Utilizing a Novel AI Tool to Detect the Posterior Superior Alveolar Artery's Location's Impact on Maxillary Sinus Mucosal Thickening in the Presence of Periapical Lesions.

Periapical lesions have been implicated in sinus-related complications, but the precise influence of anatomical variations in the posterior superior alveolar artery (PSAA) on mucosal thickening remains an uncharted aspect. The new AI tool employed in this research utilizes advanced image processing algorithms to enhance image visualization. Background and Objectives: This study examines the accuracy of a new cone beam computed tomography (CBCT) software (eVol DXS, version 1.0.1.0) employing AI to detect the PSAA's location and the effect of that on maxillary sinus thickening in the presence of periapical lesions. Materials and Methods: This retrospective study included 120 CBCT cases with posterior maxillary periapical lesions and 120 without odontogenic infections. Teeth with proximity (<2 mm) to the sinus were excluded in both groups to eliminate the sinus floor's perforation effect. Both the PSAA locations and maxillary sinus thickening were classified and compared. Results: The mucosal thickening differs significantly (p < 0.001) between the study group and the control group. The study showed that an increased sinus thickness occurred when the PSAA was beneath the sinus membrane in the study group (62.5% compared to 8.6%; p < 0.001 *). The AI tool helped to achieve a 100% identification rate in determining the PSAA locations. Conclusions: AI algorithms for PSAA localization, which affects mucosal thickness in response to periapical lesions, yield excellent results.

Automatic detection and segmentation of morphological changes of the maxillary sinus mucosa on cone-beam computed tomography images using a three-dimensional convolutional neural network.

OBJECTIVES: To propose and evaluate a convolutional neural network (CNN) algorithm for automatic detection and segmentation of mucosal thickening (MT) and mucosal retention cysts (MRCs) in the maxillary sinus on low-dose and full-dose cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 890 maxillary sinuses on 445 CBCT scans were analyzed. The air space, MT, and MRCs in each sinus were manually segmented. Low-dose CBCTs were divided into training, training-monitoring, and testing datasets at a 7:1:2 ratio. Full-dose CBCTs were used as a testing dataset. A three-step CNN algorithm built based on V-Net and support vector regression was trained on low-dose CBCTs and tested on the low-dose and full-dose datasets. Performance for detection of MT and MRCs using area under the curves (AUCs) and for segmentation using Dice similarity coefficient (DSC) was evaluated. RESULTS: For the detection of MT and MRCs, the algorithm achieved AUCs of 0.91 and 0.84 on low-dose scans and of 0.89 and 0.93 on full-dose scans, respectively. The median DSCs for segmenting the air space, MT, and MRCs were 0.972, 0.729, and 0.678 on low-dose scans and 0.968, 0.663, and 0.787 on full-dose scans, respectively. There were no significant differences in the algorithm performance between low-dose and full-dose CBCTs. CONCLUSIONS: The proposed CNN algorithm has the potential to accurately detect and segment MT and MRCs in maxillary sinus on CBCT scans with low-dose and full-dose protocols. CLINICAL RELEVANCE: An implementation of this artificial intelligence application in daily practice as an automated diagnostic and reporting system seems possible.

Evaluation of Maxillary Sinus Characteristics in Patients With Cleft Lip and Palate Using Cone Beam Computed Tomography.

OBJECTIVES: The detection of anatomical variation impairments in patients with cleft lip and palate (CLP) is crucial in combined orthodontic and maxillofacial surgical treatments. Therefore, this study aimed at evaluating the anatomical maxillary sinus characteristics, nasal septum deviation (NSD), and mucosal thickening of the maxillary sinus in patients with CLP using cone beam computed tomography (CBCT). DESIGN: The CBCT images were classified into 3 groups of unilateral cleft lip and palate (UCLP; n = 40), bilateral cleft lip and palate (BCLP; n=14), and noncleft (control; n = 54). Subsequently, the maxillary sinus linear dimensions were assessed. Height, width, depth, infundibulum height, and ostium width were assessed as quantitative measures, whereas nasal septum deviation and mucosal thickening were assessed as qualitative measures. One-way analysis of variance and χ2 tests were utilized to identify any significant differences among the groups regarding the aforementioned variables. RESULTS: Significant differences were observed among the groups regarding maxillary sinus height and depth, NSD, and mucosal thickening. Moreover, UCLP and BCLP groups showed higher incidence of NSD and mucosal thickening. However, the size of maxillary sinus height and depth was lower in the UCLP and BCLP groups. CONCLUSION: The results showed that BCLP and UCLP groups obtained lower maxillary sinus height and depth compared to the control group. On the other hand, incidence of the NSD and mucosal thickening was significantly higher in UCLP and BCLP groups than those in the control group.

