Radiographic assessment of the correlation between maxillary sinus dimensions and greater palatine canal pathway in CBCT images (a retrospective study)

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OBJECTIVE: This study aimed to correlate the dimensions of the maxillary sinus in CBCT-reformatted panoramic radiographs to the greater palatine canal geometry and its neighbor structures in CBCT multiplanar images, so considering the limitations of the current study, we could use panoramic radiographs as an alert tool before performing a variety of implant surgical and dental procedures concerning the Greater Palatine Canal (GPC). METHODS: The GPC pathway and its neighbor structures were assessed in a sample of 48 CBCT Egyptian adult patients' images (24 females and 24 males) in the three orthogonal planes and correlated to the height, width and hypothetical surface area of the maxillary sinus (MS). RESULTS: There was a statistically significant difference in sagittal planes among genders regarding GPC pathway, as Type a was the most prominent GPC pathway among females (an antero-inferior direction) in contrast to male cases that shown Type c (posterior-inferior direction, then an anterior-inferior direction) pathway. Male patients had significantly lower GPC angle than female patients (P = 0.022). Males had greater mean values of MS height, width & hypothetical surface area than females. The greater the GPC angle in sagittal plan, the lesser MS height, width & hypothetical surface area. In addition, MS of greater height had more posterior extension (depth). CONCLUSION: Considering the restrictions of the current retrospective study, the current study illustrated a significant correlation between maxillary sinus (MS) dimensions and greater palatine canal (GPC) anatomy, specifically the GPC pathway and angle. Larger MS (especially height) correlated with GPC with more posterior pathway and lesser angle, which is sex-based association. These findings are with great clinical significance to minimize the risk of GPC neurovascular bundle iatrogenic injury during interventions dealing with posterior maxilla, particularly sinus lifts, implant planning, due to potential impingement from MS expansion.

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