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Aim <p>To investigate the clinical effects of periodontal therapy and tooth extraction on patients with periodontitis-associated maxillary sinus mucosal thickening.</p> Methods <p>This retrospective study included 120 maxillary sinuses from 73 patients with periodontitis-associated mucosal thickening. Of these, 99 received periodontal therapy and 21 underwent tooth extraction. Cone-beam computed tomography was used to evaluate mucosal thickness before and 3 months after treatment. Analyses were performed both in patients with severe alveolar bone loss and after propensity score matching to balance baseline characteristics between treatment groups. Mixed-effects models were performed to identify factors associated with treatment outcomes, accounting for patient-level clustering.</p> Results <p>Both periodontal therapy and tooth extraction resulted in a significant reduction in periodontitis-associated maxillary sinus mucosal thickness (mean change: 2.77 ± 3.73&#xa0;mm and 2.83 ± 3.34&#xa0;mm, respectively; <i>P</i> &lt; 0.05). In subgroup analysis, periodontal therapy significantly reduced mucosal thickness in patients with ≥ 1/3 alveolar bone resorption (Grade II: 2.63 ± 3.67&#xa0;mm, Grade III: 3.34 ± 3.84&#xa0;mm, <i>P</i> &lt; 0.05), whereas no significant change was observed in those with &lt; 1/3 bone resorption (Grade I: 0.01 ± 0.97&#xa0;mm, <i>P</i> &gt; 0.05). No clear superiority was observed between extraction and periodontal therapy after accounting for baseline disease severity. Pre-treatment mucosal thickness, age and root-to-sinus distance were also independently associated with treatment outcomes.</p> Conclusions <p>Periodontal therapy and tooth extraction both mitigate periodontitis-associated maxillary sinus mucosal thickening, with different applicability.</p> Clinical relevance <p>This study provides clinical evidence for managing periodontitis-associated maxillary sinus mucosal thickening: it confirms treatment can reduce thickening, clarifies indications (periodontal therapy for ≥ 1/3 alveolar bone resorption, extraction for unsalvageable teeth), and identifies prognostic factors to guide efficacy prediction and individualized strategies.</p>

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Determinants and therapeutic outcomes of maxillary sinus mucosal thickening in periodontitis: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年3月23日

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  • Zirui Bian,
  • Yifan Chen,
  • Yuxuan Yang,
  • Xiaoyu Chen,
  • Qian Lin,
  • Yanmin Wu,
  • Jingyi Tan

摘要

Aim

To investigate the clinical effects of periodontal therapy and tooth extraction on patients with periodontitis-associated maxillary sinus mucosal thickening.

Methods

This retrospective study included 120 maxillary sinuses from 73 patients with periodontitis-associated mucosal thickening. Of these, 99 received periodontal therapy and 21 underwent tooth extraction. Cone-beam computed tomography was used to evaluate mucosal thickness before and 3 months after treatment. Analyses were performed both in patients with severe alveolar bone loss and after propensity score matching to balance baseline characteristics between treatment groups. Mixed-effects models were performed to identify factors associated with treatment outcomes, accounting for patient-level clustering.

Results

Both periodontal therapy and tooth extraction resulted in a significant reduction in periodontitis-associated maxillary sinus mucosal thickness (mean change: 2.77 ± 3.73 mm and 2.83 ± 3.34 mm, respectively; P < 0.05). In subgroup analysis, periodontal therapy significantly reduced mucosal thickness in patients with ≥ 1/3 alveolar bone resorption (Grade II: 2.63 ± 3.67 mm, Grade III: 3.34 ± 3.84 mm, P < 0.05), whereas no significant change was observed in those with < 1/3 bone resorption (Grade I: 0.01 ± 0.97 mm, P > 0.05). No clear superiority was observed between extraction and periodontal therapy after accounting for baseline disease severity. Pre-treatment mucosal thickness, age and root-to-sinus distance were also independently associated with treatment outcomes.

Conclusions

Periodontal therapy and tooth extraction both mitigate periodontitis-associated maxillary sinus mucosal thickening, with different applicability.

Clinical relevance

This study provides clinical evidence for managing periodontitis-associated maxillary sinus mucosal thickening: it confirms treatment can reduce thickening, clarifies indications (periodontal therapy for ≥ 1/3 alveolar bone resorption, extraction for unsalvageable teeth), and identifies prognostic factors to guide efficacy prediction and individualized strategies.