Evaluation of pathological and volumetric changes in the maxillary sinus using CBCT in patients with periodontitis

The aim of this study is to evaluate maxillary sinus volume, the presence of sinus pathologies, and the location of the posterior superior alveolar artery (PSAA) in patients with periodontitis and periodontally healthy individuals using cone-beam computed tomography (CBCT).

Periodontal examinations were performed on patients who applied to our department for CBCT for any reason and who agreed to participate in the study, and 188 adult patients were included in the study. CBCT scans were evaluated for maxillary sinus volume, sinus pathology, and (PSAA) localization. Maxillary sinus pathologies were classified as mucosal thickening, polypoidal mucosal thickening, mucus retention pseudocyst, partial opacification, and total opacification. The location of the PSAA was examined in three types: intraosseous, submembranous, and in the external cortex of the lateral wall of the sinus. Maxillary sinus volume was calculated using the IRYS software program. Measurements were performed on axial CBCT sections, and inter- and intraobserver reliability was assessed. Associations between periodontitis and CBCT parameters were analyzed using chi-square and Mann-Whitney U tests.

A total of 376 maxillary sinuses from 188 individuals were evaluated. Maxillary sinus pathology was significantly more prevalent in patients with periodontitis compared with periodontally healthy individuals (39.2% vs. 25.3%, p = 0.004). In addition, maxillary sinus volume was significantly lower in the periodontitis group than in healthy controls (10.50 ± 6.52 vs. 12.33 ± 4.98, p = 0.009). The presence of pathology in the maxillary sinus was found to be statistically significantly higher in males (40.3%) than in females (27.7%) (p = 0.015). No significant association was observed between periodontitis and PSAA localization.

Periodontitis is a disease that can lead to pathological and morphological changes in the maxillary sinus. PSAA localization does not differ significantly between groups, whereas maxillary sinus volume is influenced by periodontal health and sinus pathology. Therefore, three-dimensional evaluation of the region using CBCT is important prior to implant surgery and other maxillofacial surgical procedures involving the maxillary sinus.