Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: results from the Health 2000 Health Examination Survey.

BACKGROUND: Mucosal thickening and mucosal antral cyst (MAC) in the maxillary sinus are incidental findings in panoramic radiographs. METHODS: The study sample consisted of 5021 participants in a nationally representative Health 2000 Health Examination Survey using panoramic radiography. RESULTS: The prevalence of mucosal thickening was 12% and of MACs 7%, both being twice as frequent in men as in women. Mucosal thickening was most common in the 40- to 49-year age group, whereas MACs were most often seen in younger age groups. Pathologic dental findings and root canal treatments were significantly associated with mucosal thickening but not with MACs. The odds ratios of vertical infrabony pockets were 5.2-fold compared with edentulous. CONCLUSION: This nationally representative study indicates that dental infections are etiologic for antral mucosal thickening, but not for MACs.

Infectious dental diseases in patients with coronary artery disease: an orthopantomographic case-control study.

PURPOSE: To investigate a potential association between coronary artery disease (CAD) and a variety of radiographically detectable infectious dental diseases, a hospital-based prospective case-control study was conducted in Kuwait. MATERIALS AND METHODS: Eighty-eight consecutive patients with a first attack of unstable angina pectoris or acute myocardial infarction were enrolled as cases and were matched on the basis of age, sex and nationality with control patients who were known not to have CAD. The severity and extent of periodontal bone loss and other radiographic signs of infection in both cases and controls were analyzed with orthopantomograms. RESULTS: More cases than controls had teeth needing extraction (p = 0.043), periapical lesions (p = 0.028), molars with furcation lesions (p < 0.001), teeth with marginal bone loss > or = 6 mm (p = 0.001) and teeth with angular (vertical) bone loss (p < 0.001). Analysis of the total dental index showed that the median scores were higher for cases than controls for both radiographically diagnosed periodontitis (p < 0.001) and periapical lesions (p = 0.008). CONCLUSIONS: In summary, there was a significant association between radiographically diagnosed periodontal diseases and CAD. These results should not be regarded as indicating a causal relationship, especially given that the diagnosis of periodontitis was based only on a radiographic examination. The true impact of oral infections on CAD should be examined in a large prospective clinical and interventional study.

Comparison of three radiographic methods used to locate the mandibular canal in the buccolingual direction before bilateral sagittal split osteotomy.

OBJECTIVE: Panoramic radiographs, computerized tomography (CT), and conventional spiral tomographic (Scanora, Soredex, Helsinki, Finland) radiographs were compared for their ability to locate the mandibular canal in the buccolingual direction. Furthermore, the relationship between the cortication of the mandibular canal in panoramic radiographs and the location of the canal in both computerized and conventional tomographic radiographs was assessed. STUDY DESIGN: The buccolingual location of the mandibular canal was determined bilaterally in twenty consecutive patients scheduled for bilateral sagittal split osteotomy. The position of the mandibular canal was evaluated by means of panoramic radiography, Scanora, and CT. The three imaging methods were compared for their ability to locate the mandibular canal in the buccolingual direction. The subjective neurosensory deficit of the lower lip and chin on both sides was registered preoperatively and at 4 days, 3 weeks, and 3 months after surgery, and the operative outcome was analyzed in relation to the distance from the mandibular canal to the buccal cortex of the mandible. RESULTS: CT gave better visualization of the mandibular canal than Scanora imaging. Cortication of the mandibular canal on the panoramic radiograph did not serve as a predictor of the proximity of the mandibular canal to the cortices of the mandible. At 3-month follow-up, there were only eight operated sides with abnormal sensation of the lower lip and chin. In seven of these sides, the distance from the mandibular canal to the buccal cortex was less than 2 mm. CONCLUSION: The buccolingual location of the mandibular canal is visualized better with CT than with Scanora or panoramic radiographs.