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      Odontogenic maxillary sinusitis: A comprehensive review

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          Abstract

          Odontogenic maxillary sinusitis (OMS) is a well-recognized condition in both the dental and otolaryngology communities. Close to 30% of cases of unilateral maxillary sinusitis may have an underlying dental pathology. Failure to identify a dental cause usually lead to cases recalcitrant sinusitis often associated with serious complications. The aim of this study is to describe the literature findings on odontogenic maxillary sinusitis that discuss anatomy, epidemiology, etiology, bacteriology, diagnosis and treatment.

          The present review is based on a current search using bibliographic database and academic search engine. All the articles on odontogenic maxillary sinusitis published after 2000 were included. This study seeks to provide clinicians with evidence that motivates a comprehensive approach to the evaluation and management of OMS. Controversies on diagnosis and management have been addressed and data from different treatment plans were collected by exploring relevant publications.

          The surgical treatment of OMS is based essentially on the dental surgery, combined with endoscopic sinus surgery, in order to completely remove the infection, restore the physiological drainage of the sinus and prevent recurrences of sinusitis. A multidisciplinary otolaryngology and dental team is mandatory to successfully manage the dental pathology and the complications resulting from the dental treatments.

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          Most cited references65

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          Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis.

          The aim of this study was to evaluate the accuracy of imaging methods for detection of apical periodontitis (AP). Imaging records from a consecutive sample of 888 imaging exams of patients with endodontic infection (1508 teeth), including cone beam computed tomography (CBCT) and panoramic and periapical radiographs, were selected. Sensitivity, specificity, predictive values, and accuracy of periapical and panoramic radiographs were calculated. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic accuracy of the panoramic and periapical images. Prevalence of AP was significantly higher with CBCT. Overall sensitivity was 0.55 and 0.28 for periapical and panoramic radiographs, respectively. ROC curves and area under curve (AUC) with periapical radiography showed a high accuracy for the cutoff value of 5 for both periapical (AUC, 0.90) and panoramic (AUC, 0.84) radiographs. AP was correctly identified with conventional methods when showed advanced status. CBCT was proved to be accurate to identify AP.
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            Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology.

            To compare intraoral periapical radiography with 3D images for the diagnosis of periapical pathology. Maxillary molars and premolars and mandibular molars with endodontic problems and examined with periapical radiographs and a 3D technique (3D Accuitomo) were retrospectively selected and evaluated by 3 oral radiologists. Numbers of roots and root canals, presence and location of periapical lesions, and their relation to neighboring structures were studied. Among 46 teeth, both techniques demonstrated lesions in 32 teeth, and an additional 10 teeth were found in the Accuitomo images. As regards individual roots, 53 lesions were found in both techniques, and 33 more roots were found to have lesions in Accuitomo images. Artefacts were sometimes a problem in Accuitomo images. In 32 of the 46 cases, all observers agreed that additional clinically relevant information was obtained with Accuitomo images. A high-resolution 3D technique can be of value for diagnosis of periapical problems.
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              Cone-beam computed tomography evaluation of maxillary sinusitis.

              Dental pain originating from the maxillary sinuses can pose a diagnostic problem. Periapical lesion development eliciting inflammatory changes in the mucosal lining can cause the development of a sinusitis. The purpose of this study was to describe the radiographic characteristics of odontogenic maxillary sinusitis as seen on cone-beam computed tomography (CBCT) scans and to determine whether any tooth or any tooth root was more frequently associated with this disease. Eighty-two CBCT scans previously identified as showing maxillary sinus pathosis were examined for sinusitis of odontogenic origin in both maxillary sinuses. One hundred thirty-five maxillary sinusitis instances with possible odontogenic origin were detected. Of these, 37 sinusitis occurrences were from nonodontogenic causes, whereas 98 instances were tooth associated with some change in the integrity of the maxillary sinus floor. The average amount of mucosal thickening among the sinusitis cases was 7.4 mm. Maxillary first and second molars were 11 times more likely to be involved than premolars, whereas either molar was equally likely to be involved. The root most frequently associated with odontogenic sinusitis is the palatal root of the first molar followed by the mesiobuccal root of the second molar. Changes in the maxillary sinuses appear associated with periapical pathology in greater than 50% of the cases. Maxillary first or second molar teeth are most often involved, and individual or multiple roots may be implicated in the sinusitis. The use of CBCT scans can provide the identification of changes in the maxillary sinus and potential causes of the sinusitis. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Journal
                J Dent Sci
                J Dent Sci
                Journal of Dental Sciences
                Association for Dental Sciences of the Republic of China
                1991-7902
                2213-8862
                22 August 2020
                January 2021
                22 August 2020
                : 16
                : 1
                : 474-481
                Affiliations
                [a ]1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
                [b ]School of Dentistry, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
                [c ]1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
                Author notes
                []Corresponding author. 1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, No. 1, Stilponos Kyriakidi St., Thessaloniki, 54636, Greece. Fax: +30 2310 994 916. psill@ 123456otenet.gr
                Article
                S1991-7902(20)30177-X
                10.1016/j.jds.2020.08.001
                7770314
                33384837
                a603a153-fb0b-48ca-8417-26875ee6c93b
                © 2020 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 2 August 2020
                : 8 August 2020
                Categories
                Review Article

                odontogenic sinusitis,oroantral fistula,dental implants,dental infection,apical periodontitis

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