Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters using CBCT

Hazal Duyan Yüksel; Burcu Evlice; Muhammed Dağkıran; Gülşah Seydaoğlu

doi:10.52037/eads.2025.0012

Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters using CBCT

Abstract

Purpose: The diagnosis of rhinosinusitis relies on a combination of clinical symptoms and objective findings. This study primarily aimed to identify true rhinosinusitis patients using cone-beam computed tomography and to evaluate the relationships between rhinosinusitis and odontogenic parameters. A secondary objective was to assess mucosal thickening and its association with odontogenic factors. Material and Methods: The study included 378 patients who underwent cone-beam computed tomography scans for various indications. Rhinosinusitis diagnosis was based on “European Position Paper on Rhinosinusitis and Nasal Polyps” guidelines, incorporating clinical symptoms and radiological findings. Cone-beam computed tomography imaging parameters included periapical lesions, posterior tooth loss, root-sinus relationships, and oroantral communication. Mucosal thickening was classified as present (≥2 mm) or absent (<2 mm). Associations between categorical variables were analyzed using the chi-square test. Results: Rhinosinusitis was diagnosed in 98 patients (25.9%). Mucosal thickening was observed in 54.2% of maxillary sinus sides. Periapical lesions and oroantral communication were significant risk factors for both rhinosinusitis (p=0.019 and p=0.002, respectively) and mucosal thickening (p<0.001 for both). Root-sinus relationships were significantly associated with mucosal thickening (p=0.019) but were not predisposing factors for rhinosinusitis. Posterior tooth loss was not associated with either rhinosinusitis or mucosal thickening. Conclusions: This study highlights the importance of combining clinical symptoms and radiological findings for accurate rhinosinusitis diagnosis. It also demonstrates that cone-beam computed tomography is a suitable imaging modality for evaluating paranasal sinus findings and associated radiological parameters. Key words: cone-beam computed tomography, diagnostic imaging, mucosal thickening, paranasal sinus, rhinosinusitis

Keywords

Supporting Institution

The present study was supported by Cukurova University Scientific Research Projects Coordination

Project Number

TDH-2019-12067

Ethical Statement

The study was approved by the Non-Interventional Clinical Research Ethics Committee of Çukurova University Faculty of Medicine.

Thanks

Special thanks to Prof. Dr. Cenk Haytac for his technical contributions to this study.

References

Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1–464. doi:10.4193/Rhin20.600.
Orlandi RR, Kingdom TT, Hwang PH. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis Executive Summary. Int Forum Allergy Rhinol. 2016;6 Suppl 1:S3–21. doi:10.1002/alr.21694.
Peters AT, Spector S, Hsu J, Hamilos DL, Baroody FM, Chandra RK, et al. Diagnosis and management of rhinosinusitis: a practice parameter update. Ann Allergy Asthma Immunol. 2014;113(4):347–85. doi:10.1016/j.anai.2014.07.025.
Deosthale NV, Khadakkar SP, Harkare VV, Dhoke PR, Dhote KS, Soni AJ, et al. Diagnostic Accuracy of Nasal Endoscopy as Compared to Computed Tomography in Chronic Rhinosinusitis. Indian J Otolaryngol Head Neck Surg. 2017;69(4):494–499. doi:10.1007/s12070-017-1232-0.
Kim DH, Seo Y, Kim KM, Lee S, Hwang SH. Usefulness of Nasal Endoscopy for Diagnosing Patients With Chronic Rhinosinusitis: A Meta-Analysis. Am J Rhinol Allergy. 2020;34(2):306–314. doi:10.1177/1945892419892157.
Kobayashi K, Shimoda S, Nakagawa Y, Yamamoto A. Accuracy in measurement of distance using limited cone-beam computerized tomography. Int J Oral Maxillofac Implants. 2004;19(2):228–31.
Kolethekkat AA, Paul RR, Kurien M, Kumar S, Al Abri R, Thomas K. Diagnosis of adult chronic rhinosinusitis: can nasal endoscopy predict intrasinus disease? Oman Med J. 2013;28(6):427–31. doi:10.5001/omj.2013.120.
Nair UP, Nair MK. Maxillary sinusitis of odontogenic origin: cone-beam volumetric computerized tomography-aided diagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110(6):e53–7. doi:10.1016/j.tripleo.2010.06.020.

