Title:Orthopantomography Versus Cone Beam Computed Tomography for the
Assessment of the Proximity of Posterior Maxillary Apexes with the Maxillary
Sinus: A Cross-sectional Study
Volume: 20
Author(s): Macarena Rodríguez, Maureen Marshall, Constanza Godoy, Roxana Richa and Sven Eric Niklander*
Affiliation:
- Unit of Oral Pathology and Oral Medicine, Faculty of Dentistry, Universidad Andres Bello, Quillota 980, Viña del Mar, Chile
Keywords:
Maxillary sinus, Cone beam computed tomography, Orthopantomography, Radicular apex, Molars, Dental.
Abstract:
Background:
The lack of knowledge of the relation of the maxillary sinus with the apexes of maxillary posterior teeth can lead to important complications during
common dental procedures. This can be avoided using different imaging techniques, such as orthopantomography (OPG) and cone beam computed
tomography (CBCT). The present study aims to compare the performance of OPG with CBCT in measuring the vertical distance of the apexes of
posterior-superior teeth to the maxillary sinus.
Methods:
This study corresponded to a cross-sectional study. OPGs and CBCT scans were obtained from the same individuals, and the qualitative and
quantitative vertical distance of the apexes in relation to the maxillary sinus was categorized and measured in mm.
Results:
A total of 28 pairs of OPGs and CBCT scans from the same patients were obtained. About 381 roots were analysed, which included 89 upper first
premolars, 51 upper second premolars, 115 upper first molars, and 126 upper second molars. Projection/protrusion was observed with more
frequency in molars, specially 1º molars in both OPG (n= 75, 65.2%) and CBCT (n= 31, 27%); however, 106 more cases (27.9%) were classified
as projected in the OPG compared to CBCT (p < 0.05). When comparing the performance of the OPG and CBTC for analysing all roots
qualitatively, there was a 57.8% agreement between both techniques. This difference was statistically significant (p <0.0001). Statistically
significant differences were also observed when comparing the millimetric differences.
Conclusion:
This study showed that OPG is not an accurate technique to observe the relationship between the maxillary sinus and the apexes of the upper
posterior teeth. In those cases where precision is required when performing dental procedures in this area, CBCT should be used. When not
available, the clinicians should be aware of the limitations of the OPG and add other complementary techniques.