Roots Of Maxillary Posterior Teeth Research Articles

The Relation of Maxillary Posterior Teeth Roots to the Maxillary Sinus Floor Using Panoramic and Computed Tomography Imaging in a Sample of Kurdish People

The relation of maxillary posterior teeth roots to the maxillary sinus floor is important for diagnosing and planning of many surgical procedures. In order to determine of this relation two imaging technique were used in this study.Paired panoramic radiographs and computed tomography images of maxilla from 27 subjects were taken and analyzed in the teaching hospitals of Sulaimani city during the period from Jan to Aug 2009. For both imaging modalities a total of 146 maxillary teeth were grouped according to their topographic relationship to the inferior border of the maxillary sinus followed Kwak et al. classification, were 0 indicated no contact between the root and inferior border of the maxillary sinus); 1 indicated that the root is in contact with the inferior border of the maxillary sinus; 2 indicated that the root is projecting laterally on the maxillary sinus cavity but its apex is outside the sinus boundaries; 3 and 4 indicated that the teeth roots that projected on the maxillary sinus cavity. Then roots were measured according to their projection lengths in the sinus cavity.Results of this study show that there was a high correlation between the two imaging technique for classification 0 and 1 relations. The OPG showed statistically significant (P>0.001) longer root projection in the sinus cavity in comparison with the root protrusion into the sinus measured by using CT images.As conclusion; for the majority of the roots projecting on the sinus cavity in panoramic radiographs, no vertical protrusion into the sinus was observed in CT images. Roots protrude into the sinus in the CT showed shorter projection length in comparison with panoramic radiography. Panoramic radiographs can provide adequate assessment about relation of the maxillary sinus floor. CT is indicated to provide the information about the relation to the maxillary sinus floor when there is protrusion detected in panoramic images.

Evaluation of Association between Maxillary Posterior Teeth Periapical Pathologies and Maxillary Sinus Mucosal Changes—A Cone-Beam Computed Tomography (CBCT) Study

Abstract Introduction Odontogenic infections are one of the common causes of maxillary sinusitis. With the close proximity of the roots of maxillary posterior teeth to the sinus floor, the infection may spread into the sinus causing sinus mucosal thickening. This study aims to evaluate the association between maxillary posterior teeth periapical pathologies and maxillary sinus mucosal changes using cone-beam computed tomography (CBCT) images. Methods One-hundred six maxillary posterior teeth with periapical lesions were included in this study and were assessed using CBCT images by two maxillofacial radiologists. The proximity of the roots to the sinus floor, the proximity of the top edge of the periapical lesion to the sinus floor, and the sinus mucosal changes associated with the periapical lesions were studied. The size of the periapical lesion was measured and scored using CBCT periapical index. Mucosal thickening more than 2 mm was considered pathological and the type, pattern, and severity of mucosal thickening were assessed. Data were analyzed using chi-squared tests at a level of significance set at p-value less than 0.05. Results Among the 106 teeth with periapical lesions, 99 teeth (93.4%) revealed the presence of maxillary sinus mucosal thickening. The prevalence of mucosal thickening increased significantly with the presence of cortical bone destruction, the close proximity of the root, and the periapical lesion to the sinus floor. The generalized type of mucosal thickening was more prevalent with larger periapical lesions and a significant increase in the severity of the thickening was observed closer spatial relationship of the root to the sinus floor. Conclusion Periapical pathologies of maxillary posterior teeth often cause sinus mucosal thickening. The early diagnosis and management of these pathologies will be helpful in preventing the spread of infection into the maxillary sinus.

Proximity of Roots of Posterior Teeth to Maxillary Sinus in Different Facial Biotypes.

