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Title: Relationship of Maxillary Sinus and Maxillary First Molar Root Using Cone Beam Computed Tomography
Authors: HASSAM ANJUM MIR, Saima Shafiq, Maheen Khan, Sumbal Mukhtar, Ali Asif, Qayyum Akhter
Journal: Journal of Islamabad Medical and Dental College (JIMDC)
Publisher: Healers Educational Society
Country: Pakistan
Year: 2023
Volume: 12
Issue: 1
Language: English
Keywords: Cone beam computerized tomographyDental implantMaxillary sinusMolar
Background: Cone beam CT (CBCT) is an advancement of conventional CT that uses a divergent pyramidal or conical X-ray beam for imaging the craniofacial complex. Studies on the maxillary sinus and its relationship with the roots present within its close proximity are mostly based on computed tomography imaging and rarely being based on cone-beam computed tomography (CBCT). This study aims to determine the relationship of maxillary sinus and the mesiobuccal root of maxillary first molar using cone beam computed tomography (CBCT).
Methods: The study was conducted in Armed Forces Institute of Dentistry (AFID) from Sept, 2019 to Feb, 2020. 142 CBCTs were studied in the duration of six months. The distance between the maxillary mesiobuccal root and floor of maxillary sinus was measured using the built in software. The data collected was analyzed using SPSS 23. p-value of <0.005 was considered significant. 
Results: The mean distance was -0.85 mm ± 2.56 on left side and -0.74mm ± 2.40 on right side. There was no significant difference between left and right side. The correlation between age and left and right-side measurements was statistically significant, p-value 0.000.
Conclusion: The relationship of maxillary sinus and the mesiobuccal root of maxillary first molar is significant. The study shows that in dentate healthy patients, the maxillary mesiobuccal molar root is nearly in contact with the sinus floor. These findings lead to the conclusion that performing surgical procedures in maxillary molar region may invariably lead to sinus perforation if one is not care full.
Keywords:  Cone beam computerized tomography, Dental implant, Maxillary sinus, Molar
To determine the relationship of the maxillary sinus and the mesiobuccal root of the maxillary first molar using cone beam computed tomography (CBCT).
A cross-sectional descriptive study was conducted using non-probability consecutive sampling at the Armed Forces Institute of Dentistry. 142 CBCT scans were analyzed over six months (September 2019 to February 2020). The distance between the maxillary mesiobuccal root and the floor of the maxillary sinus was measured using built-in software. Data was analyzed using SPSS 23, with a p-value of <0.005 considered significant. Inclusion criteria included patients over eighteen years old with bilateral presence of teeth from canine to first molar in the maxillary arch, excluding those with a history of orthodontic treatment, fractures, or periapical radiolucency in the premolar/molar region.
graph TD
A["Study Design: Cross-sectional descriptive"] --> B["Sample Selection: Non-probability consecutive sampling"];
B --> C["Data Collection: Analyze 142 CBCT scans"];
C --> D["Measure distance: Mesiobuccal root to sinus floor"];
D --> E["Data Analysis: SPSS 23"];
E --> F["Statistical Tests: t-test, Chi Square"];
F --> G["Identify Correlations: Age, Gender, Side"];
G --> H["Draw Conclusions"];
The study highlights the close proximity of the maxillary first molar's mesiobuccal root to the maxillary sinus, suggesting that other posterior tooth roots are likely even closer or within the sinus. CBCT is recommended for implant and sinus lifting surgeries due to its 3D imaging capabilities. The findings emphasize the importance of awareness regarding sinus proximity to avoid complications such as implant failure, sinusitis, and sinus perforation, which can necessitate further surgical procedures. The proximity increases with age due to sinus pneumatization and tooth extraction.
The mean distance between the maxillary mesiobuccal root and the maxillary sinus floor was -0.85 mm ± 2.56 on the left side and -0.74 mm ± 2.40 on the right side. There was no significant difference between the left and right sides. A statistically significant correlation was found between age and the measurements on both sides (p-value 0.000).
The relationship between the maxillary sinus and the mesiobuccal root of the maxillary first molar is significant. In dentate, healthy patients, the maxillary mesiobuccal molar root is nearly in contact with the sinus floor. This suggests that surgical procedures in the maxillary molar region carry a risk of sinus perforation if not performed with caution.
1. Study Duration: The study was conducted from September 2019 to February 2020. (Confirmed in Methods section).
2. Sample Size: 142 CBCT scans were studied. (Confirmed in Methods and Results sections).
3. Statistical Significance Threshold: A p-value of <0.005 was considered significant. (Confirmed in Methods section).
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