Does the Presence of Pathological Change in the Schneiderian Membrane Increase the Risk of Membrane Perforation During Sinus Floor Elevation? A Systemic Review.

A Schneiderian membrane (SM) thickness of >2 mm is regarded as a pathological mucosal change. The current study aimed to determine whether sinus floor elevation (SFE) in the presence of SM pathology increases the risk of membrane perforation and implant failure rate. MEDLINE, Embase, Cochrane Library, and CNKI, Wanfang, and VIP databases were systemically searched for studies published until February 2020. Randomized and nonrandomized studies reporting the incidence of SM perforation in patients with SM pathology (antral pseudocyst or mucosal thickening) during SFE were included. The outcome measures were the incidence of SM perforation and implant survival rate. The pooled odds ratio (OR) and 95% confidence intervals (CIs) were calculated using fixed-effects model. A P value ≤.05 was considered to be statistically significant. Eighteen studies with a total of 1542 patients and 1797 SFE were included. A nonsignificant difference in the incidence of SM perforation was observed between the normal-appearing sinus and thickened sinus mucosa (fixed effects; OR, 0.896; 95% CI, 0.504-1.59; P = .707, I2 = 32%). The rates of SM perforation in the normal sinus, mucosal thickening, and antral pseudocysts were 14%, 6%, and 6% respectively. The implant survival rate was 98% in the normal sinus and 100% in antral pseudocyst and mucosal thickening. SM thickening or antral pseudocysts did not increase the risk of membrane perforation or rate of implant failure. Additional randomized controlled trials are needed to evaluate the effect of pathological changes in the SM on the failure of bone augmentation and dental implants.

Mucosal thickening of the maxillary sinus is frequently associated with diffuse glioma patients and correlates with poor survival prognosis of GBM patients: comparative analysis to meningioma patients.

Glioma patients were frequently associated with mucosal thickening of the maxillary sinus (MTMS), which reflects mucosal inflammation. We suspected that MTMS is associated with impaired mucosal immune response and correlated with dysfunction in the anti-tumor immune response in diffuse glioma patients. Therefore, the aim of this study was to determine whether the occurrence of diffuse glioma is correlated with MTMS compared to meningioma and control groups. Furthermore, we investigated whether MTMS is associated with overall survival (OS) in glioblastoma (GBM) patients. This study included 343 patients with newly diagnosed diffuse gliomas and 218 patients with meningioma treated at our institution between 2015 and 2018. As control, 201 patients with headache who did not have an intracranial organic lesion were included. Using three-axis MR images, we evaluated the incidence of MTMS in all patients. Additionally, we investigated the relationship between MTMS and OS. The incidence of MTMS in patients with diffuse glioma was significantly higher than that in the meningioma (p < .0001) and control groups (p < .0001). In 128 patients with GBM, MTMS status correlated significantly with OS (p = .0064). We revealed that the incidence of MTMS is significantly associated with patients with diffuse glioma. This suggests that MTMS is indirectly involved in the occurrence of diffuse gliomas. Furthermore, the presence of MTMS correlated significantly with shorter OS in GBM patients, indicating that MTMS is involved in suppression of anti-tumor immune response. Preoperative recognition of MTMS might be useful for improving the clinical management of GBM patients.

Association between periodontal status and degree of maxillary sinus mucosal thickening: a retrospective CBCT study.