To evaluate the relationship between maxillary posterior teeth roots to maxillary sinus floor (MSF) using three-dimensional imaging and to evaluate the correlation of vertical facial biotype, gender, and age to the proximity of posterior roots to the sinus. Observational, Cross-sectional study. Place and Duration of the Study: Department of Orthodontics, Armed Forces Institute of Dentistry, Combined Military Hospital, Rawalpindi, from January 2021 to July 2022. Three-dimensional CBCT scans of 100 patients aged between 13 to 43 years were evaluated and divided into three matching groups based on vertical face forms i.e. hyperdivergent, normodivergent, and hypodivergent. Root proximity to maxillary sinus was scored (0-3) for each scan. Nonparametric Wilcoxon Mann Whitney U test and Kruskal Wallis test were used to compare average tooth and patient scores to vertical face type, age, and gender. Out of 100 patients, 54 were males and 46 were females with 44% aged between 13-23 years, 27% between 24 to 33 years, and 29% between 34 to 43 years. Average patient and tooth scores were highest in the hyperdivergent face type (p<0.001). No statistically significant relation was found between gender and degree of root proximity to MSF (p>0.05). Age was negatively correlated to root sinus wall connection (p<0.001). Patients with hyperdivergent face forms are at greater risk of root resorption and prolonged orthodontic treatment due to the closer proximity of root apices to the maxillary sinus as compared to hypodivergent and normodivergent face forms. Moreover, roots were farther from the maxillary sinus wall with advanced age. Maxillary sinus, Cone beam computed tomography, Face.

Comparative Evaluation of the Relationship between the Root-Tips of Maxillary Posterior Teeth and Floor of Maxillary Sinus using Digital Orthopantomogram in Chhattisgarh Individuals with Different Cephalic Indices

Background and Aims: Cephalic index has significant importance in the field of forensic science and variation in the cephalic index affects the facial dimensions and growth of the maxillary sinus in an individual. Knowledge of the anatomical relationship between maxillary posterior teeth and the floor of the maxillary sinus is very important for preoperative treatment planning in dentistry. The aim of the study is a comparative evaluation of the relationship and the distances between maxillary posterior teeth root tips and the floor of the maxillary sinus in different cephalic index subjects using a digital orthopantomogram. Materials and Methods: 210 subjects were categorized as Brachycephalic, Mesocephalic and Dolichocephalic according to their cephalic index. Orthopantomograms of these subjects were taken for assessment of vertical relationships between the maxillary posterior teeth and the floor of the maxillary sinus followed by distance measurement. Recorded data were statistically analyzed. Results: Significant difference in vertical distance was observed in all three cephalic groups in the case of 1st premolars, distobuccal roots of 1st molars and mesiobuccal roots of 2nd molars. Conclusion: The study concluded variation in the cephalic index affects the relationship and vertical distance between the maxillary sinus floor and the roots of maxillary posterior teeth.

Assessing The Proximity of the Roots of Maxillary Molars and Premolars to the Maxillary Sinus in UAE Residents

Background: The proximity of the roots of the maxillary posterior teeth (MPT) to the maxillary sinus (MS) may result in an increased risk of the development of MS pathology. Moreover, surgical procedures for the MPT, which are close to the MS can result in several complications like oroantral communication and displacement of roots into the MS. Objective: This cross-sectional study evaluated the MPT's proximity to the MS using digital panoramic radiography in a sample of individuals living in the United Arab Emirates (UAE). Methods: A total of 141 panoramic radiographs showing the presence of all MPT were retrieved from the Oral Radiology Department of Ajman University, Fujairah Campus. Thus, the proximity of 1410 MPT to the MS was evaluated on a scale of zero to three. Results: The roots of the first and the second molars are the closest to the MS (χ2 = 374.612; p 0.000). The distance between the roots of MPT and MS did not differ statistically between males and females (χ2 = 2.44, p= .124), nor between the right and left sides (χ2 = 0.46, p= .872). However, there was a highly significant negative correlation between the root-sinus proximity and age. (rho= -.201, p &lt; .001). Conclusion: In UAE residents, the roots of the first and second molars are closer to the MS than other MPT. Therefore, more precautions should be taken when doing a surgical procedure in this region.

Maxillary Sinus Dimensions in Skeletal Class I Chinese Population with Different Vertical Skeletal Patterns: A Cone-Beam Computed Tomography Study.

