Odontogenic Maxillary Sinusitis Research Articles

Efficacy of endoscopic sinus surgery in management of odontogenic maxillary sinusitis after control of dental pathology

BackgroundOdontogenic sinusitis (ODS) has clinical features like rhinogenic sinusitis. Although it is usually unilateral, diagnostic overlap could happen. However, ODS necessitates different management which includes dental intervention to eliminate the dental infection source. In some patients, ODS may persist even after management of dental pathology. The aim of this study was to assess the clinical features, and diagnostic criteria of ODS that is persistent after management of dental pathology, and to evaluate the efficacy of endoscopic sinus surgery (ESS) as a therapeutic option of the disease.MethodsTwenty patients were included in this study. All patients were presented with ODS refractory to medical treatment after management of their dental problems. Clinical features of the patients were analyzed. Also, endoscopic nasal examination and computed tomography of paranasal sinuses (CT) were performed for all patients. ESS were used, with widening of the maxillary ostium for drainage. Follow-up was carried out for at least 6 months.ResultsAll patients had unilateral disease, with 3 main complaints: malodourous nasal discharge (90%), facial pain (75%), and nasal obstruction (45%). Endoscopic nasal examination showed either middle meatal purulence (70%) or polypoid mucosa (30%). CT showed either thickened maxillary sinus mucosa (50%), or complete maxillary opacity (50%) with retained foreign body in 2 patients (10%). After ESS, all patients reported relieve of their sinonasal symptoms, and nasal endoscopy showed patent middle meatus, with one patient demonstrated adhesions between the middle turbinate and lateral nasal wall which was asymptomatic.ConclusionPrior dental intervention is a suspicious diagnostic landmark for ODS, and unilateral foul nasal discharge is the main prevalent complaint. Nasal endoscopy usually shows purulence or polypoid mucosa in the middle meatus, and CT is a good diagnostic tool for ODS. ESS with good widening of the maxillary ostium is an effective therapeutic option for those patients.

Management of oculo-orbital complications of odontogenic sinusitis in adults.

Introduction: Odontogenic maxillary sinusitis (OMS) is an infectious inflammatory pathology caused by a dental condition. Considering the anatomical relations with the orbit, maxillary sinus infection can easily spread, evolving into severe oculo-orbital complications that can sometimes be life-threatening. Material and methods: We performed a retrospective study of over 2 years, examining the data of 18 patients diagnosed with OMS with oculo-orbital complications. The patients were evaluated regarding their dental history, symptoms, clinical and endoscopic findings, ophthalmologic evaluation, bacteriologic tests, computed tomography (CT) imaging, medical and surgical treatment, and outcomes. Results: The age of the patients was between 24 and 65 years old with an almost equal gender distribution: 10 female and 8 male patients. From the total, 7 patients had type II diabetes, 2 of whom were insulin-dependent, 1 patient had thrombophilia and 2 patients had renal failure with peritoneal dialysis. Regarding the type of oculo-orbital complications, 10 patients were diagnosed with preseptal cellulitis and 8 with orbital cellulitis. Just 5 patients with orbital cellulitis required surgical treatment and orbitotomy was performed, followed by endonasal endoscopic drainage. The evolution after surgical treatment was favorable for all operated patients. Discussions: Oculo-orbital complications of OMS are typically more severe than those of rhinogenic sinusitis because anaerobic bacteria are involved. Immunosuppression represents a favorable environment for the development of OMS and its complications, diabetes being the most common risk factor. A negative prognostic feature is the appearance of ophthalmological symptoms in both eyes, so visual function may be reduced. The treatment of oculo-orbital complications of OMS is urgent and depends on a broad-spectrum antibiotic therapy associated or not with surgical intervention. Conclusions: The diagnosis of oculo-orbital complications of OMS is complex and requires clinical experience as well as extensive medical knowledge to treat both the cause and the consequences of the conditions quickly and effectively. The proper management of oculo-orbital complications is based on a multidisciplinary team: ophthalmology, ENT, dentistry, imaging, and laboratory. Abbreviations: OMS = odontogenic maxillary sinusitis, CT = computed tomography, ENT = ear-nose-throat, MRI = magnetic resonance imaging, HNS = head and neck surgery.

