Avaliação da relação das raízes dos molares e pré-molares superiores com o seio maxilar: um estudo retrospectivo em tomografias computadorizadas de feixe cônico

Abstract

The roots of the upper premolars and molars have a close relationship with the maxillary sinus. This relationship can create a variety of risks, especially when performing surgical procedures, during endodontic or even orthodontic treatment. Thus, periapical and periodontal infections of these teeth can extend into the maxillary sinus, causing complications. In the present work, it was proposed to evaluate the relationship between the roots of these teeth with the maxillary sinuses, using Cone Beam Computed Tomography (CBCT). Our study was carried out with a retrospective analysis with evaluation of CBCT from the image file of the Department of Radiology, Faculty of Dentistry, Universidade Federal de Minas Gerais, obtained from January 2014 to December 2018. A total of 1,356 teeth were included (3,112 roots), between first premolars and maxillary second molars, from a total of 263 patients, 98 men and 165 women, from 16 to 79 years of age. The proximity of the roots with the maxillary sinus and the prevalence of the extension and alveolar dome in relation to the sex and age of the individuals were analyzed. Archive images were acquired using volumetric acquisition on a KODAK 9000C 3D Cone Beam Scanner (Carestream, USA) with 0.2 mm voxels. The greatest proximity of the molar roots with the sinus floor, where the root projection occurs in its interior, was found in the MV root of the upper second molar (44.8%), followed by its DV root (31.0% ). Right alveolar expansion and alveolar dome on the right and left sides had a statistically significant association with gender (p<0.05). The presence of right alveolar expansion was more prevalent in males (p=0.049). The presence of both the dome and alveolar extension was statistically significant (p<0.001) in the group up to 40 years of age. According to the results of this study, the maxillary first premolars were not related to the floor of the maxillary sinus. The buccal roots of the maxillary second molar are closest to this anatomical region. The relationship between the posterior molars and the maxillary sinus must be considered in clinical procedures such as endodontic treatment and extraction surgeries.