Diagnosing odontogenic sinusitis of endodontic origin: A multidisciplinary literature review

Craig, John R.; Tataryn, Roderick W.; Bruce, Y.; Bhargava, Puneet; Pokorny, Al; Gray, Stacey T.; Mattos, José L.; Poetker, David M.

doi:10.1016/j.amjoto.2021.102925

Cited by 41 publications

(66 citation statements)

References 68 publications

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“…Matsumoto et al [ 3 ], Pokorny et al [ 18 ], and Lechien et al [ 21 ] observed an average age between 40 and 50 years, figures somewhat lower than those observed in this study, in which the mean age reached values of 56.67 years ± 14.02 years. This agrees more with the recent review by Craig et al [ 22 ], in which the mean age was 51.2 ± 3.9 years.…”

Section: Discussionsupporting

confidence: 93%

“…One of the main challenges regarding these dental factors is the diagnostic criterion used to consider whether their impact on the sinus membrane can lead to the development of odontogenic sinusitis. Craig et al [ 22 ], in a review conducted in 2021, noted that odontogenic sinusitis should be diagnosed based on the laterality of the disease, the symptoms, the findings of nasal endoscopy, the bacterial cultures of the sinuses, and the findings of the CT scan. They note that although opacification of the nasal sinuses or the thickening of the membrane on a CT scan may suggest sinusitis, these findings are nonspecific, and nasal endoscopy is more effective at confirming infectious sinusitis.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of the Radiological Changes of the Sinus Membrane Using Cone Beam Computed Tomography and Its Relationship with Dental Treatments. A Retrospective Study

Rey-Martínez¹,

Ruiz-Sáenz

Martínez-Rodríguez

et al. 2022

Biology

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The aim of this study was to identify the most relevant dental factors and iatrogenic causes in the development of pathological changes to the sinus membrane and to analyse their possible influence on the development of odontogenic sinusitis. A descriptive, observational study was designed, with 276 patients who had been evaluated via cone beam computed tomography, analysing possible sinus thickening factors, such as apical infections, endodontic treatments, periodontitis, radicular cysts and impacted teeth, as well as iatrogenic factors caused by implant treatments or the development of oroantral communications produced during tooth extraction manoeuvres. Among the dental factors, periodontitis (47.1%), apical pathology (23.5%) and endodontic treatments (23.1%) were the predominant causes of sinus membrane thickening that most frequently produced an occupancy between 2 and 10 mm. Regarding the implant treatments, the placement of implants through the floor of the maxillary sinus was the main cause (9.8%), followed by sinus elevation techniques (6.2%). Dental extraction was the first cause of oroantral communication (5.0%), being the procedure that caused the greatest thickening of the sinus membrane. This study highlights the importance of dental treatments and iatrogenic factors in sinus pathology, and the need for diagnostic interrelations between the different specialists who address this pathology.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Analysis of the Radiological Changes of the Sinus Membrane Using Cone Beam Computed Tomography and Its Relationship with Dental Treatments. A Retrospective Study

Rey-Martínez¹,

Ruiz-Sáenz

Martínez-Rodríguez

et al. 2022

Biology

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“…With regard to sinus cultures, ODS patients have higher rates of alpha‐hemolytic streptococcal species and anaerobes compared to rhinosinusitis patients 12,21,30,31 . Lastly, compared to rhinosinusitis, ODS tends to demonstrate relative sparing of the posterior ethmoid and sphenoid sinuses on CT 1,2,16,29 . All these clinical features reached consensus as being more associated with ODS compared to other forms of rhinosinusitis.…”

Section: Diagnosing Odsmentioning

confidence: 98%

“…ODS may account for 25%–40% of all chronic maxillary sinusitis, 4,5 occurs unilaterally most commonly, 6–14 and represents 45%–75% of unilateral maxillary sinus opacification on computed tomography (CT) 6–8,15 . ODS most commonly presents in the 5th decade of life, affects males and females equally, and patients typically have chronic symptoms (median, 6 months) 2 . While ODS most commonly presents chronically, it can present acutely with extrasinus orbital, intracranial, or osseous infectious spread 16 .…”

Section: Introductionmentioning

confidence: 99%

Odontogenic sinusitis: A state‐of‐the‐art review

Craig

2022

World j. otorhinolaryngol.-head neck surg.

