Frequency and type of incidentally detected radiodensities in the maxillary sinus: a retrospective analysis using cone beam computed tomography (CBCT)
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.
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.
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.
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.
KeywordsMaxillary sinus Radiodensity Cone beam computed tomography Frequency Location
The authors are grateful to Ms. Kar Yan Li, Centralised Research Lab, Faculty of Dentistry, The University of Hong Kong, for her valuable assistance regarding the statistical analysis.
This study has been funded by departmental funds only. No external funding has been received.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was submitted to and approved by the local institutional review board (IRB) of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (approval number UW 17-462).
For this type of study (retrospective study), formal consent is not required.
- 3.Nemtoi A, Czink C, Haba D, Gahleitner A (2013) Cone beam CT: a current overview of devices. Dentomaxillofac Radiol 42:20120443. https://doi.org/10.1259/dmfr.20120443
- 5.Allareddy V, Vincent SD, Hellstein JW, Qian F, Smoker WR, Ruprecht A (2012) Incidental findings on cone beam computed tomography images. Int J Dent 2012:871532. https://doi.org/10.1155/2012/871532
- 7.Edwards R, Alsufyani N, Heo G, Flores-Mir C (2014) The frequency and nature of incidental findings in large-field cone beam computed tomography scans of an orthodontic sample. Prog Orthod 15:37. https://doi.org/10.1186/s40510-014-0037-x
- 8.Lopes IA, Tucunduva RM, Handem RH, Capelozza ALA (2016) Study of the frequency and location of incidental findings of the maxillofacial region in different fields of view in CBCT scans. Dentomaxillofac Radiol 46:20160215. https://doi.org/10.1259/dmfr.20160215
- 13.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 23:1243–1253CrossRefPubMedGoogle Scholar
- 20.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 32:1324–1332CrossRefPubMedGoogle Scholar
- 21.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 28:587–596CrossRefPubMedGoogle Scholar
- 24.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 22:1446–1453CrossRefPubMedGoogle Scholar
- 26.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 128:1261–1267Google Scholar
- 31.Duce MN, Talas DÜ, Özer C, Yildiz A, Apaydin FD, Özgür A (2003) Antrolithiasis: a retrospective study. J Laryngol Otol 117:637–640Google Scholar