Sinus Mucosal Inflammation Accompanied More Than Half of Posterior Maxillary Lesions

Edited by Dentaltown staff

Localized maxillary sinus mucosal inflammation was present in 55.5% of posterior maxillary apical periodontitis cases reviewed on cone beam computed tomography, according to a cross-sectional study in the International Endodontic Journal.

Researchers screened 586 CBCT scans from patients treated at New York University College of Dentistry between 2016 and 2021. Of those, 335 met inclusion criteria and 322 were analyzed after 13 were excluded for lacking periradicular disease.

The investigators defined periapical mucositis as inflammation of the periapical tissues with localized edema of the maxillary sinus mucosa, typically resulting from periradicular disease. On imaging it appeared as mucosal thickening or a dome-shaped expansion along the maxillary sinus floor.

Erosion of the bony sinus floor was associated with 7.56 times higher odds of periapical mucositis, at P less than .001.

Lesion severity also mattered. Each incremental increase in the CBCT periapical index corresponded to a 1.43-fold increase in the odds of mucositis, at P = .004.

The authors concluded that periapical mucositis affected more than half of patients with posterior maxillary apical periodontitis, and that sinus floor erosion and lesion size were significant predisposing factors.

Marie Mora, John R. Craig of Henry Ford Health, Asgeir Sigurdsson, and colleagues conducted the study, which was published online March 30 and appears in an August issue.

The design was cross-sectional and drew on patients referred to a single university endodontic department. It cannot establish progression to symptomatic odontogenic sinusitis or determine which areas of mucosal thickening require treatment.

Sources:
International Endodontic Journal, “Prevalence and Predisposing Factors of Periapical Mucositis: A Cross-Sectional Study,” published online March 30, 2026: onlinelibrary.wiley.com/doi/10.1111/iej.70154
DOI: doi.org/10.1111/iej.70154