Associations between odontogenic and sinus pathologies - a low-dose CBCT study

To evaluate maxillary sinus and odontogenic findings in low-dose CBCT, and to test if associations exist between these findings.  Methods: From 263 consecutive CBCT scans, 212 were included. Evaluated odontogenic parameters were periapical lesions (PAI), marginal periodontal bone loss (PBL), root contact to the maxillary sinus, the presence of crowns, implants, defective restorations and extensive caries. Maxillary sinus findings were categorized as mucosal thickening (MT; generalized and localized), mucosal retention cysts, and opacification/fluid level. Crosstabulations and generalized estimating equations were used as statistical tests. Prevalence and bias adjusted kappas were calculated for inter- and intra-observer agreement.

The only dental finding statistically associated with sinus pathology when compared to healthy sinuses was root contact, which increased the risk for generalized MT (OR = 1.47, p = 0.015), mucosal retention cysts (OR = 2.60, p < 0.001) and opacification/fluid (OR = 1.76, p = 0.018). All parameters showed almost perfect or substantial intra- and interobserver reliability, except for PBL, where the former was moderate and the latter fair.

Root contact was the only dental finding significantly associated with sinus pathology. Thus, there may be fewer associations between radiological dental findings and sinus pathology than previously thought. With the exception of PBL, all parameters demonstrated at least substantial intra- and interobserver reliability, indicating that the assessment is reliable overall.