Surgical Endoscopic Treatment of Odontogenic Sinusitis.

Introduction: Odontogenic sinusitis is a frequent disease of the maxillary sinus, resulting from a dental inflammatory condition or a foreign body migrated in the sinus cavity. We performed a clinical retrospective study aimed to review the two surgical endoscopic approaches for odontogenic maxillary sinusitis middle and inferior meatotomy, in terms of realistic indications, efficacy, outcomes, and possible complications. Materials and Methods: In our study, we included a number of 400 patients with odontogenic maxillary sinusitis divided into two groups, treated in our hospital over five years, from January 2019 to December 2023. The patients included in this research were over 18 years old, diagnosed with odontogenic maxillary sinusitis, and underwent either middle meatal antrostomy or inferior meatotomy. Results: We examined the medical records of 400 patients. The vast majority of patients had a history of dental interventions, and the most affected tooth was the first maxillary molar. The symptoms at admission were typical for sinusitis: nasal obstruction, anterior or posterior rhinorrhea, hyposmia to anosmia, cacosmia, and pain or facial pressure. 80% of the patients in the study underwent middle meatal antrostomy, while 20% underwent inferior meatotomy. There were no significant differences between these two approaches in terms of efficacy, complication rates, recovery, or relapses. The complications that occurred after the surgical treatment were minor and with a very low frequency. The most reported were middle meatus synechiae and the persistence of the meatotomy ostium, with mucus recirculation (in patients with inferior meatotomy). Conclusions: Endoscopic surgical treatment of odontogenic maxillary sinusitis can be done as middle or inferior meatotomy, each having specific indications. The maxillary antrostomy is preferred in the majority of cases, as it is a procedure in which the natural ostium of the maxillary sinus is enlarged, thereby maintaining the natural drainage pathway of the sinus. However, the inferior meatotomy is preferred in the case of foreign bodies or maxillary sinus retention cysts localized at the level of the sinus floor or in the alveolar or lateral recesses, or as part of a combined approach (inferior and middle meatotomy), when the ablation of a "fungus ball" is required.

Вивчення змін стану місцевої та загальної неспецифічної резистентності організму у хворих на одонтогенний гайморит за гальванічної патології в порожнині рота

Purpose: to determine the state of local and general nonspecific resistance to the body in the dynamics of surgical treatment of patients with odontogenic maxillary sinusitis in the presence of galvanic pathology in the oral cavity and to clarify the causes of postoperative inflammatory complications. Methods: 56 examined subjects with chronic odontogenic maxillary sinusitis were divided into two observation groups, which were subjected to immunological and general clinical examination methods. Results. In 30 patients with chronic odontogenic maxillary sinusitis with oral galvanism (compensated and decompensated forms), no decrease in local and general nonspecific resistance was observed. In 26 patients with oral galvanism (atypical and typical forms), a decrease in immunity was observed. Conclusions. Based on the examination of 56 patients with chronic odontogenic maxillary sinusitis in the presence of galvanic pathology in the oral cavity, it was found that in the case of galvanosis, there is a decrease in local and general nonspecific resistance of the body, which, in turn, in all patients leads to the development of inflammatory complications in the periosteal soft tissues and in the bone wound of the jaw, i.e., osteomyelitis (34.6%). Key words: chronic maxillary sinusitis, maxillary sinus, galvanic pathology, functional activity of neutrophils, phagocytic activity of leukocytes, contact thermometry, galvanism, galvanosis, metal inclusions.

Augmentation of Therapeutic Efficacy of Extraction of Causative Teeth by Irrigation for Odontogenic Maxillary Sinusitis.

