Descriptive CBCT Findings of Maxillary Sinus Mucosal Changes in Patients Undergoing Sinus Floor Elevation: A Retrospective Observational Study

Objectives: To assess the prevalence of maxillary sinus pathology in patients requiring sinus floor elevation to aid dental implant treatment. The study aimed to identify the degree, morphology, and location of mucosal thickening and its relation to ostium patency, as well as any odontogenic pathology contributing to mucosal thickening. Methods: This study was conducted at the ICE Postgraduate Dental Institute and Hospital, England, UK, between February and April 2025. cone-beam computed tomography (CBCT) scans of 20 patients who were partially dentate and edentulous who attended ICE for sinus floor elevation (SFE) between August 2023 and March 2025 were retrospectively examined. Mucosal thickening >2 mm was considered pathological. The CBCT scans of 26 maxillary sinuses were analysed for the following mucosal thickening characteristics: degree, morphology, and location of mucosal thickening, ostium patency, presence of odontogenic pathology, and need for onward referral to otorhinolaryngology. Data was also collected in relation to patient demographics and CBCT parameters. Descriptive statistics were used to summarise the data. Results: Of the 26 sinuses examined in the study, 69% presented with mucosal thickening greater than 2 mm. The incidence of mucosal thickening was higher in male patients. Polypoid mucosal thickening was the most common morphology observed in 46%, and circumferential thickening was the most common location observed in 50%. Ostium obstruction was seen in 12.5% of sinuses that had polypoid, circumferential thickening >10 mm. Other incidental findings included apical pathology, periodontal disease, dental implants breaching the sinus floor, and an antrolith. Conclusions: The study found a high incidence of mucosal thickening in patients undergoing sinus floor elevation. The degree and morphology of mucosal thickening, along with ostium patency and the presence of odontogenic pathology, are important factors to consider in preoperative assessment. Large field of view CBCT scans are required to allow visualisation of the osteomeatal complex. Collaboration between dental implantologists and otorhinolaryngologists is crucial for managing patients with sinus pathology and ensuring successful outcomes in SFE. Further larger prospective studies with clinical correlation are needed to better evaluate the association between sinus pathology, ostium patency, and sinus floor elevation outcomes.