BACKGROUND: To evaluate the frequency and radiodiagnostic characteristics of maxillary antroliths using cone beam computed tomography. METHODS: A review of 1166 patients aged 11-85 years was conducted to assess the frequency of maxillary antroliths, considering sex, age, and location. The relationship between antroliths and sex, location, dental treatment status, and sinus inflammation was evaluated. The shape, size, and volume of the antroliths were also analyzed. Data were analyzed using descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Spearman rank correlation, independent t-tests, and Pearson Chi-square tests. RESULTS: Forty-eight antroliths were detected in 41 patients (3.5%), with 16 in males and 25 in females. The frequency of antroliths was higher in the 81-90- and 31-40-years age groups (p <
0.001). The most common locations were the sinus floor (56.3%) and molar region (87.5%), with an amorphous shape (47.9%). Regarding the sinus-mucosa relationship, 66.7% of patients had mucosal thickness completely covering the antroliths, and 72.9% had less than one-third of the sinus opacified. Tooth extraction was the most common dental status near the antrolith (45.8%). The shape, size, and volume of antroliths did not affect the surrounding mucosal thickness (p >
0.05), but sinuses containing antroliths had significantly thicker mucosa than those without (p = 0.036). CONCLUSIONS: The findings indicate that although antroliths are relatively rare, predominantly located on the sinus floor and in the molar region, their presence is associated with increased mucosal thickening regardless of their shape, size, or volume. Understanding their radiographic features can aid in differential diagnosis and help anticipate potential complications during surgical interventions. TRIAL REGISTRATION: The trial protocol was retrospectively registered ID NCT06765148 ( https://clinicaltrials.gov/ )
09/01/2025.