Abstract
BackgroundThe proximity of the maxillary sinus floor to the maxillary molar roots increases the probability of oroantral communication on conducting any surgical or endodontic procedure in the involved area. The aim of this study is to evaluate the relationship between each maxillary molar root and maxillary sinus floor using cone beam computed tomography. Predicting the probability of protrusion of each root into the sinus will consequently predict the probability of occurrence of the oroantral fistula in a sample of the Egyptian population.ResultsThe total number of roots located outside the sinus was 121 (35.3%), while those contacting the sinus floor were 80 (23.3%) and those intruded the sinus were 141 (41.2%). The percentage of root intrusion into the sinus in males (56.9%) was significantly (p = 0.01) higher than females (42.9%). The probability of root intrusion in the left molars (54.2%) was non-significantly (p = 0.067) higher than that of the right side (44.3%). As for the type of tooth, the second molar showed the highest probability of root intrusion into the sinus (55.3%) followed by the third molars (52.6%) then the first molars (40.9). According to the type of root, the mesiobuccal root showed the highest probability of intrusion into the sinus (50.9%) followed by the palatal root (49.1%) then the distobuccal root (47.4%). However, the difference in both type of tooth and type of root was statistically non-significant (p = 0.051 and 0.869 respectively). As for the individual root with the highest probability of intrusion, the mesio-buccal root of the right third molar is the most frequent root to intrude the sinus (71.4%) and the mesio-buccal root of the right first molar is the least frequent (22.7%).ConclusionsIn a sample of the Egyptian population, males exhibit higher probability of root protrusion into the sinus than females. The side and type of tooth are of higher impact on the probability of its intrusion into the sinus compared to the type of root. Left second molars are at a higher risk of oroantral communications on surgical or endodontic procedures compared to other molars due to its highest probability of intrusion into the sinus.
Highlights
The proximity of the maxillary sinus floor to the maxillary molar roots increases the probability of oroantral communication on conducting any surgical or endodontic procedure in the involved area
As for the type of tooth, the second molar showed the highest probability of root intrusion into the sinus (55.3%) followed by the third molars (52.6%) the first molars (40.9)
The result of the present study revealed that, from a total of 342 maxillary molar roots of the Egyptian population, 35.3% was located outside the sinus, 23.4% contacted the sinus floor, and 41.2% protruded the sinus
Summary
The proximity of the maxillary sinus floor to the maxillary molar roots increases the probability of oroantral communication on conducting any surgical or endodontic procedure in the involved area. The maxillary sinuses (MS) are one of the four paired sets of the paranasal sinuses and the first to develop in fetal life [1] It is considered the most important paranasal sinus that impacts most of the work of the dentists and the maxillofacial surgeons [2]. The sinus becomes at a risk of exposure to the oral cavity either due to a surgical procedure carried out in the area of the maxillary posterior teeth or due to a pathologic invasion from a lesion arising from this area. This leads to the occurrence of the popular accident known as oroantral fistula or oroantral communication. This accident, which has always been a concern for dental practitioners, consists in the violation of the maxillary sinus floor (MSF) and may or may not involve tearing of the Schneiderian membrane [4]
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