Background:The maxillary sinus is the largest paranasal sinus which has a close anatomical relationship with the roots of maxillary posterior teeth, which results in clinical challenges during dental procedures including extractions,
implant procedures and endodontic treatments. Odontogenic infections and surgical interventions can lead to
disruption in the sinus floor, leading to oroantral communication or sinusitis. The present study aims to evaluate the
proximity of maxillary posterior tooth roots to the maxillary sinus floor using orthopantomograms (OPGs).
Methodology;A retrospective, observational study analyzing 351 OPGs of patients aged 25–30 years, were selected.
The relationship between roots of maxillary posterior teeth and maxillary sinus was assessed using a modified scoring
system by Sharan and Madjar (2006), which classified root projection into the maxillary sinus with a score from 0 (no
contact) to 4 (>2 mm intrusion). The data were tabulated in excel sheets and statistical analysis was done using SPSS
software, chi-square tests were done. A p-value of <0.05 was considered statistically significant.
Results:The present study revealed considerable variations in root-sinus proximity among different maxillary
posterior teeth. The highest root projection into the sinus cavity was observed in first and second molars. Tooth 27
exhibited the most frequent intrusion into the sinus, with 47.2% scoring 3 and 22.5% scoring 4. Gender-based analysis indicated that males had a significantly higher frequency of root projection into the sinus, particularly for tooth 16 (χ² = 17.584, p = 0.001). Chi-square analysis demonstrated significant bilateral symmetry in root-sinus relationships, with the strongest association found between the right and left first premolars (χ² = 136.47, p < 0.001).
Conclusion;The study confirms the anatomical variations in the relationship between maxillary posterior teeth and the maxillary sinus floor, with molars demonstrating the closest proximity. The findings emphasize the need for thorough preoperative radiographic evaluation, particularly for procedures involving maxillary posterior teeth, to minimize complications such as sinus perforation and infections. Gender differences in sinus pneumatization and root projection suggest potential implications for personalized treatment planning.
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