Assessment of prevalence of anatomical variations and pathosis of the maxillary sinuses using cone-beam computed tomography in a sample of the population of Saudi Arabia

Background: Cone-beam computed tomography (CBCT) technology has been a useful tool for decreasing dental treatment complications and ensuring more predictable treatment outcomes. Objectives: This study aimed to assess the prevalence of maxillary sinuses status in regard to anatomical variations and pathosis using CBCT as a diagnostic tool, in asymptomatic patients who are willing to receive dental implants at King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. Materials and Methods: Both sinuses in 263 patients (140 females and 96 males) were evaluated using iCAT Classic scanner to acquire the total of 526 CBCT images. Two calibrated dental radiology consultants evaluated the CBCT of the maxillary sinuses images using the Vision software (Imaging Sciences International, Hatfield, PA, USA) for the following finding: number of teeth in intimate relation with the maxillary sinus and the presence of septa (as anatomical variations) and the presence, extent, and configuration of mucosal thickening (MT) as sign of pathosis (mucositis). Results: The highest prevalence of dental proximity to the sinus wall was between the first left premolars and the anterior sinus wall (57.14%) followed by the second right premolars (56.14%). The presence of septa in both right and left maxillary sinuses was 54.37% and 57.41%, respectively. The prevalence of sinus pathosis was 52.7%. Interestingly, 87.07% of the MT cases were due to nonodontogenic origin compared to 12.93% of odontogenic-related pathosis. Conclusions: Preoperative radiographic assessment using CBCT is highly recommended before dental implant placement in our population due to the high anatomical variations and pathosis rates, to allow proper assessment and diagnosis of maxillary sinus disease, if present. The assessment of maxillary sinus disease before surgical intervention will provide a higher standard of care and decrease the risk of complications and failures of dental implants