- During the extraction of posterior maxillary teeth, it is crucial to consider the relationship between the tooth roots and the maxillary sinus to prevent complications such as sinus perforation or oroantral communication.
- The most important anatomical consideration is the proximity of the root apex to the floor of the maxillary sinus.

- The maxillary sinus is an air-filled cavity located above the posterior maxillary teeth.
- In some individuals, particularly the molars and premolars, the roots of these teeth may extend close to or even into the sinus floor.
- Excessive force during extraction or improper technique can lead to the disruption of the sinus floor, causing complications like sinusitis or persistent oroantral fistula.

Other factors such as the thickness of the buccal cortical plate and the number of roots influence the extraction technique but are less directly related to avoiding sinus injury. The orientation of the mental foramen is irrelevant in this context as it is located in the mandible.

In summary, assessing the distance between the root apex and the maxillary sinus floor via radiographic imaging prior to extraction is vital to minimize the risk of sinus perforation.

Reference: Orban's Oral Histology, Volume 1, Chapter 5 / Page 134