Advertisement

Clinical Oral Investigations

, Volume 18, Issue 1, pp 293–300 | Cite as

Comparative assessment of panoramic radiography and CBCT imaging for radiodiagnostics in the posterior maxilla

  • Maryam Shahbazian
  • Charlotte Vandewoude
  • Jan Wyatt
  • Reinhilde Jacobs
Original Article

Abstract

Objective

The purpose of this study was to assess whether and how the information obtained by means of cone beam computed tomography (CBCT) on maxillary posterior teeth differs from that obtained by panoramic radiography.

Materials and method

From 157 subjects (mean age 48 years, range 19–84 years; 89 females) referred to the oral imaging center, a pair of panoramic and CBCT images was selected for further analysis. Both imaging modalities were analyzed to determine the topographic relationship of maxillary teeth to the sinus floor. Pathologic conditions, apical periodontitis, and presence of soft tissue thickening were also examined with both techniques.

Results

CBCT showed an intimate relationship of the first and second molar with the maxillary sinus in 54 and 38 %, respectively. Thirty-nine apical periodontitis lesions causing reactive changes in the maxillary sinus were detected by CBCT, while just six of them were diagnosed with panoramic imaging. A total of 26 teeth with apical extension to the maxillary sinus were detected with CBCT, from which two could be identified with panoramic radiography.

Conclusion

This study emphasizes that anatomical and pathological involvement of the maxillary sinus in relation to posterior teeth is considerably high. It is of clinical importance that the 3D nature of CBCT imaging allowed a better assessment of the relationship between the maxillary sinus and posterior root apices compared to the low detection on panoramic radiographs.

Clinical relevance

CBCT imaging can be a valuable adjunct in radioanatomical and radiodiagnostic observations in the posterior maxilla. It may better visualize maxillary sinus involvement for posterior upper teeth than panoramic radiography.