Due to the close relationship between the maxillary posterior teeth roots and the maxillary sinus floor, the maxillary sinus can significantly impact various dental treatments, including endodontic procedures and surgical apicectomy, periodontal flap surgery, surgical tooth extraction, dental implantation, and orthognathic surgeries. Specifically, in orthodontics, the location of the maxillary sinus floor may affect tooth movement and insertion of temporary anchorage devices (TADs). This study aims to evaluate the dimensions and location of the maxillary sinus in the Chinese orthodontic patient population with skeletal class I. Using cone-beam computed tomography (CBCT), the volumetric size, height, width, and depth of the sinus and the amount of alveolar bone below the sinus floor and buccal/palatal to the sinus wall were compared between patients of different genders and different vertical skeletal patterns. Unlike the previously reported skeletal class II population, the skeletal class I patients with different vertical patterns do not have significantly different size sinuses. On the other hand, males have larger maxillary sinuses in all parameters than females in the testing population. In addition, no significant correlation was noticed between the SN-MP angle and sinus dimensions or between the ANB angle and sinus dimensions. Nevertheless, the distance from the sinus floor to the alveolar bone crest is not correlated with skeletally sagittal or vertical parameters in females but negatively correlated with the skeletal sagittal parameter in males. In summary, different from the skeletal class II population, there is no significant difference in maxillary sinus size and location among different vertical skeletal patterns in the skeletal class I population. Compared to the skeletal class II population, a higher percentage of the skeletal class I population has an alveolar bone with less than 5 mm thickness, representing a narrowed safe zone of TADs placements.

A CBCT based evaluation of root proximity of maxillary posterior teeth to sinus floor in a subset of Pakistani population.

To evaluate the vertical relationship of the roots of maxillary posterior teeth with maxillary sinus floor, and its association with age, gender and bilateral jaw symmetry. The cross-sectional study was conducted at a tertiary care hospital in Karachi from June to December 2018, and comprised patients who visited the dental clinics and underwent cone-beam computed tomography scans. The scans were evaluated in the axial, coronal and sagittal planes and roots were classified using Jungs classification for proximity to maxillary sinus floor. The distance between the sinus floor and the apices of maxillary posterior teeth was measured. Data was analysed using SPSS 23. There were 60 scans with 1066 roots. The most common maxillary tooth root in Type III group of Jung classification was the mesio-buccal root of the 2nd molar with the shortest mean distance of 0.44±3.05mm, followed by palatal roots of the 1st molar with the shortest mean distance of 1.58±4.01mm. The maxillary tooth root most frequent in Type I group was buccal root of 1st premolar with a mean distance of 8.15±6.65mm, and the 2nd premolar with a mean distance of 7.38±6.60mm. No significant difference was found in terms of gender and sides (p ≥0.05). The most common tooth root protruding in the sinus was found to be the mesio-buccal root of the 2nd molar, followed by palatal roots of the 1st molar. The most distant maxillary tooth root from the sinus was the buccal root of 1st and 2nd premolars.

Proximity of the roots of maxillary posterior teeth to the floor of maxillary sinus and cortical plate: A cone-beam computed tomography assessment.

The purpose of the study is to assess the vertical and horizontal relationship between the roots of maxillary posterior teeth and neighboring structures like the floor of the maxillary sinus and cortical plates using cone-beam computed tomography (CBCT). 100 CBCT scans of the patients from the Indian population were analyzed. Vertical and horizontal relationship between the roots of maxillary posterior teeth and the floor of the maxillary sinus was divided into 4 types and 3 types, respectively. Distances between the root apices and the floor of the maxillary sinus and cortical plate was measured for each root and results were formulated. In total 365 teeth were assessed, 185 first molar and 180 second molar. It was found that the roots of first molar and second molar usually had type 2 (root apices in close contact with the floor of maxillary sinus) and type 3 (roots projecting laterally into the sinus, but its apices are outside the sinus border) vertical relationship respectively with the floor of maxillary sinus. The deepest portion of the floor of the maxillary sinus was most commonly seen projecting between buccal and palatal roots. The mean distance between the cortical plate and root was highest for the distobuccal root of second molar i.e., 1.20 mm SD = 0.97. The distobuccal root of the first molar and mesiobuccal root of the second molar are closest to the sinus floor, hence clinician should be extra cautious while working on these roots during endodontic or surgical procedures in the Indian population.

