Radiographic evaluation of the maxillary sinus by icatvision. A retrospective observational study on the etiological factors of maxillary sinusitis

Resumen

Objective: To identify and evaluate the frequency of the different odontogenic causes that produce maxillary sinusitis and to perform an adequate differential diagnosis by using a Cone Beam Computerized Tomography (CBCT). To indicate the relation between frequency and severity of odontogenic sinusitis. Patients and Methods: CBCT scans made by means of iCATVision of patients being treated in the Master’s Degree Programme of Bucco-facial and Implantology of the UCM in the last 2 years, with radiographic evidence of unilateral or bilateral sinus fluid increase. The radiographic severitywas classified according to the volume of the sinus occupied by means of the Compudent program as: none, mild (less than 33%), moderate (between 33% and 66%) or severe (more than 66%). The causes of sinusitis were dental pathology (chronic periodontitis, acute periodontitis, periapical cysts and dental retention) or iatrogenic causes (root canal treatment, extraction, treatment with implants, sinus lifting, treatment of periodontal disease and oroantral communication). Result: We studied 153 CBCT, from patients not presenting any systemic pathology considered exclusion criteria, obtaining 40 maxillary sinuses belonging to 32 patients between 37 and 83 years of age. The most common cause of sinus occupation was chronic periodontitis in 19 cases and root canal treatment in 9 cases. Of the cases, 72.5% presented a mild increase in fluid, and only in 10% the increase was severe. Conclusions: The most common cause is chronic periodontitis, which begins with dental caries in an antral tooth, with greater frequency in the first and second molar. In addition, odontogenic sinusitis produces for the most part mild sinus fluid increases, although a larger sample is needed to corroborate the results.