BACKGROUND: It is well known that periodontitis can stimulate thickening of the maxillary sinus mucosa, but the association between periodontitis status and the degree of maxillary sinus mucosal thickening (maxMT) has not been reported. The objectives of this study were to investigate the effect of periodontal status of maxillary molars on the degree of maxMT. METHODS: Retrospective analysis of cone-beam computed tomographic (CBCT) images of 203 periodontitis cases with maxMT. Parameters related to periodontitis in maxillary molars were measured and recorded on CBCT images. The dimension and length of the maxMT were also recorded. Multiple linear regression analysis was used to identify periodontal factors influencing the severity of maxMT, and multivariate logistic regression analysis was used to identify the odds ratio of these factors. RESULTS: The factors affecting the degree of maxMT were mainly the amount of alveolar bone loss (ABL) and the minimum residual alveolar bone height (miniRABH). Compared to mild ABL, severe and moderate ABL were more likely to display severe maxMT. And the lower the miniRABH, the more severe the maxMT. CONCLUSIONS: The severity of periodontal status of maxillary molars can influence the degree of maxMT.

Effect of ridge preservation at molar extraction sites with severe periodontitis on the Schneiderian membrane thickness changes: a pilot study.

BACKGROUND: Information regarding the reaction of bone augmentation in terms to sinus mucosa thickness of periodontally compromised molar extraction sites is limited. This retrospective study aimed to analyze the effect of ridge preservation procedures following the extraction of molars with severe periodontitis on the healing pattern of adjacent maxillary sinus mucosal membranes. METHODS: Thirty-one periodontally compromised maxillary molar teeth either receiving ridge preservation (test group, n = 20) or undergoing spontaneous healing (control group, n = 11) were investigated. Cone-beam computed tomography (CBCT) scanning was performed before the extraction procedure and repeated 6 months later. The mucosa thickness (MT) of the adjacent periodontally compromised molar tooth was measured from CBCT images before tooth extraction and after 6 months of healing at nine assigned measurement points. The data were analyzed at α = 0.05. RESULTS: The prevalence of pre-extraction maxillary sinus mucosal thickening was 60.0% and 63.6% in the test and control groups, respectively. The average MT of the thickened sinus mucosa before tooth extraction was 3.78 ± 2.36 mm in the test group and 4.63 ± 3.20 mm in the control group (P = 0.063). The mean mucosal thickening reductions in the thickened MT subjects after 6 months of healing were 2.20 ± 2.05 mm (test group) and 2.64 ± 2.70 mm (control group), P = 0.289. The differences of MT between the time prior to extraction and after 6 months of healing were statistically significant within both groups (P < 0.05). CONCLUSIONS: Following extraction of molars with severe periodontitis, a reduction in swelling of the Schneiderian membrane has been observed regardless of the addition of a DBBM socket graft. However, a mucosal thickness > 2 mm was still frequently observed.

Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study.

OBJECTIVES: This study aimed to assess the maxillary sinus mucosal thickening and to associate them with odontogenic conditions using cone-beam computed tomographic (CBCT) images. MATERIALS AND METHODS: CBCT images of 294 patients (143 female, 151 males; age range 18-78 years) with 588 maxillary sinuses were evaluated retrospectively. The anatomic relationship between maxillary sinuses and teeth was determined and classified. The presence of root canal fillings and the periapical lesions of these teeth was also recorded. Sinus mucosal thickenings were classified as grade 1 (normal) (< 2 mm), grade 2 (moderate) (2-10 mm), and grade 3 (severe) (> 10 mm). Alveolar bone loss was measured on all maxillary premolar/M teeth. RESULTS: More than 2-mm mucosal thickening (grade 2 and grade 3) in either one or both maxillary sinuses was found in 172 (58.5%) of the patients. The prevalence of mucosal thickening (> 2 mm) for maxillary sinuses with and without any periapical lesions was 42.1 and 53.6%, respectively (p < 0.05). The prevalence of mucosal thickening increased in patients with periodontal alveolar bone loss (p < 0.05). There was a significant correlation between mucosal thickening with age, gender and missing teeth (p < 0.05). CONCLUSIONS: Multiple conditions, including periapical infection, root canal treatment, and close relationship maxillary teeth and sinus, may have a precursor effect on the occurrence of mucosal thickening in the maxillary sinus. Periodontal status and its role as a risk factor in triggering maxillary sinus infections should be also considered by not only dental professionals but also the medical professionals to plan for the treatment of maxillary sinus lesions. CLINICAL RELEVANCE: Maxillary sinuses are significantly influenced by various odontogenic conditions, including periodontal bone loss, periapical lesions, and missing teeth, which may result in thickening of the maxillary sinus mucosa.

