The Effect of Original and Invert Enhanced Panoramic Modality on the Assessment of the Relationship Between the Maxillary Posterior Roots and the Maxillary Sinus Floor

Background: Having knowledge about the anatomical and pathological relationship between the maxillary posterior root tip and the maxillary sinus floor is very significant for preoperative treatment planning.Aims and Objectives: The purpose of the present study was to compare the accuracy of original panoramic radiographs and digital panoramic images over cone beam computed tomography (CBCT) images in evaluating the relationship between the maxillary posterior teeth and the maxillary sinus floor, and to verify the accuracy of the signs of the relationship between the roots of the maxillary posterior teeth and maxillary sinus on the panoramic radiographs over CBCT images.Materials and Methods: From 106 subjects (47 males and 59 females; mean age = 39 years; range = 18-67 years) referred to our university, a pair of panoramic and CBCT images was selected for further analysis. The relationship between the maxillary posterior teeth, the maxillary sinus, and panoramic radiography signs (root projection into the sinus, interruption of the maxillary sinus floor cortex, absence of lamina dura, darkening of the root apex, and curvature of the sinus floor on the root apex) associated with the protrusion of root apexes into the sinus was evaluated.Results: The P values of the data obtained from the original and invert enhanced panoramic images were .53 and .52, respectively, and there was no statistically significant difference in the accuracy of the 2 methods ( P > .05).Conclusion: The root projection into the sinus is an indicative sign of root protrusion into the sinus on CBCT.