Comparison of panoramic radiography and cone-beam computed tomography for assessing radiographic signs indicating root protrusion into the maxillary sinus.

PurposeThis study investigated correlations between findings on panoramic radiographs and cone-beam computed tomography (CBCT) to assess the relationship between the maxillary sinus floor and the roots of maxillary posterior teeth. In addition, radiographic signs indicating actual root protrusion into the maxillary sinus were evaluated on panoramic radiographs.Materials and MethodsPaired panoramic radiographs and CBCT images from 305 subjects were analyzed. This analysis classified 2,440 maxillary premolars and molars according to their relationship with the maxillary sinus floor on panoramic radiographs and CBCT images. In addition, interruption of the sinus floor was examined on panoramic radiographs.ResultsRoot protrusion into the maxillary sinus occurred most frequently in the mesiobuccal roots of the second molars. The classification according to panoramic radiographs and CBCT images was the same in more than 90% of cases when there was no contact between the root apex and the sinus floor. When the panoramic radiograph showed root protrusion into the sinus, the CBCT images showed the same classification in 67.5% of second molars, 48.8% of first molars, and 53.3% of second premolars. There was a statistically significant relationship between interruption of the sinus floor on panoramic radiographs and root protrusion into the sinus on CBCT images.ConclusionThe presence of root protrusion into the sinus on panoramic radiographs demonstrated a moderate ability to predict root protrusion into the maxillary sinus. Interruption of the maxillary sinus floor could be considered an indicator of actual root protrusion into the maxillary sinus.

Anatomical relationship between roots of maxillary posterior teeth and maxillary sinus using cone-beam computed tomography

Aim: Maxillary sinusitis of odontogenic origin accounts for approximately 10%–12% of maxillary sinusitis cases. The primary objective of the present study was to analyze the vertical relationship between the maxillary posterior roots and the adjacent maxillary sinus floor (MSF) in the Indian population using cone-beam computed tomography. The secondary objective was to correlate the data with age and gender.Materials and Methods: The shortest distance between 452 maxillary posterior teeth and the adjacent border of MSF was measured. The data were divided into three groups. Group IS included maxillary posterior teeth roots protruding into the sinus, Group CO included root apices contacting the MSF, and Group OS included root apices not contacting the MSF. The data obtained were correlated with age and gender.Results: The vertical distance of the root apices of second premolars from the MSF was significantly lesser compared to the root apices of first premolars (P < 0.05). The difference between the vertical distance of buccal roots and palatal roots (PRs) of first molar from the MSF was significantly more (P < 0.05). Majority of the roots of posterior teeth were located below the MSF border (Type OS). Type IS was most frequently seen for PRs of maxillary first molars (29.12%). The frequency of Type IS decreased with increasing age. The distance between the posterior root apices and the adjacent border of the MSF was found to be more in males compared to females.Conclusion: The PRs of maxillary first molars were found to be closest to the MSF. Variation in the vertical relationship was found by age and gender.

Comparison of cone-beam computed tomography and panoramic radiography in the evaluation of maxillary sinus pathology related to maxillary posterior teeth: Do apical lesions increase the risk of maxillary sinus pathology?

