Global Prevalence of Maxillary Sinusitis of Odontogenic Origin and Associated Factors: A Systematic Review and Meta-Analysis

Abstract

Introduction: The overall prevalence of maxillary sinusitis of odontogenic origin (MSOO) is still unknown. Therefore, this study aimed to determine the pooled prevalence of MSOO and verify associations between different odontogenic conditions and MSOO.

Methods: Six electronic databases and the gray literature were searched on August 25, 2022. Two independent reviewers selected observational studies reporting the prevalence of MSOO and associated conditions in adults. Studies that did not use computed tomography for diagnosis were excluded. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Cross-Sectional Studies. Data were analyzed by proportion and association meta-analyses. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.

Results: Thirty-eight studies were included in the qualitative analysis and thirty-one in the meta-analyses. Only 12 studies (31.6%) fulfilled all items of the methodological quality checklist. Overall, the studies reported prevalence measures per maxillary sinus or patient. Thus, the pooled prevalence of MSOO was 51% per sinus (95% confidence interval [CI] [40%-61%]) and 50% per patient (95% CI [41%-59%]). Apical lesion (odds ratio [OR]: 4.03, 95% CI [2.26-7.19]), periodontitis (OR: 5.49, 95% CI [2.27-13.24]), moderate (OR: 2.57, 95% CI [1.85-3.57]) and severe bone loss (OR: 13.80, 95% CI [2.81-67.85] were significantly associated with MSOO. The certainty of the evidence for the associations was very low.

Conclusions: The pooled prevalence of MSOO on computed tomography assessment was 51% per maxillary sinus and 50% per patient. Therefore, half of the maxillary sinusitis may be of odontogenic origin. Apical lesion, periodontitis, and moderate and severe bone loss were significantly associated with MSOO.

Keywords: Computed tomography; periapical lesion; periodontitis; sinusitis; systematic review; tooth diseases.