Pokharel M, Karki S, Shrestha BL, Shrestha I, Amatya RC. Correlations between symptoms, nasal endoscopy computed tomography and surgical findings in patients with chronic rhinosinusitis. Kathmandu Univ Med J (KUMJ). 2013;11(43):201–5. doi:10.3126/kumj.v11i3.12504.
Schulze D, Heiland M, Thurmann H, Adam G. Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography. Dentomaxillofac Radiol. 2004;33(2):83–6. doi:10.1259/dmfr/28403350.
Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2 Suppl):S1–S39. doi:10.1177/0194599815572097.
Brullmann DD, Schmidtmann I, Hornstein S, Schulze RK. Correlation of cone beam computed tomography (CBCT) findings in the maxillary sinus with dental diagnoses: a retrospective cross-sectional study. Clin Oral Investig. 2012;16(4):1023–9. doi:10.1007/s00784-011-0620-1.
Dursun E, Keceli HG, Dolgun A, Velasco-Torres M, Olculer M, Ghoreishi R, et al. Maxillary Sinus and Surrounding Bone Anatomy With Cone Beam Computed Tomography After Multiple Teeth Loss: A Retrospective Multicenter Clinical Study. Implant Dent. 2019;28(3):226–236. doi:10.1097/ID.0000000000000862.
Mehra P, Murad H. Maxillary sinus disease of odontogenic origin. Otolaryngol Clin North Am. 2004;37(2):347–64. doi:10.1016/S0030-6665(03)00171-3.
Nurbakhsh B, Friedman S, Kulkarni GV, Basrani B, Lam E. Resolution of maxillary sinus mucositis after endodontic treatment of maxillary teeth with apical periodontitis: a cone-beam computed tomography pilot study. J Endod. 2011;37(11):1504–11. doi:10.1016/j.joen.2011.07.007.
Vallo J, Suominen-Taipale L, Huumonen S, Soikkonen K, Norblad A. 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. 2010;109(3):e80–7. doi:10.1016/j.tripleo.2009.10.031.
Bhattacharyya N, Jones DT, Hill M, Shapiro NL. The diagnostic accuracy of computed tomography in pediatric chronic rhinosinusitis. Arch Otolaryngol Head Neck Surg. 2004;130(9):1029–32. doi:10.1001/archotol.130.9.1029.
Cagici CA, Yilmazer C, Hurcan C, Ozer C, Ozer F. Appropriate interslice gap for screening coronal paranasal sinus tomography for mucosal thickening. Eur Arch Otorhinolaryngol. 2009;266(4):519–25. doi:10.1007/s00405-008-0786-6.
Janner SF, Caversaccio MD, Dubach P, Sendi P, Buser D, Bornstein MM. 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. 2011;22(12):1446–53. doi:10.1111/j.1600-0501.2010.02140.x.
Lund VJ, Mackay IS. Staging in rhinosinusitus. Rhinology. 1993;31(4):183–4.
Moore P, Blakley B, Meen E. Clinical predictors of chronic rhinosinusitis: do the Canadian clinical practice guidelines for acute and chronic rhinosinusitis predict CT-confirmation of disease? J Otolaryngol Head Neck Surg. 2017;46(1):65. doi:10.1186/s40463-017-0243-x.
Kolo ES. The role of plain radiographs in the diagnosis of chronic maxillary rhinosinusitis in adults. Afr Health Sci. 2012;12(4):459–63. doi:10.4314/ahs.v12i4.10.
Brook I. Sinusitis of odontogenic origin. Otolaryngol Head Neck Surg. 2006;135(3):349–55. doi:10.1016/j.otohns.2005.10.059.
Goller-Bulut D, Sekerci AE, Kose E, Sisman Y. Cone beam computed tomographic analysis of maxillary premolars and molars to detect the relationship between periapical and marginal bone loss and mucosal thickness of maxillary sinus. Med Oral Patol Oral Cir Bucal. 2015;20(5):e572–9. doi:10.4317/medoral.20587.
Lu Y, Liu Z, Zhang L, Zhou X, Zheng Q, Duan X, et al. Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study. J Endod. 2012;38(8):1069–74. doi:10.1016/j.joen.2012.04.027.
Nascimento EH, Pontual ML, Pontual AA, Freitas DQ, Perez DE, Ramos-Perez FM. Association between Odontogenic Conditions and Maxillary Sinus Disease: A Study Using Cone-beam Computed Tomography. J Endod. 2016;42(10):1509–15. doi:10.1016/j.joen.2016.07.003.
Maillet M, Bowles WR, McClanahan SL, John MT, Ahmad M. Cone-beam computed tomography evaluation of maxillary sinusitis. J Endod. 2011;37(6):753–7. doi:10.1016/j.joen.2011.02.032.
Vogiatzi T, Kloukos D, Scarfe WC, Bornstein MM. Incidence of anatomical variations and disease of the maxillary sinuses as identified by cone beam computed tomography: a systematic review. Int J Oral Maxillofac Implants. 2014;29(6):1301–14. doi:10.11607/jomi.3644.
Kwiatkowska MA, Szczygielski K, Brociek-Pilczynska A, Chloupek A, Jurkiewicz D. The Influence of Endodontic Lesions on The Clinical Evolution of Odontogenic Sinusitis-A Cohort Study. J Clin Med. 2023;12(3). doi:10.3390/jcm12031103.
Kwiatkowska M, Szczygielski K, Skrzypiec L, Jurkiewicz D. Predictive value of tooth and sinuses radiological characteristics in managing odontogenic sinusitis of endodontic origin. Otolaryngol Pol. 2024;78(5):33–42. doi:10.5604/01.3001.0054.6744.
Zhao Y, Huang S, Xu M, Wang Y, Zhang X, Wang K, et al. Characteristics and risk factors in odontogenic maxillary sinusitis from different dental infections: a retrospective study based on sinus CT imaging. BMC Oral Health. 2025;25(1):308. doi:10.1186/s12903-025-05690-3.
Horwitz Berkun R, Polak D, Shapira L, Eliashar R. Association of dental and maxillary sinus pathologies with ear, nose, and throat symptoms. Oral Dis. 2018;24(4):650–656. doi:10.1111/odi.12805.
Torretta S, Mantovani M, Testori T, Cappadona M, Pignataro L. Importance of ENT assessment in stratifying candidates for sinus floor elevation: a prospective clinical study. Clin Oral Implants Res. 2013;24 Suppl A100:57–62. doi:10.1111/j.1600-0501.2011.02371.x