Keywords

CBCT Panoramic radiography Apical periodontitis Maxillary sinusitis 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Lee RJ, O’Dwyer TP, Sleeman D, Walsh M (1988) Dental disease, acute sinusitis and the orthopantomogram. J Laryngol Otol 102(3):222–223PubMedCrossRefGoogle Scholar
  2. 2.
    Formby ML (1960) The maxillary sinus. Proc R Soc Med 53:163–168PubMedCentralPubMedGoogle Scholar
  3. 3.
    Patel NA, Ferguson BJ (2012) Odontogenic sinusitis: an ancient but under-appreciated cause of maxillary sinusitis. Curr Opin Otolaryngol Head Neck Surg 20(1):24–28. doi: 10.1097/MOO.0b013e32834e62ed PubMedCrossRefGoogle Scholar
  4. 4.
    Lu Y, Liu Z, Zhang L, Zhou X, Zheng Q, Duan X, Zheng G, Wang H, Huang D (2012) Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study. J Endod 38(8):1069–1074. doi: 10.1016/j.joen.2012.04.027 PubMedCrossRefGoogle Scholar
  5. 5.
    Legert KG, Zimmerman M, Stierna P (2004) Sinusitis of odontogenic origin: pathophysiological implications of early treatment. Acta Otolaryngol 124(6):655–663PubMedCrossRefGoogle Scholar
  6. 6.
    Nishimura T, Iizuka T (2002) Evaluation of the pathophysiology of odontogenic maxillary sinusitis using bone scintigraphy. Int J Oral Maxillofac Surg 31(4):389–396. doi: 10.1054/ijom.2001.0198 PubMedCrossRefGoogle Scholar
  7. 7.
    Brook I (2005) Microbiology of acute and chronic maxillary sinusitis associated with an odontogenic origin. Laryngoscope 115(5):823–825. doi: 10.1097/01.MLG.0000157332.17291.FC PubMedCrossRefGoogle Scholar
  8. 8.
    Mattila K (1965) Roentgenological investigations into the relation between periapical lesions and conditions of the mucous membrane of maxillary sinuses. Acta Odontol Scand 23(Suppl 42):41–91Google Scholar
  9. 9.
    Worth HM, Stoneman DW (1972) Radiographic interpretation of antral mucosal changes due to localized dental infection. J Can Dent Assoc (Tor) 38(3):111–116Google Scholar
  10. 10.
    Yoshiura K, Ban S, Hijiya T, Yuasa K, Miwa K, Ariji E, Tabata O, Araki K, Tanaka T, Yonetsu K et al (1993) Analysis of maxillary sinusitis using computed tomography. Dentomaxillofac Radiol 22(2):86–92PubMedGoogle Scholar
  11. 11.
    Nedbalski TR, Laskin DM (2008) Use of panoramic radiography to predict possible maxillary sinus membrane perforation during dental extraction. Quintessence Int 39(8):661–664PubMedGoogle Scholar
  12. 12.
    Bouquet A, Coudert JL, Bourgeois D, Mazoyer JF, Bossard D (2004) Contributions of reformatted computed tomography and panoramic radiography in the localization of third molars relative to the maxillary sinus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98(3):342–347. doi: 10.1016/S1079210404002173 PubMedGoogle Scholar
  13. 13.
    Loevner LA (2008) Radiology: its diagnostic usefulness in rhinosinusitis. In: Thaler ER, Kennedy DW (eds) Rhinosinusitis: a guide for diagnosis and management. Springer, New YorkGoogle Scholar
  14. 14.
    Maestre-Ferrin L, Galan-Gil S, Carrillo-Garcia C, Penarrocha-Diago M (2011) Radiographic findings in the maxillary sinus: comparison of panoramic radiography with computed tomography. Int J Oral Maxillofac Implants 26(2):341–346PubMedGoogle Scholar
  15. 15.
    Abul-Kasim K, Strombeck A, Sahlstrand-Johnson P (2011) Low-dose computed tomography of the paranasal sinuses: radiation doses and reliability analysis. Am J Otolaryngol 32(1):47–51. doi: 10.1016/j.amjoto.2009.08.004 PubMedCrossRefGoogle Scholar
  16. 16.
    Bulla S, Blanke P, Hassepass F, Krauss T, Winterer JT, Breunig C, Langer M, Pache G (2011) Reducing the radiation dose for low-dose CT of the paranasal sinuses using iterative reconstruction: feasibility and image quality. Eur J Radiol. doi: 10.1016/j.ejrad.2011.05.002 Google Scholar
  17. 17.
    Ritter L, Lutz J, Neugebauer J, Scheer M, Dreiseidler T, Zinser MJ, Rothamel D, Mischkowski RA (2011) Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111(5):634–640. doi: 10.1016/j.tripleo.2010.12.007 PubMedCrossRefGoogle Scholar
  18. 18.
    Vallo J, Suominen-Taipale L, Huumonen S, Soikkonen K, Norblad A (2010) Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: results from the Health 2000 Health Examination Survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(3):e80–e87. doi: 10.1016/j.tripleo.2009.10.031 PubMedCrossRefGoogle Scholar
