Will a computed tomography (CT) sinus facial bones scan show teeth?

Will a CT Sinus Facial Bones Show Teeth?

Yes, a CT scan of the sinuses and facial bones will show teeth, particularly the maxillary teeth, which are routinely visible in the field of view due to their anatomical proximity to the maxillary sinuses. 1

Anatomical Considerations

• The maxillary teeth roots are often in close proximity to the floor of the maxillary sinuses
• This anatomical relationship makes teeth visible on CT scans that include the paranasal sinuses
• Particularly visible are:
  • Upper molars and premolars
  • Tooth roots that may project into the maxillary sinus
  • Dental restorations and implants

Clinical Applications

Dental Pathology Detection

CT scans of the paranasal sinuses can incidentally reveal various dental conditions:

• Periapical lesions (detected in approximately 12% of routine paranasal sinus CT scans) 2
• Dental caries (detected in approximately 27% of routine scans) 2
• Periodontal disease (detected in approximately 11% of scans) 2
• Developmental dental anomalies (detected in approximately 14% of scans) 2

Odontogenic Sinus Disease

• Localized mucosal thickening in the maxillary sinus is often associated with periapical lesions 3
• CT can demonstrate the relationship between dental pathology and sinus disease
• Approximately 51% of patients undergoing paranasal sinus CT have at least one dental pathology 2

Technical Considerations

CT vs. CBCT

• Standard multidetector CT (MDCT) shows teeth but with less detail than dedicated dental imaging
• Cone Beam CT (CBCT) provides better resolution for dental structures but has limitations:
  • Less effective for evaluating soft tissue pathology 1
  • Not recommended for evaluating suspected orbital or intracranial complications 1

Imaging Protocols

• Standard paranasal sinus CT protocols typically use:
  • 5mm slice thickness (may vary by institution)
  • Both axial and coronal planes are valuable for complete assessment 4
  • Non-contrast CT is usually sufficient for evaluating bony structures including teeth

Clinical Relevance

• Identifying dental pathologies on sinus CT can help:
  • Determine the source of maxillary sinusitis (odontogenic vs. non-odontogenic)
  • Detect incidental dental disease requiring referral to dental specialists
  • Guide surgical planning for both sinus and dental procedures

Limitations

• While teeth are visible on sinus CT, dedicated dental imaging provides superior detail for:
  • Small carious lesions
  • Early periodontal disease
  • Detailed root canal anatomy
  • Subtle dental fractures

In conclusion, CT scans of the sinuses and facial bones do show teeth, particularly the maxillary dentition, and can reveal various dental pathologies. However, for detailed dental assessment, dedicated dental imaging techniques may be more appropriate.