Significance of maxillary sinus mucosal thickening in patients with periodontal disease

Abstract

Aim: To characterise and measure the Schneiderian membranes of individuals with periodontal diseases in China and to analyse the factors impacting maxillary sinus mucosal thickness using cone-beam computed tomography (CBCT).

Material and method: A cohort of 221 patients with periodontal disease was subjected to cross-sectional CBCT examination. Various parameters, including age, sex, alveolar bone loss, furcation lesions and vertical infrabony pockets, were analysed as correlates of mucosal thickening (MT). Sinus mucosal thickness ≥ 2 mm qualified as MT.

Results: MT was detected in 103 (48.9%) patients, increasing in frequency as the degree of alveolar bone loss advanced (mild, 14.5%; moderate, 29.5%; severe, 87.9%). The association between MT and vertical infrabony pockets was statistically significant (P < 0.001). The likelihood of MT increased with moderate [odds ratio (OR) = 1.02] and severe (OR = 4.62) periodontal bone loss (P < 0.001), as well as with furcation lesions (OR = 2.76) and vertical infrabony pockets (OR = 13.58).

Conclusions: Relative to the case in patients with periodontitis and normal mucosa, the probability of MT increased dramatically as alveolar bone loss worsened. Periodontal pathologies (i.e. furcation lesions and vertical infrabony pockets) were also more likely to coincide with MT.

Keywords: Periodontitis; alveolar bone loss; cone-beam computed tomography; mucosal thickening.

Figure 1.

Cone beam computed tomography (CBCT) images of maxillary sinus mucosa: (a) normal mucosa in patients with periodontitis; (b) mild mucosal thickness (MT), left maxillary sinus (a 28-year-old woman, with furcation lesion of Tooth 26); (c) moderate MT, left maxillary sinus (a 41-year-old man, with a vertical infrabony pocket of Tooth 26 and peak-type MT); and (d) severe MT, left maxillary sinus (a 32-year-old man, with the sinus floor gap penetrated by inflammation caused by periodontitis).

Figure 2.

Alveolar bone loss in patients with maxillary sinus mucosal thickening (MT): (a) mild loss (a 35-year-old man, with 2 mm left maxillary sinus MT); (b) moderate loss (a 45-year-old woman, with 3 mm left maxillary sinus MT); and (c) severe loss (a 52-year-old man, with 8.1 mm left maxillary sinus MT).

Figure 3.

Maxillary sinus mucosal thickening (MT), stratified by age and sex (male predominance) *Sex differences, P < 0.05. ^§Age differences, P < 0.05.