Evaluation of odontogenic maxillary sinusitis with cone beam computed tomography: A retrospective study with review of literature

Abstract

Aim and Objectives: 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 determine whether any tooth or any tooth root, was more frequently associated with this disease. Materials and Methods: The present study included 500 CBCT images that included the entire maxillary sinus of both the sides in all the three planes. The modified classification of Abrahams and Glassberg was used to assess maxillary sinusitis of odontogenic origin. Furthermore, the proximity of the tooth root to the sinus floor, periapical pathology, and the septae within the maxillary sinus were also assessed. Results: In the present study, 1000 hemimaxillas were analyzed. Majority of the cases (74.9%) the apex of either tooth was touching the floor of the sinus. While 16.9% were in close relationship to the sinus while 8.2% of the cases, the apices were present within the sinus. Furthermore, in the present study, 38 of the total cases had an odontogenic cause of maxillary sinusitis, whereas 273 of them had a nonodontogenic cause, 96 have an undetermined cause, and the rest 593 cases had healthy sinus. Conclusion: The incidence of odontogenic sinusitis is likely under-reported in the available literature. The introduction of low-dose CBCT is particularly useful to establish a definitive diagnosis to augment in the treatment of chronic maxillary sinusitis of odontogenic origin.

Diagnostic Criteria for Odontogenic Sinusitis: A Systematic Review

“…Forty-nine studies reported specific diagnostic criteria 7,10,16–62 and 14 studies did not report any diagnostic criteria (either original or referenced) for OS. 8,11,63–74 It should be noted that four articles 10,21,31,39 were retrospective radiological analyses and provided radiologic diagnostic criteria only. Figure 1 reports a graphical analysis of the 63 included articles in terms of their overall use of diagnostic criteria.…”

ENT and dentist cooperation in the management of odontogenic sinusitis. A review

“…While the clinical examination, both dental and otolaryngological, is straightforward, and the use of nasal endoscopy mandatory, the choice of imaging exams is more complex. Computed tomography (CT) and cone-beam CT (CBCT) are both commonly used for diagnosing sinusitis and identifying the dental problem 17,18 , albeit with different peculiarities (as a general rule, standard CT scan provide a better resolution and contrast for the sinonasal cavities and a better visualization of soft tissues alike, while CBCTs -which represent nevertheless a continuously evolving technology -usually allow for easier diagnosis of dental conditions). However, dental specialists may further require employing techniques such as orthopantomography and periapical radiographs to complete the dental study.…”

Defining appropriateness criteria for endoscopic sinus surgery in the management of adult dental implant patients with incidental maxillary sinus findings on conebeam computed tomography

“…16 Patients with periapical dental disease can lead to a breach of the Schneiderian membrane resulting in inflammatory mucosal disease and subsequent maxillary sinusitis. 17 Odontogenic sinus disease refractory to treatment with antimicrobial therapy involves definitive treatment of the underlying dental pathology. In such patients, dental extraction of affected tooth root alone may suffice in managing the sinusitis without the requirement of ESS.…”

“…Up to 40% of unilateral maxillary sinusitis is odontogenic in origin 16 . Patients with periapical dental disease can lead to a breach of the Schneiderian membrane resulting in inflammatory mucosal disease and subsequent maxillary sinusitis 17 …”