Does the quality of residual alveolar bone apical to a periodontal
lesion beneath the maxillary sinus play a vital role in preventing the
extension of periodontal disease to maxillary sinus? - A CBCT assisted
Objectives: The Mucous membrane of the maxillary sinus is sensitivis
susceptible to infection or inflammation adjacent to it, which may
contribute to mucous membrane thickening (MMT). Residual alveolar bone
quality (RABQ) is the nature of the remaining bone apical to periodontal
defect adjoining to the floor of the maxillary sinus. The current study
aimed to analyze the minimum RABQ to prevent the extension of
periodontal pathology from reaching maxillary sinus using Cone-beam
computed tomography (CBCT). Methods: In this retrospective observational
study, 240 sinus exposure CBCT records of 134 patients were evaluated.
Patients with at least one sinus exposure were included. RABQ and MMT
were calculated using CBCT inbuilt tools. RABQ was divided into four
groups based on Gray scale values (GSV). Statistical analysis was
performed using One way ANOVA and independent sample t-tests.
Correlation was completed applying Pearson’s correlation coefficient.
Results: Significant difference (p<0.05) was observed between
the MMT values of the four RABQ groups. Inverse correlation was observed
between mean MMT and GSV values. Mean MMT is higher than pathological
MMT range (>2mm), with significant differences in groups A
and B, where mean GSV values are less than 500. Mean GSV greater than
500 in groups C and D show non-pathological MMT. Prevalence of MMT is
91.4% if GSV is <500 and 7.5% if GSV is >500.
Conclusions: Our study suggests that MMT is present if RABQ has GSV
values < 500. Maxillary sinusitis and its etiology from
periodontal pathology can be excluded based on RABQ adjoining
periodontal lesion. Early detection and prompt treatment, along with
appropriate regenerative protocols can be performed to increase the
RABQ. Further microbiological investigation is required to support the