Maxillary sinus findings in the elderly: a panoramic radiographic study

Abstract

Aim: The aim of the present study was to investigate the prevalence of maxillary sinus findings in elderly subjects above the age of 50 through the use of panoramic radiography and to test the hypothesis that such findings are more prevalent in dentate subjects.

Methods and materials: A total of 105 subjects over the age of 50 years were examined both clinically and radiographically in the Department of Oral Medicine and Radiology of the Manipal College of Dental Sciences in Manipal, India, over a period of three months for various reasons. Eight were excluded due to the lack of diagnostic quality of their radiographs. The manually calculated kappa test was used to determine the statistical significance of intra-examiner reliability. The other data were analyzed using a manually calculated z-test for proportions where z > or = 1.96 or p < 0.05 were considered statistically significant.

Results: The prevalence of radiographic maxillary sinus findings in 97 elderly subjects (aged above 50 years) were investigated with the use of panoramic radiography. Fifty subjects had at least one natural tooth radiographically in the upper jaw and 39 subjects were radiographically edentulous in the upper jaw. Mucous cysts or diffused mucosal thickenings were found in 42.26% of the subjects. Of the mucosal thickenings, 74.35% were found in subjects with a dentate upper jaw (p < 0.05). The prevalence of a mucous cyst was 2.06% in subjects with a dentate upper jaw and a finding of no mucous cysts in edentulous subjects suggests an odontogenic cause.

Conclusion: According to the findings of the present study, the presence of mucosal thickening or mucosal cysts may be due to the presence of irritative stimuli, often an infection of dental origin, as these findings are more prevalent in dentulous subjects.

Clinical significance: The panoramic radiograph is an excellent diagnostic tool for the identification of mucosal thickening and mucosal cysts. The accurate diagnosis of infective foci (chronic apical periodontitis, deep pockets caused by periodontitis) is necessary, because in conditions of decreased host resistance it may lead to acute sinusitis.