Apical Periodontitis and Maxillary Sinus Alterations: Results of an Exploratory Cross-Sectional Tomographic In Vivo Study

Odontogenic sinusitis is a highly prevalent, yet, frequently overlooked condition. Since anatomically, the roots of upper molars and premolars may be in close proximity with the maxillary sinus, apical periodontitis affecting these teeth may be the responsible for the development of sinus membrane thickening and odontogenic sinusitis. The aim of the present cross-sectional study was to assess the relationship between images suggesting apical periodontitis and maxillary sinus alterations. One-hundred and thirty CBCTs of the posterior maxilla were examined for the presence of apical radiolucent lesions and thickening of the sinus membrane. The relationship between the distance of the lesions to the sinus and the prevalence of sinus alterations were described and compared. In the sample studied, 16.12% and 45.96% of the sinuses presented images suggesting mucositis and sinusitis respectively. The mere presence of radiolucent apical images was not related to sinus alterations. However, it was observed that in the groups in which the lesion was closer to the sinus, the prevalence of mucosal thickening and sinusitis was higher. Thus, it can be concluded that, in cases where images suggesting apical periodontitis are closely related to the sinus floor, the prevalence of sinus altera-tions similar to mucositis or sinusitis is greater.