Comparing Expansion of Maxillary Antrum between Periapical Surgery and Extraction of Permanent Maxillary First Molar in Pediatric Patients Using CBCT.

[AIM] To compare the expansion of maxillary antrum between periapical surgery and extraction of permanent maxillary first molar in pediatric patients using cone-beam computed tomography (CBCT).

[MATERIALS AND METHODS] In this study, 136 participants in the age-group of 11-18 years were included. The participants were divided into two groups. Group A consisted of patients who underwent extraction of the permanent maxillary first molars. Group B consisted of patients who underwent endodontic microsurgery in the periapical area. Group A included 68 participants while group B also included 68 study subjects. The expansion of the maxillary antrum was obtained after evaluating the change in volume of maxillary antrum at 6 months and 24 months in relation to the volume of maxillary antrum at the time of the procedure (baseline). For calculating the volume of the maxillary antrum, three parameters were taken into consideration. These parameters were an anteroposterior (AP) dimension, mesiodistal dimension (MD), and superoinferior (SI) dimension. Cone-beam computed tomography was used for carrying out these measurements with the help of Dolphin software.

[RESULTS] An expansion of 675.27 ± 32 mm was observed in group A between baseline and 6 months of extraction, while the expansion of 765.47 ± 24 mm was observed between 6 months and 24 months of extraction. This intragroup difference was statistically significant ( = 0.001). On the other hand, an expansion of 652.28 ± 43 mm was observed in group B between baseline and 6 months after periapical surgery and expansion of 969.43 ± 12 mm was observed between 6 months and 24 months after periapical endodontic surgery. This intragroup difference was statistically significant. In the control group, an expansion of 152.11 ± 12.101 mm was observed between baseline and 6 months after procedures while an expansion of 347.01 ± 6.781 mm was observed between 6 months and 24 months of procedures. The intragroup difference was significant statistically.

[CONCLUSION] In this study, expansion of maxillary antrum was observed in both extraction of the maxillary permanent first molar in pediatric patients and the periapical endodontic surgery, and the expansion of maxillary antrum was more in cases of periapical endodontic surgery; however, the difference was non-significant statistically.

[CLINICAL SIGNIFICANCE] Maxillary antrum expansion is clinically important during maxillary permanent tooth extraction or endodontic periapical surgery in pediatric patients because the growth of maxillary bones is in the growing stage in these patients. There are certain limitations of conventional two-dimensional (2D) radiographic techniques such as shortening, elongation, and superimposition of images. Recently, three-dimensional technique (3D) such as CBCT has been introduced in which these disadvantages have been eliminated.