International Journal of Advanced Research and Publications (2456-9992)

High Quality Publications & World Wide Indexing!

Relationship Between The Maxillary First Molar Roots And The Maxillary Sinus Floor: A Cone Beam Computed Tomoraphy Analysis

Volume 6 - Issue 5, May 2023 Edition
[Download Full Paper]

Fredrick Ikhabi Weboko, Mercy Naswa Makhanu, Katrina G De Luna, Grace Ellen S Dey, Iluminada L Viloria
Maxillary sinus floor, vertical distance
Background The knowledge of the relationship between the root apices of maxillary teeth and the inferior wall of the maxillary sinus is crucial in diagnosis and treatment, not only in the field of endodontics but also other disciplines of dentistry. The close anatomical relationship between the maxillary molar roots and the maxillary sinus floor, may result in maxillary sinusitis of odontogenic origin. Previous studies have evaluated the relationship the relationship between the maxillary molar roots and the maxillary sinus floor (MSF) with inconclusive results. Previously, periapical and panoramic radiographs were used to determine the proximity of root apices and the maxillary sinus floor. However, superimposition of anatomic structures and errors caused by magnification render these methods less accurate diagnosis. With the Cone Beam Computed Tomography, the relationship between maxillary root apices and MSF can be accurately determined The study set out to determine the relationship between the roots of the maxillary first molar and the maxillary sinus floor. Design and objective: A descriptive cross sectional study employing consecutive sampling of 327 maxillary first molar roots was conducted. The aim of the study was to establish the relationship between the maxillary first molar roots and the maxillary sinus using Cone Beam Computed Tomography analysis. Methods: An analysis of Cone beam computed tomography scans of Filipino patients was done. The iRYS deconstruction software version 5.6 was used to analyze images. Descriptive statistics were used to represent the relationship between the roots of the maxillary first molar and the maxillary sinus floor. Comparison was done across age groups, gender and side (left or right). A summary of the numerical variables (vertical distances measured) was given in terms of mean, standard deviation, median, minimum and maximum whereas categorical variable (age and gender) given in terms of percentages and frequencies. Results: In this study, the vertical distance measured from the root tip to the MSF, was 1.39mm for the palatal root, 1.14mm for the Mesiobuccal root and 1.08mm for the Distobuccal root. Therefore, the closest root to the floor of the sinus was the Distobuccal root, followed by the Mesiobuccal and then the Palatal root. For both genders the root tips on the right side were closer to the MSF than those on the left side. For both left and right side the root tips were closer to the MSF in males and in younger patents for both genders. Conclusion. The closest root to the maxillary sinus floor was the distobuccal followed by mesiobuccal and then palatal. Differences in tooth position (right or left), age and gender were noted. Recommendation: The roots tips of the maxillary first molar are located close to the Maxillary sinus floor. For that matter, clinicians must exercise extreme caution during endodontic procedures.
[1]. Abdalla, Dr.Mohammad. (2021). Maxillary Sinus Dimensions of Different Human Age Groups by CT Scan Imaging. Medicina Moderna - Modern Medicine. 28. 235-241. 10.31689/rmm.2021.28.2.235.

[2]. Iwanaga J, Wilson C, Lachkar S, Tomaszewski KA, Walocha JA, Tubbs RS. Clinical anatomy of the maxillary sinus: application to sinus floor augmentation. Anat Cell Biol. 2019 Mar;52(1):17-24. doi: 10.5115/acb.2019.52.1.17. Epub 2019 Mar 29. PMID: 30984447; PMCID: PMC6449588

[3]. Shanbhag, S., Karnik, P., Shirke, P., & Shanbhag, V. (2013). Association between periapical lesions and maxillary sinus mucosal thickening: A retrospective cone-beam computed tomographic study. Journal of Endodontics. https://doi.org/10.1016/j.joen.2013.04.010

[4]. Ariji, Y., Kuroki, T., Moriguchi, S., Ariji, E., & Kanda, S. (1994). Age changes in the volume of the human maxillary sinus: a study using computed tomography. Dento Maxillo Facial Radiology. https://doi.org/10.1259/dmfr.23.3.7835518

[5]. Ariji, Y., Obayashi, N., Goto, M., Izumi, M., Naitoh, M., Kurita, K., … Ariji, E. (2006). Roots of the maxillary first and second molars in horizontal relation to alveolar cortical plates and maxillary sinus: Computed tomography assessment for infection spread. Clinical Oral Investigations. https://doi.org/10.1007/s00784-005-0020-5