Odontogenic maxillary sinusitis is a clinically popular disease, but radical surgery and endoscopic surgery are often required. In the present study, we compared for the first time the therapeutic efficacy of the extraction of causative teeth with or without irrigation of the extraction fossa. A total of 60 patients underwent extraction of causative tooth. Among them, 34 patients underwent irrigation, while other 26 patients did not. Based on computed tomography (CT) images, treatment efficacy was quantified by the percentage of the remaining maxillary sinus mucosal lesions. The extent of therapeutic efficacy was evaluated following five grades, based on the percentage of remaining lesions: Grade 1 (0%) (disappearance of lesions), Grade 2 (roughly 10%), Grade 3 (roughly 30%), Grade 4 (approximately 50%) and Grade 5 (100%) (no improvement of the lesions). Irrigation significantly augmented the therapeutic efficacy of tooth extraction for maxillary sinus mucosal lesions (mean grade: decreasing from 3.27 to 1.35). The combination of tooth extraction and irrigation may contribute to the reduction of the necessity of surgery for the maxillary sinuses.

Management of complications of odontogenic maxillary sinusitis

Odontogenic maxillary sinusitis is damage to the mucosa of the maxillary sinus caused by the spread of inflammation from periapical dental processes in the immediate proximity or prominent in the maxillary sinus. Another ethiology can be trauma or dental tumors with or without infection. Failure to identify the etiological dental factor usually causes severe complications. An early history and a thorough clinical examination, together with a radiological evaluation, are key factors in establishing a correct final diagnosis. The multidisciplinary approach between dentists, ophthalmologists, otorhinolaryngologists, neurologists and other specialists is necessary to avoid further complications, which sometimes put the patient’s life at risk. A medical management and an early diagnosis corresponding to the dental pathology, remain critical in the treatment of maxillary sinusitis of dental origin and the prevention of severe complications.

Odontogenic maxillary sinusitis associated with foreign body displacement after tooth extraction: report of an unusual case

Odontogenic maxillary sinusitis associated with foreign body displacement after tooth extraction: report of an unusual case

Endoscopic maxillary sinus drainage combined with buccal fat pad flaps for repairing large oroantral fistulas in patients with odontogenic maxillary sinusitis

AbstractBackgroundOroantral fistula (OAF) is a pathological channel formed between the oral cavity and the maxillary sinus. A large size of OAF (≥5 mm) increases the risk of surgical failure, and an optimal surgical approach should be cautiously selected.ObjectiveThis study aims to characterize the application of nasal endoscopy and buccal fat pad (BFP) flaps to repair large OAFs in patients with odontogenic maxillary sinusitis (OMS).MethodsA total of 32 patients with large OAF combined with OMS after dental extraction who were treated in the Department of Otorhinolaryngology, Nanjing Renpin ENT Hospital from 2018 to 2022, were retrospectively recruited. A thorough preoperative evaluation was performed and all patients were first treated with nasal endoscopy, followed by the repair of OAFs using BFP flaps under general anesthesia. The cure rate and postoperative pain score were used as outcome indicators to evaluate the effectiveness of the procedure.ResultsAll patients completed a 12‐month follow‐up. The results showed that OFAs were cured in 25 (32 in total, 78.1%) patients by the second postoperative week. OFAs were healed in all patients at week 8 postoperatively. OMS was healed in 25 (32 in total, 78.1%) patients at the first postoperative week and all patients were healed by the disappearance of symptoms associated with OMS at week 8 postoperatively. At the second postoperative week, complete relief of pain symptoms was obtained in 18 (32 in total, 56.3%) patients (visual analog scale = 0 score), in 25 (32 in total, 78.1%) patients at the fourth postoperative week, and by the eighth postoperative week, all patients had complete resolution of pain symptoms.ConclusionsSecondary maxillary sinusitis is not a contraindication to the treatment of large OAFs. Large OAFs can be effectively closed using BFP flaps combined with endoscopic maxillary sinus drainage.