PurposeThe aims of this study were first, to compare panoramic radiography with cone-beam computed tomography (CBCT) for evaluating topographic relationships, such as the classification of maxillary posterior teeth and their distance to the maxillary sinus floor; and second, to determine the relationship between maxillary sinus pathology and the presence of apical lesions.Materials and MethodsIn total, 285 paired CBCT and panoramic radiography records of patients (570 maxillary sinuses) were retrospectively analyzed. Both imaging modalities were used to determine the topographic relationship of the maxillary posterior teeth to the sinus floor. Mucosal thickening >2 mm was considered a pathological state. Data were analyzed using the chi-square, Wilcoxon, and Mann-Whitney U tests. Odds ratios (ORs) and confidence intervals (CIs) were calculated.ResultsThe closest vertical distance measurements made between posterior maxillary teeth roots and the maxillary sinus on panoramic radiography and CBCT scans showed statistically significant differences from each other (P<0.05). Compared to panoramic radiography, CBCT showed higher mean values for the distance between the maxillary sinus floor and maxillary posterior teeth roots. The CBCT images showed that at least 1 apical lesion adjacent to the right maxillary sinus increased the risk of maxillary sinus pathology by 2.37 times (OR, 2.37; 95% CI, 1.58-3.55, P<0.05).ConclusionPanoramic radiography might lead to unreliable diagnoses when evaluating the distance between the sinus floor and posterior roots of the maxillary teeth. Periapical lesions anatomically associated with maxillary sinuses were a risk factor for sinus mucosal thickening.

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

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.

Correlation of Maxillary Sinus to the Roots of Maxillary Posterior Teeth and a Review of Literature

Correlation of Maxillary Sinus to the Roots of Maxillary Posterior Teeth and a Review of Literature

Correlation between maxillary sinus floor topography and relative root position of posterior teeth using Orthopantomograph and Digital Volumetric Tomography

Background: Maxillary sinus and its close proximity to the oral cavity make it a common clinical concern for medical and dental practitioners. Due to anatomical complexities, it is difficult to evaluate the relation between the root apices of maxillary posterior teeth and the floor of maxillary sinus which is essential for diagnosis of sinus pathology, understanding the path of dental infection and planning of dental treatment.Aims and Objectives: To correlate the topographic relationship of the maxillary sinus floor to the maxillary posterior teeth roots as imaged by pairs of Orthopantomograph (OPG) and Digital Volumetric Tomography images (DVT).Materials and Methods: A total of 510 maxillary teeth from 85 patients were classified according to their topographic relationship to the maxillary sinus and measured according to their projection lengths on the sinus cavity using OPG and DVT modalities.Results: In cases of classification 0, 85% and in classification 1 , 55.3% cases shows similar classification in both OPG and DVT. 28.5% of cases in both imaging modalities show classification 2. Only 15.9% of teeth roots exhibits classification 3. 11.1% of cases showed classification 4.The panoramic radiograph showed a statistically significant 2.24 times longer root projection on the sinus cavity in OPG comparison to DVT images.Conclusion: Teeth roots projecting in to the sinus in OPG, shows no vertical protrusion in to the sinus in DVT images. Hence DVT was better than OPG with measurements that were more exact and closer to anatomical reality.Asian Journal of Medical Sciences Vol.8(1) 2017 26-31

Proximity of maxillary posterior teeth roots to maxillary sinus and adjacent structures using Denta scan®.

Aim:The study aimed to investigate the proximity of maxillary posterior teeth roots to maxillary sinus and measure the distance of maxillary posterior teeth roots and the sinus floor as well as the thickness of bone between the roots and alveolar cortical bone using Denta scan®.Materials and Methods:The study samples include Denta scan® images of fifty patients with normally erupted bilateral maxillary first premolar to maxillary second molar. The vertical relationship of each tooth root with maxillary sinus is classified into four types of Denta scan® images (based on the classification by Jung in 2009). The distance between the sinus floor and root, and the bone thickness between the root and alveolar cortical plate will be measured and analyzed.Conclusion:The buccal root of the maxillary molars was more commonly protruded into the maxillary sinus. Among the roots of maxillary posterior teeth, mesiobuccal root of first molar and palatal root of second premolar were found in close proximity to the floor of maxillary sinus. The bone thickness on the buccal aspect to the root was significantly thinner in the maxillary first premolar and maxillary first molar as compared to other maxillary posterior teeth roots.Clinical Significance:Knowledge of anatomical relationship between the maxillary posterior teeth and maxillary sinus guides us not only in proper preoperative treatment planning but also avoids the possible complications encounter while performing the minor oral surgical procedures involving maxillary posterior teeth, which are close to the maxillary sinus.

