Radiologists' Awareness in Diagnosing Maxillary Sinus Abnormalities Secondary to Dental Disease

ABSTRACT Objectives Odontogenic sinusitis remains under‐recognized despite its significant prevalence. This study addresses the diagnostic challenges and clinical implications associated with odontogenic sinusitis, highlighting the critical role of radiological interpretation in its management. Methods A multicenter retrospective study across four medical centers reviewed 3400 sinus CT scans from January 2018 to January 2024. A total of 252 cases suggestive of odontogenic sinusitis were independently assessed by expert teams comprising maxillofacial surgeons and rhinologists. Diagnostic consensus was achieved for cases demonstrating dental abnormalities capable of causing sinusitis. Radiology reports were analyzed for dental pathology references. Results Among the suspected cases, 105 were confirmed as odontogenic sinusitis. Inter‐rater agreement for dental abnormality identification was robust (78.0%–90.1%), underscoring the study's reliability. Radiologists identified dental contributions in 23.8% of confirmed cases, with notable variability across centers. Sinus augmentation complications (22.9%), maxillary sinus floor bone defect (15.2%), and periapical lesions (39.0%) were prevalent, yet frequently missed in radiological reports. Conclusion This study highlights the critical deficiencies in radiological practice regarding the diagnosis of odontogenic sinusitis. Despite the high prevalence and significant clinical implications of this condition, radiologists failed to recognize dental origins in the majority of cases. This shortfall underscores the urgent need for enhanced training and interdisciplinary collaboration to improve patient outcomes. Level of Evidence 3.