The influence of clinical experience of evaluation of PAN [34] as well as the clinical experience and routine analysis of 3D radiographs (as assumed for maxillofacial surgeons when compared to those for general practitioners) strongly influence the diagnostic value of additional three-dimensional imaging. The number of incidental findings in CBCT in addition to those seen in PAN was not of major difference and did not correlate to the examiners’ experience. This difference can be explained by using sFOV-CBCTs for evaluation of symptomatic maxillary sinus pathologies only. The smaller field of view shows less incidental findings, but the radiation exposure will be kept lower as well. Nonetheless, sFOV-CBCT is not meant to be a replacement for PAN especially for patients’ screening. It seems that advanced diagnostic tools such as CBCT offer an effective solution with more precise diagnosis of the maxillary sinus when compared to PAN together with a lower radiation dose compared to a CT.

There are some limitations of the study and potential bias caused by the experimental design, the subjective evaluation, and the low number of patients. Nevertheless, the additional value of CBCT strongly depends on the level on medical and radiographic knowledge of the anatomy of sites of interest [16, 38] and the surrounding structures [2]. Based on the findings of this study and the literature, an adjunct sFOV-CBCT is a valuable diagnostic tool for cases of symptomatic maxillary sinus pathologies.