Sphenoid sinus mucosal thickening in the acute phase of pituitary apoplexy.

PURPOSE: In pituitary apoplexy (PA), there are preliminary reports on the appearance of sphenoid sinus mucosal thickening (SSMT). SSMT is otherwise uncommon with an incidence of up to 7% in asymptomatic individuals. The aim of this study was to evaluate the incidence and clinical significance of SSMT in patients with PA and a control group of surgically treated non-functioning pituitary adenomas (NFPAs). METHODS: Retrospective review of clinical and imaging variables in PA and NFPA patients. Sphenoid sinus mucosal thickness was measured on the presenting MRI scan by a blinded neuroradiologist. Pathological SSMT was defined as >1 mm adjacent to the pituitary fossa. Forward stepwise logistic regression was used to identify factors associated with SSMT. RESULTS: There were 50 NFPA and 47 PA patients. PA patients were managed conservatively (N = 11) or surgically (N = 36). The median sphenoid sinus mucosal thickness was greater in the PA than NFPA groups (2.0 vs. 0.5 mm; p < 0.001). In multivariate analysis of both the PA and NFPA groups, the presence of PA was the only factor associated with SSMT (OR 0.043, 95% CI 0.012-0.16; p < 0.001). In multivariate analysis of the PA group alone, a shorter time from symptom onset to presenting MRI scan (OR 0.12, 95% CI 0.026-0.54; p = 0.006) and a more severe grade of apoplexy (OR 7.29, 95% CI 1.10-48.40; p = 0.04), were associated with SSMT. CONCLUSION: The incidence of SSMT is higher in patients with PA, especially during the acute phase of PA. The aetiology of SSMT in PA is unclear and may reflect inflammatory and/or infective changes.

Pituitary Ring Sign Plus Sphenoid Sinus Mucosal Thickening: Neuroimaging Signs of Pituitary Apoplexy.

Two magnetic resonance imaging (MRI) signs of pituitary apoplexy are the "pituitary ring sign" and "sphenoid sinus mucosal thickening". The occurrence of both these MRI signs together in patients with ischaemic pituitary apoplexy was investigated. A literature review searching the terms "pituitary ring sign" and "sphenoid sinus mucosal thickening" in the context of pituitary apoplexy from 1990 until present was performed. To be included in the study, each case had to have ischaemic pituitary apoplexy defined as acute expansion of a pituitary adenoma or, less commonly, in a non-adenomatous gland, from infarction without haemorrhage or very little haemorrhage and a T1-weighted MRI of the brain with contrast that displayed both "sphenoid sinus mucosal thickening" and a "pituitary ring sign" either on an actual study (the author's cases) or in a figure in an article from the literature that could be reviewed and clearly illustrate these two signs. Twelve cases of ischaemic pituitary apoplexy were found, all with MRI images that showed both of these signs. Ten cases from the literature (3 of which were published by this author) plus an additional 2 recently evaluated in our hospital, totalled the 12 cases. Thus, 5 of the total 12 cases were evaluated by this author. Of these 12 patients, both headache and visual loss were present in 5 patients, headache alone was indicated in 5 patients (10 of the 12 presented with headache), and no initial symptoms identified in 2 patients (incidentally found non-functioning pituitary adenomas on MRI). These findings indicate that each sign ("pituitary ring sign" and "sphenoid sinus mucosal thickening") may exist alone with or without pituitary apoplexy, yet both signs together in the appropriate clinical context is a strong predictor of pituitary apoplexy.

Significance of maxillary sinus mucosal thickening in patients with periodontal disease.