Potentiometric Examination of Patients with Chronic Odontogenic Maxillary Sinusitis in the Presence of Galvanic Pathology

Purpose: To determine the values of potentiometric parameters in the oral cavity present between metal inclusions, as well as between metal inclusions and the mucous membrane of the alveolar process in patients with chronic odontogenic maxillary sinusitis with galvanic pathology. Methods: 56 patients with chronic odontogenic maxillary sinusitis were divided into two observation groups, which were subjected to potentiometric and general clinical examination methods. Results: In 30 patients with chronic odontogenic maxillary sinusitis with the presence of galvanism (compensated and decompensated forms) in the oral cavity, chronic inflammation in the maxillary sinus occurred without pronounced clinical symptoms, and in 26 patients with oral galvanosis (atypical and typical forms), the clinical symptoms of inflammation in the maxillary sinus were severe with an aggressive course and complications. Conclusions: Based on an examination of 56 patients with chronic odontogenic maxillary sinusitis in the presence of galvanic pathology in the oral cavity, we found that in some types of this pathology, i.e., galvanosis, inflammatory disease in the maxillary sinus is aggressive, with pronounced clinical symptoms, frequent exacerbations of the inflammatory process, the presence of many postoperative inflammatory complications and recurrence of the disease.

Diagnostic criteria for odontogenic sinusitis: narrative review of relevant literature data

Background. Specific tendency could be observed regarding increasing number of odontogenic sinusitis related publications within decades between 1990 and 2019, but even with upgrowing pool of literature data regarding odontogenic sinusitis evidences reported within it remains of low quality. Also, it should be noted that yet no evidence-based consensus decision have been made regarding strict diagnostic criteria of maxillary odontogenic sinusitis.
 Objective. To systematize relevant data regarding odontogenic maxillary sinusitis diagnostic criteria based on available guidelines, consensus reports, CBCT-based and clinical researches.
 Materials and Methods. Study was provided in the form of retrospective literature review. Seach of publications related with the objective of the research was held within PubMed Central database (https://www.ncbi.nlm.nih.gov/pmc/) by applying Mesh-terms combinations. Articles included into study group were processed due to the following categories of content-analysis: signs and symptoms which may be used to prove odontogenic origin of maxillary sinusitis; diagnostic significance of different manifestations which may be used to prove odontogenic origin of maxillary sinusitis; approaches which should be followed to provide correct diagnostics of odontogenic maxillary sinusitis.
 Results. Out of 15 targeted publications, which formed study group, 2 were represented in the form of systematic review, 1 – in the form of online-survey study, 6 – in the form of literature/comprehensive/state-of-art review, 4 – in the form of retrospective study, 1 – in the form of international multidisciplinary consensus statement, 1 – in the form of experimental imaging study. Considering only one available international multidisciplinary consensus statement regarding odontogenic sinusitis diagnosis next approach should be followed in mentioned order for correct diagnostics of such pathology: 1) suspect odontogenic maxillary sinusitis; 2) confirm sinusitis; 3) confirm odontogenic pathology.
 Conclusion. Tomographical methods of examination are more accurate for the odontogenic maxillary sinusitis diagnostics, nevertheless if multidisciplinary diagnostic approach (endoscopy, tomography and clinical examination) is possible for realization it should be held as a primary diagnostic strategy. Cases of asymptomatic maxillary odontogenic sinusitis, while also symptomatic ones developing without background of recent dental treatment, may also be observed in clinical practice, and thus should be correctly diagnosed for appropriate treatment planning.

Clinical and potentiometric examinations of adolescent patients with chronic odontogenic maxillary sinusitis in the presence of galvanic pathology in the oral cavity