Proximity of Posterior Teeth to the Maxillary Sinus and Buccal Bone Thickness: A Biometric Assessment Using Cone-beam Computed Tomography

IntroductionThe aims of this study were to evaluate the vertical and horizontal relationships between the maxillary sinus floor (MSF) and the root apices of maxillary posterior teeth with various root configurations and the distance from the root apex to the MSF and the buccal cortical plate. MethodsSerial axial, coronal, sagittal, and paraxial cone-beam computed tomographic images of 132 Korean patients with fully erupted bilateral maxillary posterior teeth were analyzed. The vertical and horizontal relationships between the roots of maxillary posterior teeth and the MSF were determined. Distances from the apex to the MSF and the buccal bone plate were measured. The data were correlated with age, sex, side, and tooth type. ResultsIn total, 2159 apices in 1056 teeth were evaluated. For the vertical relationships, the frequency in group 1, in which a root apex protruded into the MSF, significantly increased toward the posterior (first premolars: 1.5%, second premolars: 14.8%, first molars: 40.5%, second molars: 44.7%, P < .001). The apices of the mesiobuccal roots of the second molars were found frequently in group 1 (35.8%) and had the shortest mean vertical distance to the MSF (0.18 mm) and the thickest mean horizontal distance to the buccal cortical plate (4.99 mm) among buccal roots of 3-rooted molars (P < .001). The frequency of group 1 differed significantly by age (P < .05). No statistically significant difference was found in sex or side analysis. For the horizontal relationship between the molar roots and the MSF, most teeth were in group BP, in which the lowest point of the MSF was located centrally, relative to the roots (94.3% for first molars, 81.0% for second molars). For the first molars, no significant difference according to sex or side was found. However, the right side (P = .003) and males (P = .005) showed higher incidences for second molars. ConclusionsThe data in this study highlight the close proximity between the root apex of maxillary posterior teeth and the MSF and provide estimated distances from the root apex to the buccal cortical plate. Special care must be taken in treatment planning in the maxillary posterior region.

A Report of a Rare Case of a Midline Palatal Abscess in a Paediatric Patient

Midline palatal swelling in children is exceptionally rare. Periodontal abscess from palatal pockets and apical abscess of palatal roots of maxillary posterior teeth are source of palatal abscesses. The palatal abscess is often observed in premolar-molar region showing fluctuant mass or swelling, commonly lateral to midline. We report a rare case of a palatal swelling in the midline, in a 10 year old female patient.

Assessment of the relationship between the maxillary sinus floor and maxillary posterior teeth roots using cone beam computed tomography.

This study was conducted to assess the vertical and horizontal relationship between the maxillary sinus floor and maxillary posterior teeth roots using cone beam computed tomography. In this cross-sectional study, the CBCT images presented in the radiology department of Hamadan dental school was used. From 450 observed CBCT, 340 of them did not have the inclusion criteria of the study and ultimately 110 CBCT were selected. Totally 214 first premolars, 217 second premolars, 220 first molars and 220 second molars were included. For evaluating the relationship between the maxillary sinus floor and the posterior maxillary teeth, the classification implemented in the study of Jung in 2009 was used. The relation was evaluated by two radiologists twice with a 2-week time interval. One hundred and ten patients with a mean age of 31.06 ± 9.7 years were assessed. Type 0 relationship (the maxillary sinus floor is located above the root tip) was most frequently observed with the first and second premolars. The most common type observed in the first and second molars was type 3 (apical protrusion is seen over the maxillary sinus floor). The relation between different types and gender was statistically meaningful, while no statistically significant difference was found between the right and left side assessments. This study showed that although most of the teeth did not have contact with the sinus floor, but the more posterior the maxillary teeth, the more probability for root protruding into the maxillary sinus. It also confirmed that protrusion of teeth roots into the maxillary sinus is more common in male than female. Knowing the anatomical relation between the posterior teeth and the maxillary sinus, help the clinician in preoperative treatment planning of the posterior maxillary teeth and avoid problems that may occur during dental practice.