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Do periapical and periodontal pathologies affect Schneiderian membrane appearance? Systematic review of studies using cone-beam computed tomography

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Abstract

Objectives

This systematic review analyzed the relationship between periapical and periodontal pathologies in the posterior maxilla and the appearance of the Schneiderian membrane in cone-beam computed tomography (CBCT) compared with sound dentitions.

Methods

Five electronic databases (Cochrane Library, Embase, OpenGrey, PubMed, Web of Science), complemented by hand searching, were screened up to May 9, 2016. Human clinical studies that used CBCT and contained information on the periapical/periodontal status in the posterior maxilla and Schneiderian membrane appearance were included. A weighted vote counting (WVC) method was applied to summarize results across studies.

Results

Out of 413 records, 20 studies were included. In the WVC, the studies that observed a positive association between periapical lesions and the appearance of the Schneiderian membrane outweighed those that found no such association (WVC 51 % and WVC 33 %, respectively), with some studies yielding indeterminate results (WVC 16 %). Regarding the relation between periodontal pathologies and the appearance of the Schneiderian membrane, WVC produced a tie between studies demonstrating a positive association (WVC 46 %) and those showing no association (WVC 44 %); one study (WVC 10 %) reported indeterminate results.

Conclusions

On CBCT scans, periapical lesions in the posterior maxilla are likely to be associated with Schneiderian membrane thickening. In contrast, current evidence regarding the relation between periodontal diseases and the appearance of the Schneiderian membrane in CBCT is inconclusive.

Clinical relevance

Incidental maxillary sinus findings on CBCT scans warrant thorough differential diagnosis. Frequently, they may be related to dental pathologies.

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Acknowledgments

Original investigators, irrespective of their inclusion in this systematic review, whose research productivity in this field established the basis of this review are gratefully acknowledged [80].

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Authors and Affiliations

  1. Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland

    Florin Eggmann, Thomas Connert, Julia Bühler, Roland Weiger & Clemens Walter

  2. Department of Oral Surgery, Oral Radiology and Oral Medicine, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland

    Dorothea Dagassan-Berndt

Authors
  1. Florin Eggmann
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  2. Thomas Connert
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  3. Julia Bühler
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  4. Dorothea Dagassan-Berndt
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  5. Roland Weiger
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  6. Clemens Walter
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Corresponding author

Correspondence to Clemens Walter.

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The authors declare that they have no conflict of interest.

Funding

The work was funded by the Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Additional information

Florin Eggmann and Thomas Connert contributed equally to this work.

Appendix

Appendix

Table 4 Scores for assessment of methodological and reporting quality (modified from Schmidt et al. [35])
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Table 5 Weight calculation for weighted vote counting based on quality assessment and sample size
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Table 6 Methodological details of the included studies
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Table 7 Publications excluded after full-text assessment
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Eggmann, F., Connert, T., Bühler, J. et al. Do periapical and periodontal pathologies affect Schneiderian membrane appearance? Systematic review of studies using cone-beam computed tomography. Clin Oral Invest 21, 1611–1630 (2017). https://doi.org/10.1007/s00784-016-1944-7

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