Details

Primary Language

English

Subjects

Oral and Maxillofacial Radiology, Oral Medicine and Pathology

Journal Section

Research Article

Authors

Hazal Duyan Yüksel ^*
0000-0002-2765-0631
Türkiye

Burcu Evlice
0000-0003-3384-0092
Türkiye

Muhammed Dağkıran
0000-0002-1923-3731
Türkiye

Gülşah Seydaoğlu
0000-0002-0899-894X
Türkiye

Early Pub Date

August 30, 2025

Publication Date

August 31, 2025

Submission Date

January 31, 2025

Acceptance Date

May 9, 2025

Published in Issue

Year 2025 Volume: 52 Number: 2

DOI

https://doi.org/10.52037/eads.2025.0012

IZ

https://izlik.org/JA29LC48EG

Cite

RIS / Bibtex

APA

Duyan Yüksel, H., Evlice, B., Dağkıran, M., & Seydaoğlu, G. (2025). Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters using CBCT. European Annals of Dental Sciences, 52(2), 79-84. https://doi.org/10.52037/eads.2025.0012

AMA

1.Duyan Yüksel H, Evlice B, Dağkıran M, Seydaoğlu G. Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters using CBCT. EADS. 2025;52(2):79-84. doi:10.52037/eads.2025.0012

Chicago

Duyan Yüksel, Hazal, Burcu Evlice, Muhammed Dağkıran, and Gülşah Seydaoğlu. 2025. “Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters Using CBCT”. European Annals of Dental Sciences 52 (2): 79-84. https://doi.org/10.52037/eads.2025.0012.

EndNote

Duyan Yüksel H, Evlice B, Dağkıran M, Seydaoğlu G (August 1, 2025) Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters using CBCT. European Annals of Dental Sciences 52 2 79–84.

IEEE

[1]H. Duyan Yüksel, B. Evlice, M. Dağkıran, and G. Seydaoğlu, “Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters using CBCT”, EADS, vol. 52, no. 2, pp. 79–84, Aug. 2025, doi: 10.52037/eads.2025.0012.

ISNAD

Duyan Yüksel, Hazal - Evlice, Burcu - Dağkıran, Muhammed - Seydaoğlu, Gülşah. “Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters Using CBCT”. European Annals of Dental Sciences 52/2 (August 1, 2025): 79-84. https://doi.org/10.52037/eads.2025.0012.

JAMA

1.Duyan Yüksel H, Evlice B, Dağkıran M, Seydaoğlu G. Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters using CBCT. EADS. 2025;52:79–84.

MLA

Duyan Yüksel, Hazal, et al. “Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters Using CBCT”. European Annals of Dental Sciences, vol. 52, no. 2, Aug. 2025, pp. 79-84, doi:10.52037/eads.2025.0012.

Vancouver

1.Hazal Duyan Yüksel, Burcu Evlice, Muhammed Dağkıran, Gülşah Seydaoğlu. Evaluation of The Relationships Between Rhinosinusitis and Various Odontogenic Parameters using CBCT. EADS. 2025 Aug. 1;52(2):79-84. doi:10.52037/eads.2025.0012