AIM: To characterise and measure the Schneiderian membranes of individuals with periodontal diseases in China and to analyse the factors impacting maxillary sinus mucosal thickness using cone-beam computed tomography (CBCT). MATERIAL AND METHOD: A cohort of 221 patients with periodontal disease was subjected to cross-sectional CBCT examination. Various parameters, including age, sex, alveolar bone loss, furcation lesions and vertical infrabony pockets, were analysed as correlates of mucosal thickening (MT). Sinus mucosal thickness ≥ 2 mm qualified as MT. RESULTS: MT was detected in 103 (48.9%) patients, increasing in frequency as the degree of alveolar bone loss advanced (mild, 14.5%; moderate, 29.5%; severe, 87.9%). The association between MT and vertical infrabony pockets was statistically significant (P < 0.001). The likelihood of MT increased with moderate [odds ratio (OR) = 1.02] and severe (OR = 4.62) periodontal bone loss (P < 0.001), as well as with furcation lesions (OR = 2.76) and vertical infrabony pockets (OR = 13.58). CONCLUSIONS: Relative to the case in patients with periodontitis and normal mucosa, the probability of MT increased dramatically as alveolar bone loss worsened. Periodontal pathologies (i.e. furcation lesions and vertical infrabony pockets) were also more likely to coincide with MT.

Incidental findings in MRI of the paranasal sinuses in adults: a population-based study (HUNT MRI).

BACKGROUND: Diagnostic imaging of the head is used with increasing frequency, and often includes the paranasal sinuses, where incidental opacifications are found. To determine the clinical relevance of such findings can be challenging, and for the patient such incidental findings can give rise to concern if they are over-reported. Studies of incidental findings in the paranasal sinuses have been conducted mostly in patients referred for diagnostic imaging, hence the prevalence in the general population is not known. The purpose of this study was to determine the prevalence and size of incidental opacification in the paranasal sinuses in a non-selected adult population using magnetic resonance imaging (MRI) without medical indication, and to relate the results to sex and season. METHODS: Randomly and independent of medical history, 982 participants (518 women) with a mean age of 58.5 years (range, 50-66) underwent MRI of the head as part of a large public health survey in Norway. The MRIs included 3D T1 weighted volume data and 2D axial T2 weighted image (WI). Opacifications, indicating mucosal thickenings, polyps, retention cysts, or fluid, were recorded if measuring more than 1 mm. RESULTS: Opacifications were found in 66% of the participants. Mucosal thickenings were found in 49%, commonly in the maxillary sinuses (29%) where 25% had opacifications that were less than 4 mm in size. Other opacifications occurred in the anterior ethmoid (23%), posterior ethmoid (21%), frontal sinus (9%), and sphenoid (8%). Polyps and retention cysts were also found mainly in the maxillary sinuses in 32%. Fluid was observed in 6% of the MRIs. Mucosal thickening was observed more frequently in men than in women (P <0.05). No seasonal variation was found. CONCLUSIONS: In this large non-selected sample, incidental opacification in the paranasal sinuses was seen in two out of three participants, and mucosal thickening was seen in one out of two. Fluid was rare. Knowledge of incidental opacification is important because it can affect clinical practice.

Anosmia in COVID-19: Investigating the Role of Paranasal Sinus Mucosal Thickening.

Background Anosmia has been identified as a distinctive symptom of COVID-19, leading to hypotheses about its pathophysiological underpinnings, including the potential role of paranasal sinus mucosal thickening. Objective To investigate the association between paranasal sinus mucosal thickening and anosmia in COVID-19 patients, providing insights into the complex clinical manifestations of the disease. Methods This retrospective cohort study analyzed CT paranasal sinus from 270 confirmed COVID-19 patients, divided into those with anosmia (n = 23, 8.52%) and those without anosmia (n = 247, 91.48%). Statistical analysis, including independent t-tests, was employed to compare mucosal thickening between the groups. Results The study found an average mucosal thickening of 0.03 in patients with anosmia and 0.02 in those without, with no statistically significant difference between the groups (p = 0.480, which is greater than 0.05). The findings suggest that mucosal thickening in the paranasal sinuses does not serve as a definitive correlate of anosmia among COVID-19 patients. Conclusion The absence of a significant correlation between paranasal sinus mucosal thickening and anosmia in COVID-19 patients indicates that the pathophysiology of anosmia may involve factors beyond anatomical changes, including direct viral effects and systemic inflammatory responses.

Retrospective analysis of pathological changes in the maxillary sinus with CBCT.

