Skip to main content
Top
Published in: Clinical Oral Investigations 3/2019

01-03-2019 | Original Article

Frequency and type of incidentally detected radiodensities in the maxillary sinus: a retrospective analysis using cone beam computed tomography (CBCT)

Authors: Taisuke Kawai, Ray Tanaka, Andy Wai Kan Yeung, Thomas von Arx, Michael M. Bornstein

Published in: Clinical Oral Investigations | Issue 3/2019

Login to get access

Abstract

Objectives

To evaluate the frequency, location, and characteristics of radiodensities in the maxillary sinus using cone beam computed tomography (CBCT).

Materials and methods

All CBCT scans with a large field of view with both maxillary sinuses entirely visible were initially screened. Patients were included, if there was no suspicion of sinus pathology and no history of surgical intervention/trauma in the sinus region. The location and shape of the radiodensities were evaluated in axial, coronal, and sagittal CBCT views. The findings were correlated with age, gender, condition of the sinus mucosa, and status of the dentition.

Results

A total of 169 patients (338 maxillary sinuses) were included. Radiodensities were found in 35 sinuses (10.4%) of 28 patients (16.6%) with a mean age of 32.0 years. Most of the 35 affected sinuses had one radiodensity (19/54.2%). The radiodensities were typically located at the sinus floor (22/62.9%). Of the sinuses presenting with radiodensities, 17 (48.6%) were exhibiting reactive changes of the Schneiderian membrane. The presence of periodontal pathology was found to be associated with the presence of radiodensities. Age and sinus pathology were influencing factors on the shape of radiodensities, and the status of the dentition was an influencing factor on the number of lesions.

Conclusions

One-sixth of the patients analyzed had incidentally diagnosed radiodensities in their maxillary sinuses. As almost 50% of the sinuses with radiodensities exhibited a form of chronic rhinosinusitis, the diagnosed ectopic calcifications may have formed as a result of mucosal changes of inflammatory origin. The presence of periodontal pathology was associated with a higher incidence of radiodensities. Nevertheless, this finding has to be interpreted with some caution due to the limited sample size available.

