# Maximly Sinusitis of Odontogenic Origin: Prevalence among 3D Imaging--A Retrospective Study
###### Abstract  
The aim of this study was to investigate the prevalence of maxillary sinus mucosal thickening and compare it to the presence of odontogenic pathology of adjacent teeth. Three hundred and twenty-one full maxilla cone-beam computed tomography scans were examined. The parameters investigated included signs of maxillary sinus mucosal thickening and the diagnosis and proximity of the adjacent teeth. Statistical analysis was conducted using IBM SPSS version-16.0 (SPSS Inc., Chicago, IL, USA). Out of the 2001 teeth examined, 888 (44.4%) were associated with mucosal thickening with a significant difference between the different tooth types (\(p\) = 0.04). Mucosal thickening in a maxillary sinus was more likely if the neighboring teeth had apical disease. Interruption of the maxillary sinus floor was noticed more in specific teeth, particularly the first and second molars (\(p\) < 0.001). Sinusitis of odontogenic origin can be more prevalent than clinicians expect. The treatment of odontogenic sinusitis should be straightforward, whereby the diseased tooth is root treated or extracted. The sinusitis will then resolve if there are no other etiological factors.  
paranal sinus diseases; sinusitis; radiology; imaging; sinus anatomy +
Footnote †: journal: _sciences_  
retrospectively, they found that 75% of the cases were linked to an odontogenic infection. In a study by [PERSON], [PERSON] et al. [10] conducted in the United Kingdom, where the authors reviewed the incidence of odontogenic sinusitis, they reported that 73% of the OS cases were caused by periapical (PA) lesions, 23% by oroantral fistula, and 4% by retained teeth; the study sample was small and consisted of twenty-six patients. Severe periodontal bone loss was also suggested as a major cause of OS. [PERSON], [PERSON] et al. [11] concluded that periodontal disease may be a major cause of OS, as it has been found that periodontal disease increases the incidence of apical pathology associated with increasing bone loss. Of all the maxillary teeth, it was found that the first molar, which lies in close proximity to the sinus membrane, is the most common tooth to cause OS. Of the three roots of the maxillary first molar, it has been stated that the palatal roots, followed by the mesiobuccal roots, were most commonly associated with the maxillary sinus [12; 13].  
Determining that sinusitis is of odontogenic origin can be challenging, as many factors should be considered, such as the degree of MT, and at what point the odontogenic factor should be considered as an etiology and when to exclude it, which proves that the diagnostic criteria are heterogenous [14]. Additionally, diagnosing OS using different imaging modalities by relying on unilateral MT without a proper clinical examination is not accurate and can end up in misdiagnosis. Other possible causes of unilateral MT can be caused by a cyst or tumor, and in both cases, further investigations would be necessary [15; 16].  
The American Association of Endodontists (AAE) issued a position paper [17] in 2018 on maxillary sinusitis of endodontic origin (MSEO). The presentation of MSEO was divided into three main categories: Periapical Osteeoriostitis (PAO), Periapical Mucositis (PAM), and Sinus Obstruction from MSEO. The position paper emphasized the importance of limited field of view (FOV) CBCT in the source detection of MSEO. It was concluded that MSEO can be easily overlooked, and emphasis was placed on the importance of endodontists in the process of the detection and treatment of MSEO.  
The aim of this study was to detect the presence and prevalence of maxillary sinus mucosal thickening and assess its relationship to the adjacent teeth's health and proximity.