The aim of this study is to examine the frequency of maxillary sinus pathologies and their relationship with each other using cone beam computed tomography (CBCT) and to make a new grade according to the number of affected walls. 1000 maxillary sinuses of 500 patients with CBCT images were included in the study. Anatomical variations and pathological formations of the maxillary sinuses were examined. Images were evaluated for the presence of flat, polypoidal, partial and generalized mucosal thickening, partial and total opacification, polyps and mucous retention cysts. Maxillary sinus pathologies were graded according to the number of walls affected. In the examined CBCT images, no pathology was found in 54.2% of the maxillary sinuses, while pathology was observed in 45.8%. The most common sinus pathologies were mucous retention cyst (12.3%) and polypoidal thickening (12.2%). While pneumatization, ostium obstruction, and the presence of sinus-related roots were associated with sinus pathology, no relationship was found with nasal septum deviation and the presence of septa. Before dental implant and sinus surgery applications, the presence of sinus pathologies and their relationship with anatomical variations can be evaluated with CBCT, a three-dimensional technique, and complications such as sinus membrane perforation, infection, failure to break the bone window due to the presence of antral septa, graft loss and oroantral fistula formation can be reduced.

Multilevel Modeling Analysis of Odontogenic Risk Factors and Nasal Septum Deviation Associated with Maxillary Sinus Mucosal Thickening: A Cone-Beam Computed Tomography Study.

(1) Background: In this study, the impact of odontogenic risk factors with nasal septum deviation on maxillary sinus mucosal thickening was assessed using Cone-beam computed tomography CBCT. (2) Methods: A total of 328 maxillary sinus regions from 164 patients (85 males and 79 females) were examined. Images were interpreted by dental specialists and Otolaryngologists. Coronal and sagittal sections were examined to assess the proximity of the root tips of posterior maxillary teeth (RPMT) to the maxillary sinus. The periodontal bone loss for all maxillary posterior teeth was also assessed. Consequently, maxillary sinus mucosal thickening (MT) was further classified into three gradings. Multilevel modeling regression analysis was used due to the hierarchical structuring of the data. Four models were developed, a null model with no factors, a model with tooth-level factors (RPMT, PBL, tooth condition, and root length), a model with patient-level factors (gender and nasal septum deviation), and a model with combined patient- and tooth-level factors. Regression estimates (AOR) and 95% confidence intervals (CIs) of individual and tooth factors were calculated. (3) Results: Multilevel regression analysis showed that RPMT was significantly associated with MT of maxillary sinus (p < 0.001), where patients who had RPMT > 0 had higher odds of MT of maxillary sinus. Tooth condition was also found to be significantly associated with MT of maxillary sinus, where teeth with failed RCT (p < 0.001) and teeth with restorations (p < 0.008) had higher odds of MT of maxillary sinus (AOR = 2.87, 95%CI 1.65, 4.42, AOR = 1.64, 95%CI 1.14, 2.36, respectively). (4) Conclusions: In order to plan preoperative treatment for maxillary posterior teeth, it is important to assess the anatomical relationship between the sinus floor and the root tips of the maxillary posterior teeth. Additionally, we establish a better understanding of the clinician before surgical intervention is conducted.

Evaluation of Association between Maxillary Posterior Teeth Periapical Pathologies and Maxillary Sinus Mucosal Changes-A Cone-Beam Computed Tomography (CBCT) Study.

Introduction Odontogenic infections are one of the common causes of maxillary sinusitis. With the close proximity of the roots of maxillary posterior teeth to the sinus floor, the infection may spread into the sinus causing sinus mucosal thickening. This study aims to evaluate the association between maxillary posterior teeth periapical pathologies and maxillary sinus mucosal changes using cone-beam computed tomography (CBCT) images. Methods One-hundred six maxillary posterior teeth with periapical lesions were included in this study and were assessed using CBCT images by two maxillofacial radiologists. The proximity of the roots to the sinus floor, the proximity of the top edge of the periapical lesion to the sinus floor, and the sinus mucosal changes associated with the periapical lesions were studied. The size of the periapical lesion was measured and scored using CBCT periapical index. Mucosal thickening more than 2 mm was considered pathological and the type, pattern, and severity of mucosal thickening were assessed. Data were analyzed using chi-squared tests at a level of significance set at p -value less than 0.05. Results Among the 106 teeth with periapical lesions, 99 teeth (93.4%) revealed the presence of maxillary sinus mucosal thickening. The prevalence of mucosal thickening increased significantly with the presence of cortical bone destruction, the close proximity of the root, and the periapical lesion to the sinus floor. The generalized type of mucosal thickening was more prevalent with larger periapical lesions and a significant increase in the severity of the thickening was observed closer spatial relationship of the root to the sinus floor. Conclusion Periapical pathologies of maxillary posterior teeth often cause sinus mucosal thickening. The early diagnosis and management of these pathologies will be helpful in preventing the spread of infection into the maxillary sinus.