Clinical relevance

Incidentally detected radiodensities in the maxillary sinus are not an infrequent finding in CBCT scans of asymptomatic patients, and are located typically on the sinus floor. Future studies are needed to assess the clinical significance of these findings especially with regard to planned surgical interventions in the posterior maxilla.
Literature
1.
go back to reference De Vos W, Casselman J, Swennen G (2009) Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. Int J Oral Maxillofac Surg 38:609–625CrossRefPubMed De Vos W, Casselman J, Swennen G (2009) Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. Int J Oral Maxillofac Surg 38:609–625CrossRefPubMed
2.
go back to reference Kiljunen T, Kaasalainen T, Suomalainen A, Kortesniemi M (2015) Dental cone beam CT: a review. Phys Med 31:844–860CrossRefPubMed Kiljunen T, Kaasalainen T, Suomalainen A, Kortesniemi M (2015) Dental cone beam CT: a review. Phys Med 31:844–860CrossRefPubMed
4.
go back to reference Horner K, Islam M, Flygare L, Tsiklakis K, Whaites E (2009) Basic principles for use of dental cone beam computed tomography: consensus guidelines of the European Academy of Dental and Maxillofacial Radiology. Dentomaxillofac Radiol 38:187–195CrossRef Horner K, Islam M, Flygare L, Tsiklakis K, Whaites E (2009) Basic principles for use of dental cone beam computed tomography: consensus guidelines of the European Academy of Dental and Maxillofacial Radiology. Dentomaxillofac Radiol 38:187–195CrossRef
6.
go back to reference Drage N, Rogers S, Greenall C, Playle R (2013) Incidental findings on cone beam computed tomography in orthodontic patients. J Orthod 40:29–37CrossRefPubMed Drage N, Rogers S, Greenall C, Playle R (2013) Incidental findings on cone beam computed tomography in orthodontic patients. J Orthod 40:29–37CrossRefPubMed
8.
9.
go back to reference Price JB, Thaw KL, Tyndall DA, Ludlow JB, Padilla RJ (2012) Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clin Oral Implants Res 23:1261–1268CrossRefPubMed Price JB, Thaw KL, Tyndall DA, Ludlow JB, Padilla RJ (2012) Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clin Oral Implants Res 23:1261–1268CrossRefPubMed
10.
go back to reference Rheem S, Nielsen IL, Oberoi S (2013) Incidental findings in the maxillofacial region identified on cone-beam computed tomography scans. J Orthod Res 1:33–39CrossRef Rheem S, Nielsen IL, Oberoi S (2013) Incidental findings in the maxillofacial region identified on cone-beam computed tomography scans. J Orthod Res 1:33–39CrossRef
11.
go back to reference Benavides E, Rios HF, Ganz SD, An C-H, Resnik R, Reardon GT, Feldman SJ, Mah JK, Hatcher D, Kim M-J (2012) Use of cone beam computed tomography in implant dentistry: the International Congress of Oral Implantologists consensus report. Implant Dent 21:78–86CrossRefPubMed Benavides E, Rios HF, Ganz SD, An C-H, Resnik R, Reardon GT, Feldman SJ, Mah JK, Hatcher D, Kim M-J (2012) Use of cone beam computed tomography in implant dentistry: the International Congress of Oral Implantologists consensus report. Implant Dent 21:78–86CrossRefPubMed
12.
go back to reference Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R (2014) Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants 29:55–77CrossRefPubMed Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R (2014) Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants 29:55–77CrossRefPubMed
13.
go back to reference Harris D, Horner K, Gröndahl K, Jacobs R, Helmrot E, Benic GI, Bornstein MM, Dawood A, Quirynen M (2012) EAO guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw. Clin Oral Implants Res 23:1243–1253CrossRefPubMed Harris D, Horner K, Gröndahl K, Jacobs R, Helmrot E, Benic GI, Bornstein MM, Dawood A, Quirynen M (2012) EAO guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw. Clin Oral Implants Res 23:1243–1253CrossRefPubMed
14.
go back to reference Jemt T, Lekholm U (1995) Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption. Int J Oral Maxillofac Implants 10:303–311PubMed Jemt T, Lekholm U (1995) Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption. Int J Oral Maxillofac Implants 10:303–311PubMed
15.
go back to reference Bornstein MM, Chappuis V, Von Arx T, Buser D (2008) Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients. Clin Oral Implants Res 19:1034–1043CrossRefPubMed Bornstein MM, Chappuis V, Von Arx T, Buser D (2008) Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients. Clin Oral Implants Res 19:1034–1043CrossRefPubMed
16.
go back to reference Bornstein MM, Horner K, Jacobs R (2017) Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research. Periodontol 2000 73:51–72CrossRefPubMed Bornstein MM, Horner K, Jacobs R (2017) Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research. Periodontol 2000 73:51–72CrossRefPubMed
17.
go back to reference Chang T, Teng M, Wang S, Li W, Cheng C, Lirng J (1992) Aspergillosis of the paranasal sinuses. Neuroradiology 34:520–523CrossRefPubMed Chang T, Teng M, Wang S, Li W, Cheng C, Lirng J (1992) Aspergillosis of the paranasal sinuses. Neuroradiology 34:520–523CrossRefPubMed
18.
go back to reference Dufour X, Kauffmann-Lacroix C, Ferrie J, Goujon J, Rodier M, Klossek J (2006) Paranasal sinus fungus ball: epidemiology, clinical features and diagnosis. A retrospective analysis of 173 cases from a single medical center in France, 1989–2002. Med Mycol 44:61–67CrossRefPubMed Dufour X, Kauffmann-Lacroix C, Ferrie J, Goujon J, Rodier M, Klossek J (2006) Paranasal sinus fungus ball: epidemiology, clinical features and diagnosis. A retrospective analysis of 173 cases from a single medical center in France, 1989–2002. Med Mycol 44:61–67CrossRefPubMed
19.
go back to reference Krennmair G, Lenglinger F, Müller-Schelken H (1994) Computed tomography (CT) in the diagnosis of sinus aspergillosis. J Craniomaxillofac Surg 22:120–125CrossRefPubMed Krennmair G, Lenglinger F, Müller-Schelken H (1994) Computed tomography (CT) in the diagnosis of sinus aspergillosis. J Craniomaxillofac Surg 22:120–125CrossRefPubMed
20.
