Abstract
Background A study is made of the association between maxillary sinus pathology and odontogenic lesions in patients evaluated with cone beam computed tomography. Material and Methods A literature search was made in five databases and OpenGrey. Methodological assessment was carried out using the Newcastle-Ottawa tool for observational studies. The random-effects model was used for the meta-analysis. Results Twenty-one studies were included in the qualitative review and 6 in the meta-analysis. Most presented moderate or low risk of bias. The periodontal disease showed to be associated with the thickening of the sinus membrane (TSM). Mucous retention cysts and opacities were reported in few studies. The presence of periapical lesions (PALs) was significantly associated to TSM (OR=2.43 (95%CI:1.71-3.46); I2=34.5%) and to odontogenic maxillary sinusitis (OMS) (OR=1.77 (95%CI: 1.20-2.61); I2=35.5%). Conclusions The presence of PALs increases the probability of TSM and OMS up to 2.4-fold and 1.7-fold respectively. The risk differences suggests that about 58 and 37 of out every 100 maxillary sinuses having antral teeth with PALs are associated with an increased risk TSM and OMS respectively. The meta-evidence obtained in this study was of moderate certainty, and although the magnitude of the observed associations may vary, their direction in favor sinus disorders appearance, would not change as a result. Key words:Sinus pathology, Odontogenic Sinusitis, Sinus membrane thickening, CBCT, Periapical lesions, Periodontal disease
Highlights
Maxillary sinus pathology may be of rhinogenic, odontogenic, traumatic, allergic, neoplastic and bone-related origin (1)
Cone beam computed tomography (CBCT) has been recommended for preoperative evaluation of the available bone in the posterior maxilla and to assess the health or pathology of maxillary sinus in different dental medicine disciplines, and it provides three-dimensional images of maxillofacial structures, with negligible radiation doses compared to medical CT (12)
Periapical lesions are associated to the sinus membrane (TSM) and odontogenic maxillary sinusitis (OMS), as evaluated by CBCT
Summary
Maxillary sinus pathology may be of rhinogenic, odontogenic, traumatic, allergic, neoplastic and bone-related origin (1). The causes underlying sinus diseases and their association to dental lesions remain subject to controversy, ear, nose and throat specialists consider that a dental origin should be considered in the presence of chronic sinusitis, though such explorations are rarely described in routine clinical practice (13) In keeping with these observations, the primary aim of this systematic review was to evaluate the association between odontogenic lesions and the appearance of TSM and OMS in patients evaluated using cone beam computed tomography (CBCT). - Focused question The review was made to answer the following focused question in Population, Exposure and Outcome (PEO) format (14): (P) Among dentulous or partially edentulous patients subjected to (E) CBCT evaluation, what relationship is there between odontogenic lesions and the appearance of (O) anatomical alterations of the sinus membrane, maxillary sinusitis and mucosal retention cysts? OMS: Odontogeneic Maxillary Sinusitis; MS: Maxillary sinusitis; MRC: Mucous Retention Cysts; TSM: Thickening of Sinus Membrane
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