Diagnostic accuracy of maxillary periapical pathology perforating the sinus floor: a comparison of pantomograph and CBCT images
Year: 2020
Type: article
Study design: Observational Study
Abstract: Introduction: Periapical lesions are fairly common pathology associated with the apex of a nonvital tooth.Some chronic lesions develop without an acute phase with no recollection of previous symptoms.It is known that maxillary odontogenic infections can breach the sinus floor with succeeding complications.Pantomography, a widespread conventional radiographic technique, provides a generalized view of the maxillofacial region.Advanced modalities like CBCT may facilitate in navigating complex anatomy, which would otherwise be obscured.Aim: To evaluate the diagnostic accuracy of PAN and CBCT images related to maxillary posterior teeth periapical pathology that perforates the floor of the maxillary sinus by comparing two radiographic modalities.Material and methods: Data from archived CBCT volumes and corresponding conventional PAN images of subjects were examined.The presence and radiographic features of the pathology was recorded for both modalities.A comparison was made by cross-examination.Results: 42 cases of maxillary sinus floor perforation of odontogenic origin were analysed.Median and average age showed prevalence for the 4 th decade with a negligible gender ratio.Majority of cases associated the 1 st molar with slight 2 nd quadrant predominance.Greater number of lesions presented asymptomatic.Predominant radiographic features included well-defined lucent/low-densities.More than half of the associated teeth were previously restored or endodontically treated.Almost all cases depicted maxillary sinus mucosal reaction.The overall performance of the PAN appeared 'poor' and insufficient as a diagnostic tool in detecting a perforation.Conclusion: High rates of asymptomatic lesions were on restored or endodontically treated teeth.Inconclusive clinical examination, testing, and conventional imaging of a suspicious tooth may prompt further investigation.In selected cases, small FOV CBCT accompanied by appropriate interpretation and reporting thereof by a skilled clinician may be considered.A subsequent correct diagnosis and treatment plan can facilitate achieving an uncomplicated outcome.
Author: Jaco Walters
Language: English
Subfield: Oral Surgery
Field: Dentistry
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3091990210