Avaliação dos seios maxilares de pacientes com implantes osteointegráveis em região posterior de maxila: estudo em tomografia computadorizada de feixe cônico

Abstract

The aim of this study was to correlate the presence of dental implants in the posterior region of the maxilla with sinusal alterations. The study was based on a retrospective evaluation of examinations of Cone Beam Computed tomography (TCFC) of 199 patients, by three evaluators. 459 implants were evaluated for the following factors: the corresponding dental insertion site, the relationship with the maxillary sinus and the fixation bone tissue. The maxillary sinuses were evaluated for the presence or absence of the following alterations: sinus mucosa thickening; sinus polyp; antral pseudocyst; nonspecific opacification and anthrolit. To verify intra and inter-rater reliability, the kappa and weighted kappa tests were applied. The association between the variables was performed using the Kruskal-Wallis test ( = 5%). The kappa and weighted kappa values ranged from 0.89 to 0.94 in the intra-rater tests and from 0.86 to 0.92 in the inter-rater tests. It could be observed a higher prevalence of mucosal thickening and nonspecific opacification in the implants located from 2 mm to direct contact with the maxillary sinus` floor (p = 0.047). Of the 66 implants with apical third in the interior of the maxillary sinus, 31 (46.7%) were associated sinusal alterations. Despite of the low number of implants located inside the maxillary sinus (n = 5), all cases were associated with alterations to the maxillary sinuses. There was no association between the sinusal alterations and the bone tissue fixation of the implants (p = 0.812). It can be concluded that there was a significant association between the presence of dental implants near or inside the sinus with sinus alterations, especially mucosal thickening and nonspecific opacification.