Cone beam computed tomography for diagnostic imaging prior to dental implant therapy in the posterior maxilla with special emphasis on the visualization of the maxillary sinus

© Quintessenz. The maxillary sinus is a symmetric and pyramid-shaped, air-filled space in the facial skeleton that is regularly depicted on oral radiographs. For dental indications and especially prior to implant therapy, cone beam computed tomography (CBCT) is the recommended imaging modality for 3-dimensional visualizations of the sinus. Although considered desirable, depiction of the natural sinus ostium on the respective field of view (FOV) of the CBCT is not mandatory. Thus, for most CBCT scans performed for implant treatment-planning purposes, a small- to medium-sized FOV depicting only the maxillary sinus intended for surgery is sufficient. Knowledge of the possibilities and limitations in diagnostic imaging helps the practitioner to make adequate decisions and to avoid radiographic modalities that may result in unnecessary radiation exposure to the patient. Changes and pathologies of the maxillary sinuses are rather frequent findings and exhibit a wide variability, from harmless anatomical variants to malignant neoplasias. Benign and malignant lesions tend to grow in the lumen of the maxillary sinus without any clinical symptoms for quite some time and may only be incidentally diagnosed on dental radiographs. This underlines the importance of a proper initial clinical and radiographic assessment of patients referred for dental implant treatment planning-especially with regard to the health or pathology of the maxillary sinus. If further diagnostic imaging or treatment of unclear sinus conditions is deemed necessary, referral to a medical specialist such as an ear, nose, and throat specialist must be considered.status: publishe