Justification of the criteria of symmetry of the maxillary sinuses depending on the dental status of age groups

The aim of the study was to substantiate the criteria of symmetry of the maxillary sinuses and to determine their dependence on the dental status of patients of different age groups.
Materials and methods. The study included 51 patients (20 men, 31 women) aged 19 to 86 years who underwent dental examination with the calculation of the integral T-Health index, as well as cone-beam computed tomography of the maxillofacial region. Three complementary criteria have been proposed and applied to assess the symmetry of the sinuses: 1) the percentage of overlap between the contours of the right and left sinuses when mirrored; 2) shape index (MSI) as the ratio of the height to the width of the sinus with the calculation of the relative difference; 3) the relative difference in volumes calculated using the pyramid formula. Patients are stratified into four age groups: 18–34, 35–49, 50–64, and ≥65 years of age. Statistical processing included the t-test, Mann–Whitney test, Pearson and Spearman correlation analysis.
Results. According to the criterion of mirror overlap, patients were divided into a group with symmetrical (n=29, similarity 92.81%) and asymmetrical (n=22, similarity 83.18%) sinuses. The average T-Health index in the symmetry group was significantly higher (95,26±9,51 versus 71,83±13,67; p=0.0127; Cohen’s d=1.18). Strong negative correlations of T-Health with age (r=-0.634; p=0.00013) and the number of teeth removed (r=-0.907; p<0.001), as well as a moderate negative relationship with the number of carious teeth (r=-0.504; p=0.0039) were revealed. A significant positive correlation was found between T-Health and the percentage of sinus similarity (r=0.444; p=0,012). In the analysis of age groups, a decrease in T-Health and the percentage of sinus similarity was noted in the older cohorts: in the group ≥65 years, the similarity was 75,62% versus 92,52–92,66% in the groups under 50 years.
Conclusion. The hypothesis of the relationship between dental status and the symmetry of the maxillary sinuses has been confirmed. The proposed quantitative criteria (contour overlap, shape index, volume asymmetry) allow an objective assessment of the bilateral symmetry of the sinuses.
Keywords: maxillary sinus, asymmetry, dental status, cone beam computed tomography, age factors, T-Health index, morphometry, odontogenic sinusitis, implantation planning Conflict of interest. The authors declare no conflict of interest.
Financing. The work was completed without sponsorship.