Endo-Periodontal Lesions—An Overlooked Etiology of Odontogenic Sinusitis

Abstract

The aim of this study was to analyze the oral etiology of patients with odontogenic sinusitis (ODS) and to compare the differences in demographic data, clinical symptoms, extent of sinus involvement, bone penetration of the maxillary sinus floor (MSF) between different etiologies. A retrospective investigation was conducted on 103 patients with ODS recruited from Beijing TongRen Hospital. All enrolled patients underwent sinus CT, nasal endoscopy, and oral examination. A comparison of the patients’ clinical symptoms, the extent of involvement of the sinuses, and bone resorption of the MSF according to odontogenic etiologies was conducted. Follow-up was based on symptoms and clinical examination. The most common odontogenic etiologies were endo-periodontal lesions (EPLs, 49.5%), apical periodontitis (AP, 32.0%), and periodontitis (PE, 8.7%). There were statistically significant differences in age (p = 0.002), sex (p = 0.036), inflammation involving the ethmoid sinus (p = 0.037), and bone penetration of the MSF (p < 0.001) between the AP, EPL, and PE groups. There were no significant differences in sinusitis symptoms (p > 0.005) among patients with different odontogenic etiologies. In conclusion, EPL is a neglected oral etiology with a destructive effect on the bone of the MSF, which deserves more attention in diagnosis and treatment.

Diagnostic criteria for odontogenic sinusitis: narrative review of relevant literature data

“…Recent data supported previous findings regarding 55.97% of odontogenic sinusitis being caused by iatrogenic factors and increase trend in odontogenic sinusitis epidemiology over the last decade in general [6]. Nowadays endo-perio lesions could be interpreted as one the most common etiological factor observed among patients with maxillary odontogenic sinusitis, but self-reported sinonasal symptomatics of patients did not differ significantly among cases with different dental-related etiologies [7]. Specific tendency could be observed regarding increasing number of odontogenic sinusitis related publications within decades between 1990 and 2019, but even with upgrowing pool of literature data regarding odontogenic sinusitis evidences reported within it remains of low quality [8].…”