Objectives: This systematic review analyzed the relationship between periapical and periodontal pathologies in the posterior maxilla and the appearance of the Schneiderian membrane in cone-beam computed tomography (CBCT) compared with sound dentitions.
Methods: Five electronic databases (Cochrane Library, Embase, OpenGrey, PubMed, Web of Science), complemented by hand searching, were screened up to May 9, 2016. Human clinical studies that used CBCT and contained information on the periapical/periodontal status in the posterior maxilla and Schneiderian membrane appearance were included. A weighted vote counting (WVC) method was applied to summarize results across studies.
Results: Out of 413 records, 20 studies were included. In the WVC, the studies that observed a positive association between periapical lesions and the appearance of the Schneiderian membrane outweighed those that found no such association (WVC 51 % and WVC 33 %, respectively), with some studies yielding indeterminate results (WVC 16 %). Regarding the relation between periodontal pathologies and the appearance of the Schneiderian membrane, WVC produced a tie between studies demonstrating a positive association (WVC 46 %) and those showing no association (WVC 44 %); one study (WVC 10 %) reported indeterminate results.
Conclusions: On CBCT scans, periapical lesions in the posterior maxilla are likely to be associated with Schneiderian membrane thickening. In contrast, current evidence regarding the relation between periodontal diseases and the appearance of the Schneiderian membrane in CBCT is inconclusive.
Clinical relevance: Incidental maxillary sinus findings on CBCT scans warrant thorough differential diagnosis. Frequently, they may be related to dental pathologies.
Keywords: Cone-beam computed tomography; Maxillary sinus; Periapical disease; Periodontal disease; Schneiderian membrane.