Purpose - to determine the values of potentiometric parameters in the oral cavity present between metal inclusions, as well as between metal inclusions and the mucous membrane of the alveolar ridge in adolescent patients with chronic odontogenic maxillary sinusitis in the presence of galvanic pathology in the oral cavity Materials and methods. 30 patients with chronic odontogenic maxillary which were subjected to potentiometric and general clinical examination methods. The control group consisted of 22 practically healthy people (without concomitant diseases) of the same age, but without metal inclusions in the oral cavity (amalgam fillings and metal fixed dentures) with obligatory sanitized oral cavity. All numerical data obtained during the survey were processed by mathematical method with calculation of Student's criterion. The indicators were considered reliable at p<0.05. Results. In 30 patients with chronic odontogenic maxillary sinusitis with the presence of galvanism (compensated and decompensated forms) in the oral cavity, chronic inflammation in the maxillary sinus occurred without pronounced clinical symptoms. Conclusions. In adolescent patients with chronic odontogenic maxillary sinusitis with the presence of galvanism in the oral cavity (compensated and decompensated forms), chronic inflammation in the maxillary sinus occurred without pronounced clinical symptoms. Exacerbation of the inflammatory process was rare. Among the inflammatory complications in the postoperative period, we found only gingivitis in the oral cavity. We did not observe any other inflammatory complications in the area of the postoperative soft tissues of the postoperative wounds and recurrence of inflammatory disease of the maxillary sinus. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

Factors Influencing Recurrence after Surgical Treatment of Odontogenic Maxillary Sinusitis: An Analysis from the Oral and Maxillofacial Surgery Point of View.

The aim of the study was to determine the factors influencing the development of recurrence after the surgical treatment of odontogenic maxillary sinusitis in an oral and maxillofacial surgery clinic over a 7-year period. Demographic and anamnesis data, clinical and radiological findings, treatment and outcome were analyzed. A multivariable analysis was performed to find associations between patient age, causative focus, surgical access for sinus revision, multilayer closure with a buccal fat pad, inferior meatal antrostomy (IMA) for temporary sinus drainage and sinusitis recurrence. A total of 164 patients with a mean age of 51.7 years were included. Sinusitis recurrence was observed in nine patients (5.48%) within 6 months after primary surgery. No significant correlation was detected between patient age, causative focus, surgical access for sinus revision, multilayer closure with a buccal fat pad, IMA for sinus drainage and the development of recurrence (p > 0.05). Patients with a history of antiresorptive-related osteonecrosis of the jaw showed a significant tendency toward disease recurrence (p = 0.0375). In conclusion, except for antiresorptive administration, none of the investigated variables were related to a higher risk of sinusitis recurrence. We encourage a combined approach of intraoral removal of the infective focus and sinus drainage via FESS, as well as an individual treatment decision in a multidisciplinary setting with collaboration between dentistry, maxillofacial surgery and otorhinolaryngology to avoid sinusitis recurrence.

Examination of Treatment Methods for Odontogenic Maxillary Sinusitis

歯性上顎洞炎の治療は, 治療方針に一定の見解が得られていないのが現状である. 今回われわれは, 可能な限り原因歯を温存する方針で歯科と合同の前向き研究を行った. 対象は2018年9月～2022年3月までに, 可能な限り原因歯を温存する治療方針での前向き研究の同意が得られた歯性上顎洞炎43例である. 耳鼻咽喉科ではマクロライド少量長期投与療法を開始し, 歯科では根管治療を開始する. ここで抜歯の絶対適応と判断した症例は, 抜歯をした. 保存的治療の効果判定は, 治療開始3カ月後の問診および CT による画像診断で行った. 改善しなかった症例は内視鏡下鼻副鼻腔手術を行い, 術後4～6カ月で再評価を行った. 内視鏡下鼻副鼻腔手術を行っても改善しない場合は, 抜歯をする方針とした. その結果, Lund-Mackay score が1増すと保存的治療 (ML療法および根管治療) では改善しないリスクが1.63倍となった. そして77%の症例で原因歯を温存できた. 内視鏡下鼻副鼻腔手術後に改善が得られず抜歯した症例はなかった. 保存的治療で改善しない症例に対しては, 外科的治療として内視鏡下鼻副鼻腔手術を行うことは抜歯を回避するのに有効である可能性が示唆された.

