Assessment of Posterior Maxillary Tooth Apices and the Sinus Floor Using Cone-Beam CT in Zahedan

Abstract

Background: The proximity of the apices of posterior teeth to the maxillary sinus is a major concern for treatments performed in this region. Overextension of root canal fillings beyond the apex, apical surgery, extraction of retained roots, and maxillary sinus surgery in the presence of healthy teeth highlight the importance of understanding the anatomy of this area. Objectives: The aim of this descriptive-analytical study was to investigate the relationship between the apices of the maxillary posterior teeth and the floor of the maxillary sinus in the Zahedan population in 2023. Methods: In this study, 90 cone-beam computed tomography (CBCT) images from patients at Zahedan University of Medical Sciences were examined to assess the position of the apices of the maxillary posterior teeth in relation to the floor of the maxillary sinus. The roots examined included the palatal and buccal roots of premolars, as well as the palatal, distobuccal, and mesiobuccal roots of molars on both the left and right sides, totaling 1,307 roots. Data were collected by direct observation of the images. Statistical analysis was performed using the chi-square test. Results: The mean age of the participants was 26.8 ± 7.5 years, ranging from 18 to 46 years. Of the subjects, 14 (15.5%) were male and 76 (84.5%) were female. The results showed that the relationship between the apices of the maxillary posterior teeth and the floor of the maxillary sinus in the second premolars was associated with gender, and with age in both the second molars and second premolars. In addition, the presence or absence of adjacent teeth was significantly related to the proximity of the apices of the maxillary posterior teeth to the maxillary sinus floor. Conclusions: Age and gender play a decisive role in the position of the apices of maxillary posterior teeth in relation to the floor of the maxillary sinus. This relationship also depends on the type of tooth, type of root, and the presence or absence of adjacent teeth. The findings can aid clinicians in planning endodontic treatment, extractions, and implant placement.