Journal of endodontics · 2025
Impact of Maxillary Sinus Mucosal Thickening on Endodontic Outcomes: A Retrospective Cone-beam Computed Tomographic Cohort Study.
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Buizastrow Jeff, Roque-Torres Gina D, Handysides Robert, Gray Richard, Noorvash Shabab, Oyoyo Udochukwu, Silvestrin Tory, Rice Dwight D
Аннотация
INTRODUCTION: To evaluate whether maxillary sinus mucosal thickening (MT) observed on cone-beam computed tomography (CBCT) influences endodontic outcomes, and to identify other radiographic predictors of healing.
METHODS: This retrospective cohort study included cases treated at a graduate endodontic clinic with pretreatment or intraoperative limited field-of-view CBCT scans and a minimum 5.5 months recall. MT was measured in coronal and sagittal planes and classified by severity, morphology, and presumed origin. Additional variables included CBCT-periapical index (CBCT-PAI) scores, lesion proximity, and treatment type and quality. Outcomes were assessed with clinical testing and periapical radiographs. Associations were analyzed with bivariate tests and multivariable logistic regression.
RESULTS: MT ≥ 2 mm was present in 70% of cases, most commonly with polypoidal morphology and presumed odontogenic origin. However, MT presence, severity, and origin showed no association with treatment outcome. In contrast, changes in periapical index (ΔPAI) strongly correlated with favorable healing, while higher baseline CBCT-PAI scores and retreatment cases were linked with less favorable outcomes.
CONCLUSIONS: MT was a frequent radiographic finding but was not prognostic of endodontic healing. Prognosis was best indicated by ΔPAI, with baseline lesion severity and treatment type contributing additional value. ΔPAI should be interpreted in conjunction with clinical findings and patient-reported symptoms to provide a comprehensive assessment of treatment outcome.
METHODS: This retrospective cohort study included cases treated at a graduate endodontic clinic with pretreatment or intraoperative limited field-of-view CBCT scans and a minimum 5.5 months recall. MT was measured in coronal and sagittal planes and classified by severity, morphology, and presumed origin. Additional variables included CBCT-periapical index (CBCT-PAI) scores, lesion proximity, and treatment type and quality. Outcomes were assessed with clinical testing and periapical radiographs. Associations were analyzed with bivariate tests and multivariable logistic regression.
RESULTS: MT ≥ 2 mm was present in 70% of cases, most commonly with polypoidal morphology and presumed odontogenic origin. However, MT presence, severity, and origin showed no association with treatment outcome. In contrast, changes in periapical index (ΔPAI) strongly correlated with favorable healing, while higher baseline CBCT-PAI scores and retreatment cases were linked with less favorable outcomes.
CONCLUSIONS: MT was a frequent radiographic finding but was not prognostic of endodontic healing. Prognosis was best indicated by ΔPAI, with baseline lesion severity and treatment type contributing additional value. ΔPAI should be interpreted in conjunction with clinical findings and patient-reported symptoms to provide a comprehensive assessment of treatment outcome.