  19. 19.
    White SC, Pharoah MJ (2004) Periodontal diseases. In: White SC, Pharoah MJ (eds) Oral radiology; principles and interpretation, vol 1. 5th edn. Mosby, St. Louis, pp 314–329Google Scholar
  20. 20.
    Kilic C, Kamburoglu K, Yuksel SP, Ozen T (2010) An assessment of the relationship between the maxillary sinus floor and the maxillary posterior teeth root tips using dental cone-beam computerized tomography. Eur J Dent 4(4):462–467PubMedCentralPubMedGoogle Scholar
  21. 21.
    Kwak HH, Park HD, Yoon HR, Kang MK, Koh KS, Kim HJ (2004) Topographic anatomy of the inferior wall of the maxillary sinus in Koreans. Int J Oral Maxillofac Surg 33(4):382–388. doi: 10.1016/j.ijom.2003.10.012 PubMedCrossRefGoogle Scholar
  22. 22.
    Sharan A, Madjar D (2006) Correlation between maxillary sinus floor topography and related root position of posterior teeth using panoramic and cross-sectional computed tomography imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102(3):375–381. doi: 10.1016/j.tripleo.2005.09.031 PubMedCrossRefGoogle Scholar
  23. 23.
    Eberhardt JA, Torabinejad M, Christiansen EL (1992) A computed tomographic study of the distances between the maxillary sinus floor and the apices of the maxillary posterior teeth. Oral Surg Oral Med Oral Pathol 73(3):345–346PubMedCrossRefGoogle Scholar
  24. 24.
    Freisfeld M, Drescher D, Schellmann B, Schuller H (1993) The maxillary sixth-year molar and its relation to the maxillary sinus. A comparative study between the panoramic tomogram and the computed tomogram. Fortschr Kieferorthop 54(5):179–186PubMedCrossRefGoogle Scholar
  25. 25.
    Abrahams JJ, Glassberg RM (1996) Dental disease: a frequently unrecognized cause of maxillary sinus abnormalities? AJR Am J Roentgenol 166(5):1219–1223PubMedCrossRefGoogle Scholar
  26. 26.
    Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR (2008) Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod 34(3):273–279. doi: 10.1016/j.joen.2007.11.023 PubMedCrossRefGoogle Scholar
  27. 27.
    Lurie AG (2004) Panoramic imaging. In: White SC, Pharoah MJ (eds) Oral radiology: principles and interpretation, vol 1. 5th edn. Mosby, St. Louis, pp 191–209Google Scholar
  28. 28.
    Temmerman A, Hertele S, Teughels W, Dekeyser C, Jacobs R, Quirynen M (2010) Are panoramic images reliable in planning sinus augmentation procedures? Clin Oral Implants Res 22(2):189–194. doi: 10.1111/j.1600-0501.2010.02000.x PubMedCrossRefGoogle Scholar
  29. 29.
    Hauman CH, Chandler NP, Tong DC (2002) Endodontic implications of the maxillary sinus: a review. Int Endod J 35(2):127–141PubMedCrossRefGoogle Scholar
  30. 30.
    Obayashi N, Ariji Y, Goto M, Izumi M, Naitoh M, Kurita K, Shimozato K, Ariji E (2004) Spread of odontogenic infection originating in the maxillary teeth: computerized tomographic assessment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98(2):223–231. doi: 10.1016/S1079210404003518 PubMedCrossRefGoogle Scholar
  31. 31.
    Ludlow JB, Davies-Ludlow LE, Brooks SL (2003) Dosimetry of two extraoral direct digital imaging devices: NewTom cone beam CT and Orthophos Plus DS panoramic unit. Dentomaxillofac Radiol 32(4):229–234PubMedCrossRefGoogle Scholar
  32. 32.
    Ngan DC, Kharbanda OP, Geenty JP, Darendeliler MA (2003) Comparison of radiation levels from computed tomography and conventional dental radiographs. Aust Orthod J 19(2):67–75PubMedGoogle Scholar
  33. 33.
    Pauwels R, Beinsberger J, Collaert B, Theodorakou C, Rogers J, Walker A, Cockmartin L, Bosmans H, Jacobs R, Bogaerts R, Horner K (2012) Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol 81(2):267–271. doi: 10.1016/j.ejrad.2010.11.028 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Maryam Shahbazian
    • 1
  • Charlotte Vandewoude
    • 1
  • Jan Wyatt
    • 2
  • Reinhilde Jacobs
    • 1
  1. 1.Oral Imaging Center, Department of Oral Health SciencesKU Leuven & Dentistry, University Hospitals, KU LeuvenLeuvenBelgium
  2. 2.Pediatric Dentistry, Department of Oral Health SciencesKU Leuven & Dentistry, University Hospitals, KU LeuvenLeuvenBelgium

Personalised recommendations