Abstract
ObjectivesThe purpose of the present study was to elucidate the significance of cone bean computed tomography (CBCT) for patients hoping to undergo implant-supported restorations of the maxilla. Therefore, two studies were planned. One was to compare the prevalence of anatomic variations and lesions in the maxillary sinus on CBCT of patients hoping to undergo implant-supported restorations of the maxilla with that in patients with other chief complaints in a private dental office in Japan. The other study was to elucidate the limitations of panoramic radiographs in the detection of anatomic variations and lesions in the maxillary sinus.Study designSixty-one pairs of panoramic radiographs and CBCT were retrospectively analyzed in two groups of patients, those who hoped to undergo implant-supported restorations in the maxilla (Implant group) and those who did not (Non-implant group). The presence of anatomic variations and lesions in the maxillary sinus were analyzed.ResultsThe detection rate of mucosal thickening was significantly higher in the Implant group than in the Non-implant group. The detection rates for the features analyzed were significantly lower on panoramic radiographs. In particular, the detection rates of internal and anterior locations of some features were noticeably lower on panoramic radiographs. A significant relationship was found between the change in the detection rate on panoramic radiographs and the widths of mucosal thickening or the lengths of the major axis of SOLs in the maxillary sinus. If the width of mucosal thickening or the length of the major axis of SOLs was <3 mm or <4 mm, respectively, the detection rate on panoramic radiographs was significantly decreased.ConclusionCBCT is important for patients hoping to undergo implant-supported restorations of the maxilla because of the mucosal thickening in the maxillary sinus in such patients and their lower detection rates on panoramic radiographs.
Highlights
Dental implant treatment is continually developing new methods to provide a better understanding of the biologic principles that direct the development of dynamic interference between the living tissue and the biomaterial
A significant relationship was found between the change in the detection rate on panoramic radiographs and the widths of mucosal thickening or the lengths of the major axis of space occupying lesions (SOLs) in the maxillary sinus
cone bean computed tomography (CBCT) is important for patients hoping to undergo implant-supported restorations of the maxilla because of the mucosal thickening in the maxillary sinus in such patients and their lower detection rates on panoramic radiographs
Summary
Dental implant treatment is continually developing new methods to provide a better understanding of the biologic principles that direct the development of dynamic interference between the living tissue and the biomaterial. In the maxilla, there might be some cases in which relatively difficult and invasive techniques are required, such as sinus floor elevation procedures and bone grafting With these techniques, some complications have been reported [1,2,3,4,5,6], and a precise diagnosis is required before dental implant treatment planning. Dental panoramic radiographs are a more useful tool than dental radiographs for complete visualization of the maxillary sinus and evaluating the relationship between the level of the sinus floor and alveolar bone They have a limitation for the three-dimensional (3D) visualization of anatomical structures because of their two-dimensional nature. There is as yet no precise understanding of the limitations of panoramic radiographs for the evaluation of anatomical variations and lesions of the maxillary sinus
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