The use of dental implants as a treatment for replacing missing teeth has been increasingly prevalent. Historical evidence suggests that the Mayans were among the first to create implants around 600 AD. Over time, this technique has evolved, offering numerous benefits to humanity. Regardless of the causes of tooth loss and the patient's age, it significantly impacts various aspects of an individual's life, including nutrition, psycho-emotional well-being, and social interactions. One of the primary consequences is the negative effect on self-esteem due to the aesthetic concerns associated with missing teeth. Additionally, pronunciation difficulties can lead to communication challenges, reducing the desire and ability to engage with others. Extensive research in the specialized literature explores the psychological impact of dental implant usage. It is widely acknowledged that the dental implant technique is complex and carries inherent risks and potential adverse effects. An illustrative case serves to underscore the significance of psychological considerations in dental implant treatment. In this instance, a 55-year-old woman attempted suicide by throwing herself down the stairs of her home after receiving dental implants in both sections of her oral cavity. The distress she experienced stemmed from the inability to consume anything beyond fluids and semisolid food for an extended period of eight months. This alarming incident underscores the importance of recognizing and addressing the psychological impact that dental implant procedures can have on vulnerable individuals.
Diabetes mellitus is a serious condition, causing multiple health problems due to the disease itself, but also to the complications that these patients are predisposed to. Being a current health problem, many patients tend to disregard the doctor's recommendations concerning the necessary measures to maintain adequate and continuous control of the glycaemia levels. This, in turn, may cause complications, which include neuropathy, microangiopathy and a predisposition to infections due to weak local defence mechanisms. In otorhinolaryngology, the infectious pathology is one of the most often causes for presentation to the physician. Ranging from common otitis, acute pharyngitis or laryngitis and sinusitis, these different entities will cause significant discomfort for the patient, prompting the need for medical care. In patients with diabetes, the natural course of the disease is altered, with more severe symptoms, a more extended period of recovery and the predisposition for aggravated cases with the tendency to complications. Such complications may be life-threatening if we take into account the complications associated with acute sinusitis for example, which include orbital or cerebral abscesses. Our paper aims to present the authors experience on the complete approach of patients with infectious pathology concerning the sinuses associating diabetes mellitus. Always, we must keep in mind that patients with diabetes represent a particular class of patients that require a personalized approach. They are predisposed to a vicious circle, in which the infection causes diabetes imbalance, which in turn decreases the defense mechanism and predisposes to complications. The correct management must always include a proper control of diabetes, a complete evaluation that will determine if complications are already present and aggressive management of the infection, with regular check-ups to determine the evolution of the patient.
Background: Although CBCT was introduced in dentistry, it has a specific role in rhinology for assessing uncomplicated maxillary sinusitis. CBCT offers valuable information on anatomy and pathology with a low irradiation dose. Methods: We performed a systematic search on PubMed on the use of CBCT in detecting maxillary sinus pathology and the relation between dental lesions and maxillary sinusitis. Results: Specific findings, such as mucosal thickening, retention cysts, or antroliths, have been found to be associated with dental problems. These alterations can be incidental findings during the management plan for patients with dental problems, but can also be the reason that prompts the patient to perform the imaging investigation. Conclusions: The literature on the topic is quite comprehensive and clarifies percentages and the correct use of CBCT. As a minimally invasive procedure, CBCT finds its utility in assessing patients with dental problems, as they are more prone to accepting this fast, pain-free, and non- claustrophobic method. There are several limitations, such as the not-so-large target area and the less-than-average, limited pictures. However, CBCT remains a valuable tool that can be used for patients with suspected sinus problems that require dental treatment to ensure there are no future sinus complications.
Cone-beam computed tomography (CBCT) has expanded from dento-maxillofacial radiology to otorhinolaryngology, being proposed as a low-dose alternative to multidetector computed tomography (MDCT) for evaluating uncomplicated sinonasal disease and for surgical planning. Major guidelines (EPOS, ICAR-RS, ACR) recommend native high-resolution CT for bone and MRI for loco- regional complications, while the role of CBCT remains focused on bone anatomy and the oro-sinusal interface. The objective of this review was to systematically synthesize the evidence on the diagnostic performance, radiation dose, indications/contraindications, and limitations of CBCT in sinonasal pathology, and to propose a practical algorithm for its use. The methodology consisted of searching PubMed/Medline and “gray” literature (professional society positions, guidelines) until September 2025; relevant guidelines/consensuses and original/comparative studies reporting the utility of CBCT for rhinosinusitis (acute/chronic), odontogenic sinusitis, fungal pathology, anatomical variations, pre- and intraoperative planning, doses/technical parameters were included. Papers focused exclusively on non-sinonasal pathology or on contrast-enhanced CBCT were excluded. The synthesis is narrative, oriented towards clinical questions. The key results were: (1) CBCT provides an excellent representation of the bone anatomy of the osteomeatal complex, with superior spatial resolution to MDCT, but with clearly inferior tissue contrast (limiting the evaluation of complications, soft tissues, and perisinusal extension); (2) the effective dose of CBCT for sinuses typically varies ~0.05–0.48 mSv depending on the protocol/FOV, usually below conventional MDCT, but not consistently below ultra-low-dose MDCT or photon- counting CT (PCCT) protocols, which can achieve even lower doses with superior image quality; (3) tor uncomplicated chronic rhinosinusitis (CRS), CBCT correlates well with endoscopy and is adequate for scoring (e.g., LM analog), assessing anatomical variations, and planning FESS; for orbital/intracranial complications, suspected tumors, or invasive fungal rhinosinusitis, CBCT does not replace CT/MRI; (4) In odontogenic sinusitis (ODS), CBCT is the first-line investigation because it finely delineates dental pathology, oro-antral defects, and foreign bodies, and consensus recommendations support its use guided by indications; (5) Intrinsic limitations: poor tissue contrast, uncalibrated/unreliable HU values, metal artifacts, and sometimes restrictive FOV; (6) In the clinical setting, “point-of-care” CBCT shortens the diagnostic pathway and can reduce costs/delays, but careful case selection and adherence to the justification principle are essential. In conclusion, CBCT has robust diagnostic value for uncomplicated rhinosinusal disease and for the dento-sinusal interface, with the advantage of dose and access, but it does not substitute MDCT/MRI in risk/complication scenarios. Responsible implementation, according to guidelines and radioprotection principles, maximizes benefits and minimizes risks.
