The Impact of Posterior Maxillary Teeth on Maxillary Sinus: Insights From Cone-Beam Computed Tomography Analysis

Background Odontogenic maxillary sinusitis arises mainly from dental origins, emphasizing the connection between dental health and sinus issues. Understanding these relationships is crucial for implant planning, sinus augmentation procedures, and managing post-extraction complications. This knowledge can help clinicians make informed decisions about treatment timing and approach. In this study, the influence of tooth periapical and periodontal conditions on maxillary sinus mucous membrane thickening using cone-beam computed tomography (CBCT) imaging was evaluated. Methods In this retrospective cross-sectional study, 124 patients who underwent CBCT for dental treatment covering 248 maxillary sinuses and 992 teeth were examined. Coronal and sagittal sections were examined to assess the maxillary sinus mucosal thickening (MT), the periodontal bone loss for maxillary posterior teeth, and their proximity to the maxillary sinus (RPMS). The mean ± standard deviation of quantitative variables was compared using a one-way ANOVA test. Multivariable logistic regression analysis was used to assess the relation between the different independent variables and MT of the maxillary sinus. P < 0.05 was considered to be statistically significant. Results MT was detected in 90 (72.6%) patients. We found 42 (33.9%) patients bilaterally. Grade 1 mucosal thickness was the most prevalent grade (72.5%), followed by Grade 2 (19.2%). Almost half the teeth examined were not in contact with the cortical borders of the sinus (56.0%). Most of the teeth showed mild to moderate periodontal bone loss (80.2%). Logistic regression analysis showed that the variables significantly associated with higher odds of MT of maxillary sinus occurrence were tooth location (second molar vs. first premolar AOR = 2.30, 95% CI: 1.29-2.79, first molar vs. first premolar AOR = 3.79, 95% CI: 1.82- 3.10, and second premolar vs. first premolar AOR = 1.57, 95% CI: 1.27-2.84), the relation of roots of posterior maxillary teeth to the sinus floor (Type 2 vs. Type 0 AOR = 2.27, 95% CI: 1.38-3.34, and Type 1 vs. Type 0 AOR = 2.24, 95% CI: 1.54-3.26), periodontal bone loss (severe vs. non-periodontitis AOR = 2.75, 95%CI: 1.29-5.86, and mild-moderate periodontitis vs. non-periodontitis AOR = 1.68, 95%CI: 1.19-4.93), and periapical and periodontal tooth condition (periapical lesion vs. extracted AOR = 32.7, 95% CI: 4.53-83.61, and no periapical lesion vs. extracted AOR = 19.8, 95% CI: 8.18-74.23). Conclusions Second molars, severe periodontal bone loss, and periapical lesions were associated with increased sinus MT risk, highlighting the need for dental health consideration in maxillary sinus management.