Association between maxillary sinusitis and periapical diseases: a systematic review

Objectives: The purpose of this study was tosystematically evaluate the evidence on the association between maxillary sinusitis and periapicaldiseases. Methods: An electronic search were performed of the Cochrane Library, PubMed, Embase and LILACS databases up to September 2020. The gray literature was also searched. Additional studies sought through hand searching of endodontic journals. Observational studies associating maxillary sinusitis with periapical diseases, diagnosed by radiography and/or computed tomography/CBCT were included. Risks of bias assessment and data extraction were performed. Results: Fourteenstudies were selected and included in the qualitative analysis. Assessing methodological quality through the Checklist proposed by Downs and Black, most of the studies had scores below 0.50, not meeting most of the quality items. A meta-analysis cannot be performed due to the heterogeneity of the studies. According to the included studies, periapical diseases represented from 18% to 94.9% the etiology of odontogenic MS. Conclusions: Conflicting with other studies results, periapical diseases consisted the most frequent etiological factor associated with odontogenic MS.