Association between Maxillary Sinus Diseases and Periapical Endodontic Infections: A Retrospective Cone-beam Computed Tomography Study

Background: The objective of this study was to determine the prevalence and patterns of maxillary sinus (MS) diseases related to periapical (PA) endodontic infection, compare these in primary versus persistent apical periodontitis (AP), and evaluate relationships between types of AP associated with endodontics. Materials and Methods: A retrospective review of 400 cone-beam computed tomography (CBCT) scans of patients referred to the Radiology Department at College of Dentistry, King Abdulaziz University was carried out. The presence of PA lesions in the maxillary posterior teeth, types of MS diseases, and their association with root tips, PA lesions, and the sinus floor were evaluated. Statistical analyses were performed to assessment of the relationships between the study variables. Results: PA lesions were found in 54% of primary infections and 46% of persistent infections. In 56% of cases, the lesions were confined to the bone. MS disease was observed in 28% of cases with persistent infections ( P < 0.05). Unilateral sinus disease occurred in 68% of cases, whereas bilateral involvement was present in only 10% ( P < 0.05). Conclusion: PA mucositis occurred significantly more than PA osteoperiostitis, especially in predominantly primary endodontic infections. This information gives critical insights into the link between the diseases of the MS and endodontic infections, which may help in coming up with clinical management.