ORAL HEALTH STATUS OF INTERNALLY DISPLACED PERSONS

Diseases of the oral cavity organs and tissues are an urgent medical problem. The urgency of the problem has been exacerbated by the extreme conditions in Ukraine in recent years: the COVID-19 pandemic and the war. These factors lead to stress, changes in living standards and living conditions, which leads to exacerbation of chronic diseases, and also impede the receipt of full, qualified medical care.
 The Ministry of Health of Ukraine presents the regulatory framework "Rights and Obligations of Internally Displaced Persons", which guarantees medical examinations and treatment. According to the MoH order, the Poltava Regional Centre of Dentistry Dental Clinical Polyclinic has created conditions to provide dental care to IDPs at present.
 Ways of implementation:
 
 provision of dental care to patients by dentists of the polyclinic;
 providing emergency dental care around the clock;
 providing consultative and medical care by teachers of dental departments and doctors-interns.
 
 The study analysed the condition of the oral cavity organs (teeth, periodontium, oral mucosa) of internally displaced persons and identified possible ways to preserve and restore dental health through preventive work, therapeutic, surgical and orthopaedic care.
 The study analysed the work of dentists and teachers of dental departments in providing assistance to internally displaced persons over the 7 months of war in Ukraine. A total of 7388 people sought help. To assess the condition of the tissues and organs of the oral cavity, examinations were carried out using clinical, radiological and laboratory methods. If necessary, patients were consulted by related specialists.
 It was found that in all examined patients, the caries prevalence rate was 100%, and the CPV index was equivalent in patients of the main group (19±1.27) and the control group (18±2.45). The number of patients with pulpitis was 2268 (37%) (acute, chronic pulpitis and exacerbation of chronic pulpitis).
 Acute and exacerbation of chronic periodontitis was treated in 1852 patients (22.7%), periostitis in 855 (14%), and odontogenic maxillary sinusitis in 196 (3.2%).
 Out of the total number of patients, 263 (4.26%) sought treatment for exacerbation of gingivitis, 482 (7.82%) for exacerbation of periodontitis, and 698 (11.4%) for diseases of the oral mucosa.
 A high degree of reliability of exacerbation of periodontal and oral mucosa diseases was found in comparison with the control group.

Sinusitis Following Reduction Malarplasty.

The aim of this paper was to search for reported cases of sinus infection following reduction malarplasty and present guidelines for the prevention of sinusitis. Two cases of maxillary sinusitis that developed after reduction malarplasty has been reported, which were treated with endoscopic sinus surgery. Histologically, thickness of the mucosal lining of the maxillary sinus (Schneiderian membrane) was 0.41 mm at sinus floor, and 0.38 mm at 2 mm above the floor. In functional endoscopic sinus surgery (FESS), the uncinate process is removed, exposing the hiatus semilunaris. The anterior ethmoid air cells are opened, allowing better ventilation but leaving the bone covered with mucosa. FESS improves the function of the osteomeatal complex and therefore provides better ventilation of the sinuses. In odontogenic maxillary sinusitis, regeneration of the mucosal lining (ciliated epithelium regeneration and bone healing) was achieved in 1.4±1.2 years after modified endoscopic sinus surgery. In in zygomatic implant surgery, 12.3% patients presented maxillary sinusitis, and the most common treatment was antibiotics alone or combined with FESS. To prevent sinusitis after reduction malarplasty, accurate osteotomy and fixation are needed, especially when using only an intraoral incision. After surgery, radiological examinations (Water's view, computed tomography if needed) should be performed as part of follow-up. Prophylactic antibiotics (macrolides) are recommended for 1 week if the sinus wall is opened. If swelling or air-fluid level persists, re-exploration and drainage should be performed. In patients with risk factors such as age, comorbidities, smoking, nasal septal deviation, or other anatomical variants, simultaneous FESS is suggested.