A Retrospective Study of Correlation between Radiological and Intra-Operative Findings in FESS: A Case Series.

Introduction: The imaging of the paranasal sinuses has advanced from plain X-ray films to CT and MRI. This advancement in the radiological field helps to yield more accurate information and aids in arriving at a proper differential diagnosis, especially for rhinosinusitis. However, CT should be used cautiously among patients considering its effects due to radiation. Aim: This study aims to correlate the pre-operative radiological findings with the intraoperative functional endoscopic sinus surgery findings in a series of 100 cases. Materials and Methods: A retrospective case series was conducted among 100 cases who had complaints relating to nose and paranasal sinuses in a tertiary care hospital, Chengalpattu. Their symptoms, clinical examination, pre-operative radiological findings, and intra operative findings have been recorded. The collected data was analyzed for correlation and agreement between pre-operative radiological findings and intraoperative findings. Results: Almost all the CT revealed pathologies like polyps, mucosal thickening, and anatomical variations. However, intraoperatively, only 64.5% had mucosal thickening and 23.6% had polyps. Poor to acceptable correlation has been reported among patients with OMC obstruction, polyps, and mucosal thickening, respectively. Yet, no agreement was seen between pre-operative radiological and intraoperative findings. Conclusion: Endoscopy remains the most valuable test to diagnose, confirm the severity and manage sinus related diseases.

Pathogenic factors of maxillary sinus mucosal thickening observed by cone-beam computed tomography (CBCT).

OBJECTIVE: To explore the pathogenic factors associated with maxillary sinus mucosal thickening with Cone-beam computed Tomography (CBCT). METHODS: From 2016 through 2020, 93 patients with periapical periodontitis or periodontitis in the maxillary posterior dental region were selected. RESULTS: The preoperative thickness of the periodontitis group was significantly higher than that of the periapical periodontitis group (P < 0.05). The difference achieves statistical significance for the comparison of the thickness change with various severity of inflammation (F = 54.824, P = 0.000), the change with time (F = 312.741, P = 0.000). and the change with the interaction severity of inflammation and time（F = 86.132, P = 0.000). CONCLUSIONS: Patients with maxillary sinus mucosa thickening caused by periodontitis and periapical periodontitis should be extracted their infectious teeth and get thoroughly debridement. Maxillary sinus augmentation can perform favorable efforts 3-6 months after extracting teeth.

Prevalence and pattern of proximity of maxillary posterior teeth to maxillary sinus with mucosal thickening: A cone beam computed tomography based retrospective study.

Context: Odontogenic sinusitis is a prevalent but frequently unrecognized condition, and periapical pathologies of maxillary posterior teeth are accused as one of the main causative factors. Aim: This study aimed to evaluate the relationship between the periapical status of maxillary posterior teeth and its proximity to the maxillary sinus floor in the occurrence of incidental sinus pathologies using cone-beam computed tomography (CBCT). Methodology: CBCT scans of 118 patients of age range 18-77 years were evaluated retrospectively to determine the relationship of maxillary posterior teeth to sinus floor in which vertical relationship was assessed using modified Kwak's classification and periapical status using CBCT periapical index. Statistical analysis was performed using SPSS statistics software. Results: Of all 227 sinuses examined, 56.8% showed pathological changes, with mucosal thickening being the most common. More than 50% (50.2%) of sinuses were associated with periapical lesions of at least one maxillary posterior tooth based on evidence of pathological mucosal thickening. The presence of pathologic mucosal thickening was also significantly related (P < 0.05) to the presence of periapical pathologies. There was a significant association between tooth position and pathological sinus mucosal thickening, especially with second molars, first molars, and second premolars, respectively (P < 0.05). Second molar involvement was the most significant (P < 0.05). Conclusion: The present study established a positive association between periapical disease status of maxillary posteriors and maxillary sinus mucosal thickening. Maxillary second premolar and first and second molars pathologies can significantly affect the maxillary sinus compared to other maxillary posterior tooth. CBCT proved to be an efficient imaging modality in detecting these changes.

