Pathophysiology and clinical presentation of odontogenic maxillary sinusitis

Abstract

This study aims to consolidate the emerging data regarding the pathophysiology and clinical features of odontogenic maxillary sinusitis (ODMS). A search of existing English literature was performed on Pubmed, and Scopus databases using the following keywords: “odontogenic sinusitis” and “maxillary sinusitis of dental origin”. A total of 56 articles were included in this study. Endodontic and periodontal infections are one of the most frequently mentioned causes of ODMS in the literature. However, newer studies suggest iatrogenic causes as the leading cause. Microbiological studies reveal that the most common anaerobic isolates are Peptostreptococcus spp, Fusobacterium spp, pigmented Prevotella, and Porphyromonas spp. Histological findings of the maxillary sinus mucosa demonstrate numerous papillary-like folds in the surface of the epithelium with an increased expression of TJ protein claudin-4, round cell infiltration, fibrosis, cystic degeneration, and mucosal hyperplasia. The most common symptoms are: unilateral purulent rhinorrhoea and foul smell/ taste. Patients may also have post nasal drip, nasal congestion, cheek pain, purulent discharge in the oral cavity and dental pain. Our study comprehensively reviews the pathophysiology and clinical features of ODMS to provide a more holistic understanding of this condition, facilitating the early diagnosis and management of ODMS patients.