Radiologic diagnostic methods in maxillary sinusitis caused by dental implant intrusion

Objective. To analyze preoperative computed tomography scans of patients to identify predictors of maxillary sinusitis caused by dental implant intrusion.

Materials and methods. The study involved 35 patients who underwent dental implant placement. In the preoperative period the peculiarities of the anatomy of the facial skull were evaluated, namely, pathologies of the air-bearing passages, factors of the aeration disturbance of the maxillary sinus. The anatomy of the lower wall of the sinus and the thickness of the mucosa were evaluated.

Results. The block of the natural accessory of the maxillary sinus with the middle nasal passage had a statistically significant influence on the development of sinusitis (p = 0,43; r < 0,05). In 86% of the patients who underwent dental implantation sinusitis developed, at the same time 60% of them had some organic pathology of the nasal passages system. When determining the diagnostic significance of the angle between the anterolateral and medial sinus walls for mucous membrane perforation the following results were obtained: AUC=0.609 with 95% CI 0.507-0.710 (p = 0.034). When analyzing the diagnostic significance of maxillary sinus mucosal perforation for predicting implant-dependent complications, the sensitivity of the test is 43.8% and specificity is 84.2%.

Conclusion. CT-assessment of maxillary sinus anatomy is extremely important in predicting postimplantation sinusitis. Special attention should be paid to the risk factors of sinus aeration disturbance as well as to the risk factors of intraoperative perforation of its mucosa.