What is odontogenic sinusitis

Why odontogenic sinusitis can occur

There are different ways of occurrence of odontogenic sinusitis. The causes of odontogenic sinusitis are as follows:

• A sick tooth. The lesion can occur through a diseased tooth, when the infection enters the bone tissue through the root canals. The tips of large chewing teeth (sixes and sevens) often sprout directly into the maxillary sinus, which simplifies its infection.
• Apical cyst of a tooth. If there is a thin bony partition (literally 1.5-2 mm) between the upper teeth and the maxillary sinus, then an apical cyst (sometimes up to 10-15 cm in diameter) may form at the top of the root, which breaks into the maxillary sinus and causes inflammation.
• Poor dental treatment. Sometimes odontogenic sinusitis manifests itself after dental treatment. Unfortunately, due to the complex anatomical location of the canals, it is not always possible to wash, disinfect and seal them properly – the infection also penetrates into the maxillary sinus through untreated canals.
• There are even such extreme cases when, when trying to remove a tooth, a fragment of the root or even the entire tooth ends up in the maxillary sinus. Or, after the tooth is removed, the mouth remains.
• Entry of filling materials into the maxillary sinus. If you do not notice this immediately, sinusitis becomes chronic, and the material becomes overgrown with fungus.

Since the microflora of the oral cavity and maxillary sinus differ significantly, any foreign bodies cause inflammation. Eventually, because of this, there are complaints about unpleasant discharge from the nose after tooth extraction — a characteristic symptom of odontogenic sinusitis.

How does odontogenic sinusitis differ from other types of sinusitis

The peculiarity of odontogenic sinusitis is the actual method of infection – through the oral cavity, accordingly, in its treatment, it is necessary not only to eliminate the consequences of the disease, but also to identify and get rid of the cause. That is why the participation of at least two doctors is necessary in the operation: the ENT surgeon widens the joint between the maxillary sinus and the nasal cavity, conducts a revision of the sinus, washes it well and ensures reliable drainage. The maxillofacial surgeon, depending on the situation, removes a cyst or a poorly healed tooth, removes a foreign body from the sinus, and sews up a hole that is too large after the tooth is removed. Such combined operations are currently the most advanced and effective way of treating odontogenic sinusitis, which excludes the possibility of recurrence. After all, both the cause of the disease and the inflammation itself are eliminated.

If the infection entered the maxillary sinus from the nasal cavity, then we are talking about rhinogenic sinusitis, which is treated only by an ENT doctor.

Complications in odontogenic sinusitis

Odontogenic sinusitis can turn into inflammation of the bone tissue of the upper jaw — osteomyelitis. This is an aggressive disease: the bone rots from the inside, and sequestrations are formed – fragments of dead bone that are not connected to any surrounding tissues. They are removed surgically after the necrotic process has been stopped. But the worst thing is that the upper jaw has an important skeletal function of the middle third of the face, and osteomyelitis leads to disability and disfigurement of a person.

But that’s not all: other possible complications are collateral swelling with the formation of an abscess (a disease in which a cavity filled with pus forms) or phlegmon (pus does not collect in the cavity, but spills over the surrounding tissues) of the temporal region. These conditions also require surgical treatment — exclusively with external access (an incision on the face), and at the same time, large scars remain: the wound cannot be sutured after phlegmon removal, it heals on its own.

Diagnosis of odontogenic sinusitis

In order to diagnose odontogenic sinusitis and find out exactly why it occurred (inflammation of the tooth root, cyst, dental material or root fragment in the maxillary sinus), the doctor prescribes a CT scan of the upper jaw and paranasal sinuses. Signs of odontogenic sinusitis are also:

• discharge from the nose with an extremely unpleasant smell;
• congestion and pain in the ears;
• feeling of mucus running down the back wall of the nasopharynx;
• nasal congestion;
• radiation of pain in the eye or cheek (when the inflammation also affects the trigeminal or subocular nerve);
• feeling of pressure on the eye.

Acute sinusitis (like any inflammatory process) can be accompanied by a high temperature. Usually, with these symptoms, a person turns to an ENT surgeon, who, if necessary, involves a maxillofacial surgeon in the treatment.

Is it possible to cure odontogenic sinusitis at home?

Odontogenic sinusitis is not a condition that can be easily and safely treated at home. First, a person cannot make a diagnosis and discover the cause of the disease by himself. Secondly, most often such a patient needs surgical intervention. If you don’t consult a doctor and try to solve the problem with remedies from the home first aid kit, everything can end in severe and unavoidable complications – osteomyelitis of the upper jaw, phlegmon and eventually disability.

Which doctor treats odontogenic sinusitis

As a rule, odontogenic sinusitis is diagnosed by an otolaryngologist, to whom a person has turned with relevant complaints. Sometimes it happens that problems in the maxillary sinus are seen on a CT scan by a maxillofacial surgeon or an implantologist who is preparing a patient for a dental implant. Surgical treatment is carried out by a maxillofacial surgeon and an ENT surgeon together, because it is necessary not only to cope with the consequences – inflammation of the maxillary sinus, but also to remove its cause: a diseased tooth, a cyst, a foreign body that accidentally got into the sinus. If we are talking about advanced sinusitis, then a mushroom-like body is formed in the sinus: a gray mass that resembles porridge in consistency, occupies most of the space and has an unpleasant smell. Its complete removal requires time and endurance from doctors. But as a result of the operation, the patient receives a clean maxillary sinus without inflammation and a healthy oral cavity.