Intelligent Decision Support System for Differential Diagnosis of Chronic Odontogenic Rhinosinusitis Based on U-Net Segmentation

The share of chronic odontogenic rhinosinusitis is 40% among all chronic rhinosinusitis. Using automated information systems for differential diagnosis will improve the efficiency of decision-making by doctors in diagnosing chronic odontogenic rhinosinusitis. Therefore, this study aimed to develop an intelligent decision support system for the differential diagnosis of chronic odontogenic rhinosinusitis based on computer vision methods. A dataset was collected and processed, including 162 MSCT images. A deep learning model for image segmentation was developed. A 23 convolutional layer U-Net network architecture has been used for the segmentation of multi-spiral computed tomography (MSCT) data with odontogenic maxillary sinusitis. The proposed model is implemented in such a way that each pair of repeated 3 × 3 convolutions layers is followed by an Exponential Linear Unit instead of a Rectified Linear Unit as an activation function. The model showed an accuracy of 90.09%. To develop a decision support system, an intelligent chatbot allows the user to conduct an automated patient survey and collect patient examination data from several doctors of various profiles. The intelligent information system proposed in this study made it possible to combine an image processing model with a patient interview and examination data, improving physician decision-making efficiency in the differential diagnosis of Chronic Odontogenic Rhinosinusitis. The proposed solution is the first comprehensive solution in this area.

Cone-beam computed tomography texture analysis can help differentiate odontogenic and non-odontogenic maxillary sinusitis.

This study aimed to assess texture analysis (TA) of cone-beam computed tomography (CBCT) images as a quantitative tool for the differential diagnosis of odontogenic and non-odontogenic maxillary sinusitis (OS and NOS, respectively). CBCT images of 40 patients diagnosed with OS (N=20) and NOS (N=20) were evaluated. The gray level co-occurrence (GLCM) matrix parameters, and gray level run length matrix texture (GLRLM) parameters were extracted using manually placed regions of interest on lesion images. Seven texture parameters were calculated using GLCM and 4 parameters using GLRLM. The Mann-Whitney test was used for comparisons between the groups, and the Levene test was performed to confirm the homogeneity of variance (α=5%). The results showed statistically significant differences (P<0.05) between the OS and NOS patients regarding 3 TA parameters. NOS patients presented higher values for contrast, while OS patients presented higher values for correlation and inverse difference moment. Greater textural homogeneity was observed in the OS patients than in the NOS patients, with statistically significant differences in standard deviations between the groups for correlation, sum of squares, sum of entropy, and entropy. TA enabled quantitative differentiation between OS and NOS on CBCT images by using the parameters of contrast, correlation, and inverse difference moment.

Surgical Approach to Odontogenic Maxillary Sinusitis Caused by Tooth Root Displacement into the Maxillary Sinus: A Case Report

Paranasal sinuses affected by foreign bodies are uncommon clinical situations. Foreign body displacement into facial sinuses is a potential iatrogenic complication, that may cause an oroantral fistula, sinusitis, cellulitis, and subdural emphysema. The maxillary sinus is usually the most affected by tooth displacements, due to its proximity. A dental fragment in the maxillary sinus may cause Odontogenic Maxillary Sinusitis (OMS). The present case report presents a case from the diagnosis to treatment of OMS originated by a fragment of tooth root displacement into the sinus during a previous dental extraction. A female patient, 13-yearold, had characteristic signs of sinusitis, reporting rhinorrhoea, headache, eye pain, and pain on the left side of the face. The clinical examination showed pain on palpation in the buccal region of the upper left first molar, which was absent. The Cone Beam Computed Tomography (CBCT) showed a foreign body inside the maxillary sinus, complete opacification, and bone defect on the sinus floor. Given the final diagnosis of OMS, the treatment selected was the combination of antibiotic therapy and fragment removal from the sinus. The diagnosis, planning, and correct use of surgical techniques described in the literature are essential for preventing iatrogenesis and actively ensuring patient health. In this sense, patients need to be informed about any complication, which should be written in the medical records along with resolution measures.

Effects of Preoperative Tooth Extraction on Surgery for Odontogenic Maxillary Sinusitis

Effects of Preoperative Tooth Extraction on Surgery for Odontogenic Maxillary Sinusitis

Current diagnostic concepts of chronic odontogenic maxillary sinusitis

Current diagnostic concepts of chronic odontogenic maxillary sinusitis