Résumé Contexte: La sinusite odontogène est une affection fréquente mais souvent méconnue, et les pathologies périapicales des dents postérieures maxillaires sont accusés comme l'un des principaux facteurs causals. Objectif: Cette étude visait à évaluer la relation entre le statut périapical du maxillaire dents postérieures et sa proximité avec le plancher du sinus maxillaire dans la survenue de pathologies sinusales accidentelles à l'aide du calcul par faisceau conique tomographie (CBCT). Méthodologie: Les scans CBCT de 118 patients âgés de 18 à 77 ans ont été évalués rétrospectivement pour déterminer la relation entre les dents postérieures maxillaires et le plancher sinusal dans laquelle la relation verticale a été évaluée à l'aide de la classification de Kwak modifiée et état périapical à l'aide de l'index périapical CBCT. L'analyse statistique a été réalisée à l'aide du logiciel de statistiques SPSS. Résultats: Sur les 227 sinus examinés, 56.8 % présentaient des modifications pathologiques, l'épaississement de la muqueuse étant le plus fréquent. Plus de 50 % (50.2 %) des sinus étaient associée à des lésions périapicales d'au moins une dent postérieure maxillaire sur la base de preuves d'un épaississement pathologique de la muqueuse. La presence d'épaississement muqueux pathologique était également significativement lié (P < 0.05) à la présence de pathologies périapicales. Il y avait un important association entre la position des dents et l'épaississement pathologique de la muqueuse des sinus, en particulier avec les deuxièmes molaires, les premières molaires et les deuxièmes prémolaires, respectivement (P < 0.05). L'atteinte de la deuxième molaire était la plus importante (P < 0.05). Conclusion: La présente étude a établi un bilan positif association entre l'état de la maladie périapicale des postérieurs maxillaires et l'épaississement de la muqueuse du sinus maxillaire. Deuxième prémolaire maxillaire et les pathologies des premières et deuxièmes molaires peuvent affecter de manière significative le sinus maxillaire par rapport aux autres dents postérieures maxillaires. Le CBCT s'est avéré être une modalité d'imagerie efficace pour détecter ces changements. Mots-clés: Tomodensitométrie à faisceau conique, épaississement de la muqueuse du sinus maxillaire, sinusite odontogène, pathologie périapicale.

Maxillary sinus volume and mucosal thickening according to the septal deviation angle and age of the children.

We examined the relationship between nasal septal deviation (SD) angle and maxillary sinus volumes by examining the paranasal sinus computed tomography (PNSCT) images in children. In this retrospective study, PNSCT images of 106 children with one-sided nasal SD were included. According to the SD angle, two groups were identified: Group 1 (n = 54): SD angle ≤ 11°, Group 2 (n = 52): SD angle > 11°. There were 23 children between 9 and 14 years and 83 children between 15 and 17 years. Maxillary sinus volume and mucosal thickening were evaluated. In 15- to 17-year age group, maxillary sinus volumes of males were higher than females bilaterally. For each of the males and females, ipsilateral maxillary sinus volume was significantly lower than the contralateral side in all children and in 15- to 17-year age group. In each of the SD angle values (≤11 or >11) separately, ipsilateral maxillary sinus volume was lower; and in the SD angle > 11° group, maxillary sinus mucosal thickening values were higher than those of the contralateral side. In young children in 9- to 14-year age group, bilateral maxillary sinus volumes decreased, in this group maxillary sinus volume was not affected according to the SD. However, in 15- to 17-year age groups, maxillary sinus volume was lower on the ipsilateral SD side; and ipsilateral and contralateral maxillary sinus volumes of the males were significantly higher than those in the females. SD should be treated at an appropriate time to prevent SD-related maxillary sinus volume shrinkage and rhinosinusitis.