[6]. Nunez-Castruita, A.; Lopez-Serna, N.; Guzman-Lopez, S. (2012). Prenatal Development of the Maxillary Sinus: A Perspective for Paranasal Sinus Surgery. Otolaryngology -- Head and Neck Surgery, 146(6), 997–1003. doi:10.1177/0194599811435883

[7]. Hamdy, R. M., & Abdel-Wahed, N. (2014). Three-dimensional linear and volumetric analysis of maxillary sinus pneumatization. Journal of Advanced Research. https://doi.org/10.1016/j.jare.2013.06.006

[8]. Goller-Bulut, D., Sekerci, A. E., Köse, E., & Sisman, Y. (2015). Cone beam computed tomographic analysis of maxillary premolars and molars to detect the relationship between periapical and marginal bone loss and mucosal thickness of maxillary sinus. Medicina Oral, Patologia Oral y Cirugia Bucal. https://doi.org/10.4317/medoral.20587

[9]. Shokri, A., Lari, S., Yousefi, F., & Hashemi, L. (2015). Assessment of the relationship between the maxillary sinus floor and maxillary posterior teeth roots using cone beam computed tomography. Journal of Contemporary Dental Practice. https://doi.org/10.5005/jp-journals-10024-1589

[10]. Kang, S. H., Kim, B. S., & Kim, Y. (2015). Proximity of posterior teeth to the maxillary sinus and buccal bone thickness: A biometric assessment using cone-beam computed tomography. Journal of Endodontics. https://doi.org/10.1016/j.joen.2015.08.011

[11]. Sieron HL, Sommer F, Hoffmann TK, Grossi AS, Scheithauer MO, Stupp F, Lindemann J. Funktion und Physiologie der Kieferhöhle [Function and physiology of the maxillary sinus]. HNO. 2020 Aug;68(8):566-572. German. doi: 10.1007/s00106-020-00869-2. PMID: 32405680.

[12]. Pokorny, A., & Tataryn, R. (2013). Clinical and radiologic findings in a case series of maxillary sinusitis of dental origin. International Forum of Allergy and Rhinology. https://doi.org/10.1002/alr.21212

[13]. Oberli, K., Bornstein, M. M., & von Arx, T. (2007). Periapical surgery and the maxillary sinus: radiographic parameters for clinical outcome. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. https://doi.org/10.1016/j.tripleo.2006.09.017

[14]. Kamburo?lu, K., Y?lmaz, F., Gulsahi, K., Gulen, O., & Gulsahi, A. (2017). Change in Periapical Lesion and Adjacent Mucosal Thickening Dimensions One Year after Endodontic Treatment: Volumetric Cone-beam Computed Tomography Assessment. Journal of Endodontics. https://doi.org/10.1016/j.joen.2016.10.023

[15]. Brook, I. (2006). Sinusitis of odontogenic origin. Otolaryngology - Head and Neck Surgery. https://doi.org/10.1016/j.otohns.2005.10.059

[16]. Leonardi Dutra, K., Haas, L., Porporatti, A. L., Flores-Mir, C., Nascimento Santos, J., Mezzomo, L. A., … De Luca Canto, G. (2016). Diagnostic accuracy of cone-beam computed tomography and conventional radiography on apical periodontitis: A systematic review and meta-analysis. Journal of Endodontics. https://doi.org/10.1016/j.joen.2015.12.015

[17]. Ludlow, J. B., Davies-Ludlow, L. E., Brooks, S. L., & Howerton, W. B. (2006). Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofacial Radiology. https://doi.org/10.1259/dmfr/14340323

[18]. Kwak, H. H., Park, H. D., Yoon, H. R., Kang, M. K., Koh, K. S., & Kim, H. J. (2004). Topographic anatomy of the inferior wall of the maxillary sinus in Koreans. International Journal of Oral and Maxillofacial Surgery. https://doi.org/10.1016/j.ijom.2003.10.012

[19]. Eberhardt, J. A., Torabinejad, M., & Christiansen, E. L. (1992). A computed tomographic study of the distances between the maxillary sinus floor and the apices of the maxillary posterior teeth. Oral Surgery, Oral Medicine, Oral Pathology. https://doi.org/10.1016/0030-4220(92)90133-B