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Odontogenic sinusitis (ODS) is more common than historically reported, and is underrepresented in the sinusitis literature. ODS is distinct from rhinosinusitis in that it is infectious sinusitis from an infectious dental source or a complication from dental procedures, and most commonly presents unilaterally. ODS clinical features, microbiology, and diagnostic and treatment paradigms are also distinct from rhinosinusitis. ODS evaluation and management should generally be conducted by both otolaryngologists and dental providers, and clinicians must be able to suspect and confirm the condition. ODS suspicion is driven by certain clinical features like unilateral maxillary sinus opacification on computed tomography, overt maxillary dental pathology on computed tomography, unilateral middle meatal purulence on nasal endoscopy, foul smell, and odontogenic bacteria in sinus cultures. Otolaryngologists should confirm the sinusitis through nasal endoscopy by assessing for middle meatal purulence, edema, or polyps. Dental providers should confirm dental pathology through appropriate examinations and imaging. Once ODS is confirmed, a multidisciplinary shared decision‐making process should ensue to discuss risks and benefits of the timing and different types of dental and sinus surgical interventions. Oral antibiotics are generally ineffective at resolving ODS, especially when there is treatable dental pathology. When both the dental pathology and sinusitis are addressed, resolution can be expected in 90%–100% of cases. For treatable dental pathology, while primary dental treatment may resolve the sinusitis, a significant percentage of patients still require endoscopic sinus surgery. For patients with significant sinusitis symptom burdens, primary endoscopic sinus surgery is an option to resolve symptoms faster, followed by appropriate dental management. More well‐designed studies are necessary across all areas of ODS.

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“…4,5 Potential dental pathologies causing ODS include apical periodontitis with or without periapical lesions (endodontic infection), marginal periodontitis (periodontal infection), oroantral communication or fistula, or dental treatment–related maxillary sinus foreign bodies. 6-8 Studies have shown that ODS could account for 25% to 40% of all chronic maxillary sinusitis 9,10 and 45% to 75% of unilateral maxillary sinus opacification on computed tomography (CT). 11-14…”

mentioning

confidence: 99%

Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

Craig¹,

Cheema²,

Dunn

et al. 2021

Otolaryngol.--head neck surg.

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Objective Odontogenic sinusitis (ODS) can cause infectious orbital, intracranial, and osseous complications. Diagnosis and management of complicated ODS have not been discussed in recent sinusitis guidelines. The purpose of this systematic review was to describe epidemiological and clinical features, as well as management strategies of complicated ODS. Data Sources PubMed, EMBASE, and Cochrane Library. Review Methods A systematic review was performed to describe various features of complicated ODS. All complicated ODS studies were included in qualitative analysis, but studies were only included in quantitative analysis if they reported specific patient-level data. Results Of 1126 studies identified, 75 studies with 110 complicated ODS cases were included in qualitative analysis, and 47 studies with 62 orbital and intracranial complications were included in quantitative analyses. About 70% of complicated ODS cases were orbital complications. Only 23% of complicated ODS studies were published in otolaryngology journals. Regarding ODS-related orbital and intracranial complications, about 80% occurred in adults, and 75% were male. Complicated ODS occurred most commonly from apical periodontitis of maxillary molars. There were no relationships between sinusitis extent and orbital or intracranial complications. High rates of anaerobic and α-hemolytic streptococcal bacteria were identified in complicated ODS. Management generally included systemic antibiotics covering aerobic and anaerobic bacteria, and surgical interventions were generally performed to address both the complications (orbital and/or intracranial) and possible infectious sources (dentition and sinuses). Conclusion ODS should be considered in all patients with infectious extrasinus complications. Multidisciplinary management between otolaryngologists, dental specialists, ophthalmologists, and neurosurgeons should be considered to optimize outcomes.

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Diagnosing odontogenic sinusitis of endodontic origin: A multidisciplinary literature review

Cited by 41 publications

References 68 publications

Analysis of the Radiological Changes of the Sinus Membrane Using Cone Beam Computed Tomography and Its Relationship with Dental Treatments. A Retrospective Study

Analysis of the Radiological Changes of the Sinus Membrane Using Cone Beam Computed Tomography and Its Relationship with Dental Treatments. A Retrospective Study

Odontogenic sinusitis: A state‐of‐the‐art review

Extrasinus Complications From Odontogenic Sinusitis: A Systematic Review

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