Nakai et al. performed this exam 6 months following the placement of 15 zygomatic implants in nine patients and found an absence of signs and symptoms of sinusitis. Maló et al. evaluated the association between zygomatic implants and maxillary sinusitis using sinusoscopy on 14 patients and found no cases of infection or inflammation of the mucosa surrounding the implants, demonstrating that titanium implants are compatible with the health and normal function of the maxillary sinus. However, the studies cited employed the original technique.

In a systematic review, Chrcanovic and Abreu report that immobility of zygomatic implants is one of the main factors contributing to the homeostasis of the maxillary sinus. This immobility is accomplished by adequate anchorage of the implant in the zygomatic bone and, when possible, the maxillary bone as well as a firm connection with the overdentures. The rigorous selection of patients with no history of active sinus disease is another important factor and was confirmed in the present sample through preoperative computed tomography, following the normal routine of the hospital at which this study was carried out.

Computed tomography is currently the method of choice for the determination of sinusitis. A number of scoring systems have been proposed for this purpose, most of which are based on the presence and extent of inflammation in the interior of the paranasal sinuses. The Lund-McKay scoring system is an objective method for the evaluation of opacification of the sinuses on tomograms that eliminates the occurrence of false positives or negatives. A clinical exam and computed tomography performed by an otolaryngologist allows a precise diagnosis of sinus disease, which can present in a similar manner without necessarily being maxillary sinusitis. Moreover, a number of studies have demonstrated that cone-beam computed tomography (as employed in the present study) is a good imaging tool for the evaluation of sinus disease.