Various definitions have been proposed for the term ‘chronic sinusitis’ but too often reports on chronic sinusitis lack a definition. In order to improve the diagnosis and treatment of this disease...

Chronic Maxillary Sinusitis: Definition, Diagnosis and Relation to Dental Infections and Nasal Polyposis

The interrelationship between the maxillary sinus and endodontics.

By a careful ENT and oral examination of 111 patients with suspected chronic maxillary sinusitis, the diagnosis was verified in only 56% (62/111). In 29 of these 62 patients (47%) a relation to dental infections was found, periodontitis being as frequent as apical granulomas. In 61 % of the patients, in whom the diagnosis chronic maxillary sinusitis could not be verified, dental infections and/or myofascial pain dysfunction syndrome (MPD) were the most common and likely cause of the symptoms. A careful oral examination including dental radiographs is thus important in patients with chronic maxillary sinusitis.

Chronic Maxillary Sinusitis:Differential Diagnosis and Genesis

Infection of pulpally involved teeth near the maxillary sinus sometimes spreads into the sinus and causes serious complications. This pathological complex, involving both antral and periapical tissues, is referred to as the endo-antral syndrome (EAS). It includes diagnostic difficulties, treatment considerations, and occasionally persistent pathological antral alterations after nonsurgical endodontic therapy. Surgical measures are occasionally required to stimulate healing and preserve the teeth.

The endo-antral syndrome: an endodontic complication

Aim: The aim of the present study was to investigate the prevalence of maxillary sinus findings in elderly subjects above the age of 50 through the use of panoramic radiography and to test the hypothesis that such findings are more prevalent in dentate subjects. Methods and Materials: A total of 105 subjects over the age of 50 years were examined both clinically and radiographically in the Department of Oral Medicine and Radiology of the Manipal College of Dental Sciences in Manipal, India, over a period of three months for various reasons. Eight were excluded due to the lack of diagnostic quality of their radiographs. The manually calculated kappa test was used to determine the statistical significance of intra-examiner reliability. The other data were analyzed using a manually calculated z-test for proportions where z ≥1.96 or p<0.05 were considered statistically significant. Results: The prevalence of radiographic maxillary sinus findings in 97 elderly subjects (aged above 50 years) were investigated with the use of panoramic radiography. Fifty subjects had at least one natural tooth radiographically in the upper jaw and 39 subjects were radiographically edentulous in the upper jaw. Mucous cysts or diffused mucosal thickenings were found in 42.26% of the subjects. Of the mucosal thickenings, 74.35% were found in subjects with a dentate upper jaw (p<0.05). The prevalence of a mucous cyst was 2.06% in subjects with a dentate upper jaw and a finding of no mucous cysts in edentulous subjects suggests an odontogenic cause. Conclusions: According to the findings of the present study, the presence of mucosal thickening or mucosal cysts may be due to the presence of irritative stimuli, often an infection of dental origin, as these findings are more prevalent in dentulous subjects.

Maxillary Sinus Findings in the Elderly: A Panoramic Radiographic Study

Roentgenological investigations into the relation between periapical lesions and conditions of the mucous membrane of maxillary sinuses.

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Roentgenological investigations into the relation between periapical lesions and conditions of the mucous membrane of maxillary sinuses.