Morphologic Analysis of Maxillary Sinus Floor and its Correlation to Molar Roots using Cone Beam Computed Tomography

Objective: To analyse the anterior extension of the maxillary sinus, distribution of the sinus septa and vertical relationship between the maxillary sinus and molar roots using cone beam computed tomography (CBCT). Methods: Imaging data of 970 consecutive patients who underwent CBCT scans were retrospectively collected. The anterior border, septa distribution of the maxillary sinus and relationship between the maxillary sinus and molar roots were analysed. The root-sinus relationship was divided into three types; the roots protruding into the sinus or touching the floor without a bony barrier was defined as Type I root-sinus relationship. Results: Overall, 15.5% of the maxillary sinuses extended beyond the incisor region and 68.9% extended beyond the canine region. A bony septum of ≥ 2 mm was detected in 16.9% (328/1940) of the maxillary sinuses from 26.0% (252/970) of the patients. Among the 355 septa in the 328 sinuses with septa, 108 (30.4%) were located at the first and second premolar region, 180 (50.7%) at the first and second molar region and 67 (18.9%) posterior to the second molar. Among the first molars, a Type I root-sinus relationship was detected in 61.0% of palatine roots, 55.4% of distobuccal (DB) roots, and 52.7% of mesiobuccal (MB) roots. Moreover, among three-rooted second molars, a Type I relationship was detected in 62.0%, 58.2% and 45.8% of MB, DB and palatine roots, respectively. Conclusion: The maxillary sinus can extend beyond the incisor region; approximately 1/6 of sinuses have bony septa; and 1/2 of molar roots protrude into the maxillary sinus or touch the sinus floor without a bony barrier. Keywords: maxillary sinus, sinus septum, sinus border, maxillary molar, cone beam computed tomography (CBCT)