Abstract
Oroanthral fistula (anastomosis) is an element preventing the restoration of homeostasis in the maxillary sinus due to the constant flow of microbes from the oral cavity. It is also contributes to frequent exacerbations of maxillary sinusitis. Saprophytic gram-positive cocci and fungi of the oral cavity are dominating representatives of the microbial flora in the maxillary sinus. As the result of research, we found that in the case of maxillary sinusitis with oroantral fistula fungi made up 25.0% of microbiota, gram-positive bacteria – 41.7%, gram-negative bacteria – 33.3%. Gram-positive cocci from the Staphylococcus genus (Staphylococcus aureus and Staphylococcus epidermidis) and fungi (Candida albicans) comprised the biggest proportion of microbial flora that 33.3% and 16.7%, respectively. Slightly decreased levels of monocytes in venous blood was noted in 69.2% of patients. The average value of total serum IgE in group with oroantal fistula was 226.2 (70.4) IU/ml, the result exceeded normal limits almost in 2.26 times. Large circulating immune complexes (CICs) were normal in all patients in the group with iatrogenic maxillary sinusitis. The average lavels of small size CICs was 170.2 (4.23) ОU, which is in 1.06 times higher the upper limit of the norm (160 ОU). Elevated levels of total Ig E in serum of patients with oroanthral fistula indicates allergic sensitization. The detection of increased levels of CICs with small and medium sizes in serum may indicate a susceptibility of this category of patients to the development of immunopathological reactions.
Highlights
Dental maxillary sinusitis accompanied by communication of the maxillary sinus with the oral cavity differs from others by pathophysiology, microbiology, and clinical symptoms [15]
One of the local factors that form the clinical course of the traumatic iatrogenic sinusitis is oroantral fistula
This study enables the creation of a general presentation of the pathogenesis of the traumatic iatrogenic sinusitis with stomatogenic genesis
Summary
Inflammation in the sinus with the iatrogenic origin and spreading from periapical foci of untreated teeth (odontogenic) are the most common causes of maxillary sinusitis [13]. Symptoms in both odontogenic and non-odontogenic sinusitis are similar, but there are clear clinical differences. Maxillary sinuses of patients with iatrogenic sinusitis In their early works, Brook I (2017) defined that normal healthy sinus is colonized by aerobic and anaerobic bacteria, including Staphylococcus aureus [5]. The studies show the large predominance of sterile maxillary sinus cavities in asymptomatic adults with endoscopically normal mucosa [15]
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