"Accuracy of Intraoral Digital Radiography in Assessing Maxillary Sinus-Root Relationship Compared to CBCT"

Abstract

This study aimed to propose a decision-making rationale on the need for CBCT scans before dentoalveolar surgery in the posterior maxilla since the previous researchers failed to reach an agreement concerning this point. The impact of this study on the dental field is reducing the dose and cost of CBCT images on patients undergoing surgical procedures in the maxillary molar region. CBCT and digital periapical images for 23 patients, with a total of 342 maxillary molar roots, were acquired and investigated carefully to evaluate the accuracy of digital periapical images in showing the sinus-root relation compared to CBCT. A scoring system was implemented represented in Score 1: root apex placed outside the sinus, Score 2: root apex just contacting the sinus floor and Score3: root apex is projected into the sinus. Furtherly three periapical features were investigated for each root: A= Interruption of the sinus floor B= Discontinuity of lamina dura and C= Upward bending of the sinus floor to envelop the root partially or completely. Three tests were used to evaluate the reliability of digital periapical images in assessing sinus-root relation compared to CBCT. McNemar-Bowker Test revealed significant difference between both imaging modalities. Fleiss's Kappa test reported the reliability of periapical technique in showing sinus-root relation especially when the root is placed outside the sinus. In terms of accuracy, sensitivity and specificity, digital periapical images are considered accurate by 73 %, sensitive by 88% and specific by 63%.