M 71 radicular cyst R chr sinusitisChance finding of large unilocular 8  mm diameter well defined apical lucency of #4 as seen in right image which is a sagittal CT slice. The arrows point to extreme thickening of the bony sinus walls with soft tissue thickening of the mucosal lining. The left image axial slice allows the comparison of the left maxillary sinus which has air (black region) and normal thickness bony walls. There is some mucosal thickening of the posterior compartment of the left maxillary sinus due to apical pathology of #15 (not shown).

In addition, the whole palatal root of #3 was retained (not shown).

Take-home message:

  1. Apical pathology is a common cause of maxillary sinusitis.
  2. Long standing chronic sinusitis can lead to bone thickening of sinus walls.
  3. A thorough radiographic assessment is required before inserting implants!

— Dr. Douglas K Benn

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