Correlation between Endodontic Infection and Periodontal Disease and Their Association with Chronic Sinusitis: A Clinical-tomographic Study

Abstract

IntroductionThe proximity of the roots of maxillary posterior teeth to the maxillary sinus floor can be associated with the development of chronic maxillary sinusitis (CMS). Therefore, this study evaluated the correlation between the presence of endodontic infection and periodontal disease in maxillary posterior teeth and the presence of CMS. MethodsA total of 83 patients (159 maxillary sinuses) were selected and underwent clinical dental examination to assess tooth mobility and pulp condition. In addition, cone-beam computed tomography was performed to evaluate the presence of periapical lesion and periodontal bone loss, and measure the distance from the root apex to the cortical of the maxillary sinus. The maxillary sinuses were divided into 2 groups: CMS and no maxillary sinusitis. Data were analyzed using χ2 test and binary logistic regression analysis (P < .05). ResultsPeriodontal disease was positively associated with CMS, leading to a 3.45-fold higher association between these disorders (P < .05). CMS was significantly more common in patients with periodontal disease or endodontic infection in close proximity with the maxillary sinus. Periodontal disease or endodontic infection that was more distant from the maxillary sinus was more common in patients with no maxillary sinusitis (P < .05). To the extent that the tooth is more distant from the maxillary sinus floor, the chance of presenting CMS is reduced up to 2.5-fold (P < .05). ConclusionPeriodontal disease and proximity to the maxillary sinus are more common in cases of CMS, requiring a dental assessment and cone-beam computed tomography evaluation in patients with CMS with ineffective treatment.