Abstract
Objectives To explore the alterations in maxillary sinus mucosal thickening after extracting teeth with severe periodontal disease using cone-beam computed tomography (CBCT). Methods 30 patients with severe periodontal disease of maxillary posterior teeth that needed to be extracted and who were radiographically diagnosed with mucosal thickening (MT) in the maxillary sinus participated in the study. CBCT scans were taken before tooth extraction and 2-29 months after tooth extraction. The postextraction follow-up time was divided into two groups: group 1 (<4 months) and group 2 (≥4 months). Dimensions of maxillary sinus MT, including the MT zone length (SL) and the maximum thickness of the MT zone (ST), were evaluated preextraction and postextraction; the residual ridge height (RRH) was evaluated at the sites of extracted and nonextracted teeth. Result Of the 24 patients with unilateral tooth extraction, there was a statistically significant difference in MT between the extraction and nonextraction sides (p < 0.05). The RRH at the site of the extracted teeth was significantly lower than that of the nonextracted teeth (p < 0.05). MT decreased significantly after tooth extraction on the extraction side but not on the nonextraction side. There was no significant difference between group 1 and group 2 regarding the reduction in mucosal thickness over time. Conclusions Severe periodontitis can cause MT in the maxillary sinus. The RRH was lower at the sites of extracted teeth. MT reduced quickly by a thorough debridement after tooth extraction in 4 months. MT will not decrease further over time.
Highlights
With the popularity and development of dental implants, an increasing number of people are using cone-beam computed tomography (CBCT) for preoperative evaluation; mucosal thickening (MT) is found in symptomless maxillary sinuses
A total of 30 patients with 60 sinuses were included for analysis of changes in MT based on their CBCT images
MT was present in 49 sinuses (81.7%), with 35 exhibiting MT on the tooth extraction side (71.4%) and 14 exhibiting MT on the nonextraction side (28.6%)
Summary
With the popularity and development of dental implants, an increasing number of people are using cone-beam computed tomography (CBCT) for preoperative evaluation; mucosal thickening (MT) is found in symptomless maxillary sinuses. Radiographic membrane thickness was in agreement with clinical measurements of the human maxillary sinus membrane [3, 4]. When it is infected or irritated by an allergic reaction, the thickness increases 10-15 times. A thickened sinus membrane is one of the important characteristics of maxillary sinus mucosa infection or stimulation. There are many factors influencing MT, such as infection (caused by bacterial, fungal, or viral agents), foreign bodies, trauma, allergies, and immune deficiency [7, 8]. Patients older than 60 years and smokers tend to have thicker mucous membranes [9]
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