go back to reference Schriber M, von Arx T, Sendi P, Jacobs R, Suter VG, Bornstein MM (2017) Evaluating maxillary sinus septa using cone beam computed tomography: is there a difference in frequency and type between the dentate and edentulous posterior maxilla? Int J Oral Maxillofac Implants 32:1324–1332CrossRefPubMed Schriber M, von Arx T, Sendi P, Jacobs R, Suter VG, Bornstein MM (2017) Evaluating maxillary sinus septa using cone beam computed tomography: is there a difference in frequency and type between the dentate and edentulous posterior maxilla? Int J Oral Maxillofac Implants 32:1324–1332CrossRefPubMed
21.
go back to reference Schneider AC, Brägger U, Sendi P, Caversaccio MD, Buser D, Bornstein MM (2013) Characteristics and dimensions of the sinus membrane in patients referred for single-implant treatment in the posterior maxilla: a cone beam computed tomographic analysis. Int J Oral Maxillofac Implants 28:587–596CrossRefPubMed Schneider AC, Brägger U, Sendi P, Caversaccio MD, Buser D, Bornstein MM (2013) Characteristics and dimensions of the sinus membrane in patients referred for single-implant treatment in the posterior maxilla: a cone beam computed tomographic analysis. Int J Oral Maxillofac Implants 28:587–596CrossRefPubMed
22.
go back to reference Soikkonen K, Ainamo A (1995) Radiographic maxillary sinus findings in the elderly. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 80:487–491CrossRefPubMed Soikkonen K, Ainamo A (1995) Radiographic maxillary sinus findings in the elderly. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 80:487–491CrossRefPubMed
23.
go back to reference Yeung AWK, Tanaka R, Khong P-L, von Arx T, Bornstein MM (2018) Frequency, location, and association with dental pathology of mucous retention cysts in the maxillary sinus. A radiographic study using cone beam computed tomography (CBCT). Clin Oral Investig 22:1175–1183CrossRefPubMed Yeung AWK, Tanaka R, Khong P-L, von Arx T, Bornstein MM (2018) Frequency, location, and association with dental pathology of mucous retention cysts in the maxillary sinus. A radiographic study using cone beam computed tomography (CBCT). Clin Oral Investig 22:1175–1183CrossRefPubMed
24.
go back to reference Janner SF, Caversaccio MD, Dubach P, Sendi P, Buser D, Bornstein MM (2011) Characteristics and dimensions of the Schneiderian membrane: a radiographic analysis using cone beam computed tomography in patients referred for dental implant surgery in the posterior maxilla. Clin Oral Implants Res 22:1446–1453CrossRefPubMed Janner SF, Caversaccio MD, Dubach P, Sendi P, Buser D, Bornstein MM (2011) Characteristics and dimensions of the Schneiderian membrane: a radiographic analysis using cone beam computed tomography in patients referred for dental implant surgery in the posterior maxilla. Clin Oral Implants Res 22:1446–1453CrossRefPubMed
25.
go back to reference Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRef Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRef
26.
go back to reference Chen YW, Lee FY, Chang PH, Huang CC, Fu CH, Huang CC, Lee TJ (2018) A paradigm for evaluation and management of the maxillary sinus before dental implantation. Laryngoscope 128:1261–1267 Chen YW, Lee FY, Chang PH, Huang CC, Fu CH, Huang CC, Lee TJ (2018) A paradigm for evaluation and management of the maxillary sinus before dental implantation. Laryngoscope 128:1261–1267
27.
go back to reference Nunes CA, Guedes OA, Alencar AHG, Peters OA, Estrela CR, Estrela C (2016) Evaluation of periapical lesions and their association with maxillary sinus abnormalities on cone-beam computed tomographic images. J Endod 42:42–46CrossRefPubMed Nunes CA, Guedes OA, Alencar AHG, Peters OA, Estrela CR, Estrela C (2016) Evaluation of periapical lesions and their association with maxillary sinus abnormalities on cone-beam computed tomographic images. J Endod 42:42–46CrossRefPubMed
28.
go back to reference Raghav M, Karjodkar FR, Sontakke S, Sansare K (2014) Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent 5:361–365CrossRefPubMedPubMedCentral Raghav M, Karjodkar FR, Sontakke S, Sansare K (2014) Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent 5:361–365CrossRefPubMedPubMedCentral
29.
go back to reference Som PM, Lidov M (1994) The significance of sinonasal radiodensities: ossification, calcification, or residual bone? AJNR Am J Neuroradiol 15:917–922PubMed Som PM, Lidov M (1994) The significance of sinonasal radiodensities: ossification, calcification, or residual bone? AJNR Am J Neuroradiol 15:917–922PubMed
30.
go back to reference Yoon JH, Na DG, Byun HS, Koh YH, Chung SK, Dong H-J (1999) Calcification in chronic maxillary sinusitis: comparison of CT findings with histopathologic results. AJNR Am J Neuroradiol 20:571–574PubMed Yoon JH, Na DG, Byun HS, Koh YH, Chung SK, Dong H-J (1999) Calcification in chronic maxillary sinusitis: comparison of CT findings with histopathologic results. AJNR Am J Neuroradiol 20:571–574PubMed
31.
go back to reference Duce MN, Talas DÜ, Özer C, Yildiz A, Apaydin FD, Özgür A (2003) Antrolithiasis: a retrospective study. J Laryngol Otol 117:637–640CrossRef Duce MN, Talas DÜ, Özer C, Yildiz A, Apaydin FD, Özgür A (2003) Antrolithiasis: a retrospective study. J Laryngol Otol 117:637–640CrossRef
32.
go back to reference Bagis N, Eren H, Kolsuz ME, Kurt MH, Avsever H, Orhan K (2018) Comparison of the burr and chemically induced periodontal defects using different field-of-view sizes and voxel resolutions. Oral Surg Oral Med Oral Pathol Oral Radiol 125:260–267CrossRefPubMed Bagis N, Eren H, Kolsuz ME, Kurt MH, Avsever H, Orhan K (2018) Comparison of the burr and chemically induced periodontal defects using different field-of-view sizes and voxel resolutions. Oral Surg Oral Med Oral Pathol Oral Radiol 125:260–267CrossRefPubMed
Metadata
Title
Frequency and type of incidentally detected radiodensities in the maxillary sinus: a retrospective analysis using cone beam computed tomography (CBCT)
Authors
Taisuke Kawai
Ray Tanaka
Andy Wai Kan Yeung
Thomas von Arx
Michael M. Bornstein
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 3/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2541-8

Other articles of this Issue 3/2019

Clinical Oral Investigations 3/2019 Go to the issue