Application of spiral computed tomography for determination of the minimal bone density variability of the maxillary sinus walls in chronic odontogenic and rhinogenic sinusitis

Abstract

Background. There are many questions regarding the peculiarities of the course of odontogenic maxillary sinusitis, the likelihood of complications and the correct dosage of load during dental implantation. Purpose – to identify changes in minimal bone density in chronic odontogenic maxillary sinusitis and to compare it with chronic rhinogenic catarrhal maxillary sinusitis and physiological state of maxillary sinus. Materials and Methods. Our study involved 10 patients with chronic odontogenic maxillary sinusitis, 10 patients with chronic maxillary non-polyposis sinusitis of rhinogenic etiology, combined with hyperplasia of the sinus mucosa up to 1 cm. The control group comprised 10 patients with physiological condition of maxillary sinuses. In all subjects minimal bone density of superior, medial and inferior walls of maxillary sinus was analyzed. Results. The study showed that the maximum in physiological conditions is the minimal density of the upper wall of the maxillary sinus, the minimum is the lower wall. The minimal density of the lower wall was shown to undergo a statistically significant reduction in chronic catarrhal maxillary sinusitis only by 2%, the upper by 5%, the medial by 4% compared with the intact sinus, but with the odontogenic nature of maxillary sinusitis, this figure was 31% in the lower wall, 27% in the medial region. Only the density of the upper wall of the maxillary sinus remained quite stable, it decreased relative to the physiological one only by 6%. Conclusions. Minimal physiological densitometric parameters of lower, medial and upper walls were calculated. The reduction of minimal density of bone tissue in the cases of rhinogenic chronic catarrhal maxillary sinusitis. In the cases of chronic odontogenic maxillary sinusitis, maximum significant decrease of minimal density of both lower and medial walls is determined.