An Analysis of the Proximity of Maxillary Posterior Teeth to the Maxillary Sinus Using Cone-beam Computed Tomography

doi:10.1016/j.joen.2015.10.017

Journal of Endodontics

Volume 42, Issue 3, March 2016, Pages 371-377

https://doi.org/10.1016/j.joen.2015.10.017 Get rights and content

Abstract

Introduction

It is known that the level of the maxillary sinus floor varies with age. Because few studies have investigated whether the position of the posterior roots relative to the maxillary sinus varied with the variation of the sinus floor or not, the present study assessed the position according to age.

Methods

Cone-beam computed tomographic images of 848 patients were reconstructed to evaluate the position of the posterior roots relative to the sinus floor, which were divided into 3 types, and quantify the distances between posterior root apexes and the adjacent border of the sinus floor. Measurements were taken for each root, and data were correlated with age, which was divided into 4 groups (≤20 years, 21–40 years, 41–60 years, and >60 years).

Results

A total of 3063 premolars and 3095 molars were evaluated. The mean distances from the root tips to the border of the maxillary sinus floor increased with increasing age. From the first and second premolar roots, the mean distances ranged from 3.6 ± 4.1 mm to 8.9 ± 4.6 mm and from 0.7 ± 3.3 mm to 5.3 ± 3.9 mm, respectively. From the mesiobuccal, distobuccal, and palatinal roots of the first molars, the mean distances were −0.4 ± 2.8 mm to 4.6 ± 4.0 mm, −0.3 ± 2.4 mm to 4.4 ± 3.8 mm, and −0.4 ± 3.5 mm to 3.9 ± 4.1 mm, respectively. From the mesiobuccal, distobuccal, and palatinal roots of the second molars, the mean distances were −0.5 ± 2.2 mm to 3.4 ± 3.5 mm, 0.3 ± 2.2 mm to 3.9 ± 3.7 mm, and 1.1 ± 3.2 mm to 4.6 ± 4.5 mm, respectively. The frequency of type IS decreased with increasing age. It was very low in first premolars (0%–8.13%) and higher in second premolars (0%–25.68%), first molars (0%–44.75%), and second molars (0%–32.89%). Age significantly influenced the mean distances to the sinus floor and the frequencies of type IS (inside).

Conclusions

Cone-beam computed tomographic imaging is an effective method to study the position of the posterior roots to the maxillary sinus floor. Variation in proximity measurements was found by age, with those under the age of 40 showing a greater likelihood of the position of maxillary roots above/inside the sinus floor.

Section snippets

Subjects

The study materials were composed of dental CBCT images retrospectively selected from the CBCT database at the department of Stomatology Special Consultation Clinic, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, from January 2013 to December 2013. Because of the retrospective nature, the study was exempt from approval by an institutional review board. Subjects were selected, and a total of 848 patients' CBCT images fulfilled the following inclusion

Results

A total of 3063 maxillary premolars and 3095 molars were assessed in 848 patients (females: 64.27%, males: 35.73%) who had a mean age of 34.04 ± 15.13 years (range, 14–81 years). Among the evaluated premolars, 1525 (49.78%) were first premolars, and 1538 (50.22%) were second premolars. Among the evaluated molars, 1564 (50.53%) were first molars, and 1531 (49.47%) were second molars.

Discussion

It is known that the level of the border of the maxillary sinus floor varied with age 10, 12, 13. However, whether the position of maxillary posterior roots with respect to the sinus floor varied with the variation of the maxillary sinus floor or not had not attracted attention. Therefore, the present study aimed at investigating the relationship and measuring the distances between the posterior roots and the maxillary sinus floor by using reconstructed CBCT images and correlated the data with

Conclusions

This study assessed the proximity between the border of the maxillary sinus floor and the maxillary posterior roots using dental CBCT images. It can be summarized as follows:

1.
The first premolar was always farther and the second molar mesiobuccal root was closer to the border of the maxillary sinus floor.
2.
The root protruding into the sinus was rare in the first premolar and dominated in the first molar palatinal root.
3.
The root was closer to the border of the maxillary sinus floor before the age of

Acknowledgments

Xiao-mei Tian and Liang Qian contributed equally to this work and should be considered cofirst authors.

Supported in part by a research grant from 973 Program Grant 2012 CB910401 and Science and Technology Committee of Shanghai (grant no. 13140902701).

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The distances were relatively constant in 21- to 40-year-old patients and increased after 41 years of age. This study showed similar results to those of a previous report22,23,30,35,38. The reason for this similarity was probably that the volume of the maxillary sinus decreases as age increases39.
The aim of this study was to use cone-beam computed tomographic imaging to investigate the relationship between the surgical access line (SAL) of maxillary posterior teeth and the maxillary sinus floor (MSF) in endodontic microsurgery.
Cone-beam computed tomographic scans of 190 subjects with clear and integrated maxillary posterior teeth and sinus floors on both sides were evaluated. The correlation of the average distance between the SAL and the MSF with age was analyzed. Three types of relationships between the SAL and MSF were classified. The minimum vertical distance between the SAL and the MSF for the type 1 relationship was measured.
A total of 1134 teeth, including 758 premolars and 376 first molars, were evaluated. The average distance between the SAL of maxillary posterior teeth and the MSF increased with age, except in the 31- to 40-year-old group. The highest rates of the SAL touching the MSF and protruding into the maxillary sinus occurred among first molars at 25.6% and 8.1%, respectively. For the type 1 relationship, the mean distance from the SAL of the first and second premolars and the first molar to the MSF was 7.11 ± 4.40, 4.92 ± 3.69, and 4.76 ± 3.61 mm, respectively.
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Clinical ResearchAn Analysis of the Proximity of Maxillary Posterior Teeth to the Maxillary Sinus Using Cone-beam Computed Tomography

Abstract

Introduction

Methods

Results

Conclusions

Section snippets

Subjects

Results

Discussion

Conclusions

Acknowledgments

J Endod

J Endod

Int J Oral Surg

Int J Oral Surg

Dent Clin North Am

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Otolaryngol Head Neck Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Endod

Int J Oral Maxillofac Surg

J Endod

J Endod

Clinical Research
An Analysis of the Proximity of Maxillary Posterior Teeth to the Maxillary Sinus Using Cone-beam Computed Tomography