
The upper posterior roots and the floor of the maxillary sinus are separated by a thin cortical bone and, not rarely, solely by the sinus mucosa, which facilitates the spread of infection into sinus [3]
In 54.76% of cases, periapical bone lesion associated with mucosal thickening was around the first and second molar mesiobuccal root, and more rarely around the palatal root (40.47%) and distobuccal root (35.71%)
Summary
Apical periodontitis (AP) is an inflammation and destruction of periapical tissues. It occurs as a sequence of various infectious or physical insults to the dental pulp or the damaging effects of root canal filling materials.Microorganisms from the infected root canals produce a sufficient amount of endotoxins, which egress in high concentrations into the periapical area.The microbial factors and host defence destroy much of the periapical tissue, resulting in a formation of various kinds of periapical lesions, such as reactive granulomas and cysts [1].Sinusitis 2020, 4, 8–20; doi:10.3390/sinusitis4010003 www.mdpi.com/journal/sinusitisa close anatomical proximity of the maxillary posterior lateral teeth to the maxillary sinuses renders them vulnerable to this periodontal inflammation [2].Infection from periapical lesion can affect the maxillary sinus mucosa via bone marrow, blood vessels and lymphatics. Apical periodontitis (AP) is an inflammation and destruction of periapical tissues. It occurs as a sequence of various infectious or physical insults to the dental pulp or the damaging effects of root canal filling materials. Infection from periapical lesion can affect the maxillary sinus mucosa via bone marrow, blood vessels and lymphatics. The detailed relationship between apical periodontitis and maxillary sinus mucosal thickening is still unknown. The aim of this study was to evaluate the association between maxillary posterior teeth periapical odontogenic lesions and maxillary sinus mucosal (MSM) thickening by using volumetric 3D CT analysis. Methods: A total of 83 subjects with apical periodontitis around maxillary posterior teeth and maxillary sinus mucosal thickening were selected.
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