The Prevalence of Odontogenic Pathology in Patients With Bilateral Rhinosinusitis

Abstract

Objective We investigated cases with opacification on maxillary sinus computed tomography (CT) among patients with rhinosinusitis with opacification in both paranasal sinuses (bilateral rhinosinusitis) to confirm the involvement of odontogenic infections. Methods This study included 75 patients who were diagnosed with bilateral rhinosinusitis based on clinical examination and evident opacification on at least one side on maxillary sinus imaging with computed tomography CT. The definition of odontogenic sinusitis was determined by examining EPT and oral findings, in addition to the CT and orthopantomography (OP), by one oral surgeon and two otolaryngologists. Results We found that 45.3% of patients had odontogenic infections, which were associated with multiple infected teeth in some cases. Odontogenic infection was observed in both sinuses in some patients. Sinusitis with polyps was frequently associated with dental infection, and some cases were also associated with mycosis. Almost no oral symptoms were observed. Conclusions The results suggest that clinicians should consider odontogenic infection in patients with bilateral rhinosinusitis with opacification, on at least one side on maxillary sinus imaging. This means that accurate diagnosis may be challenging for otolaryngologist or dentists alone, suggesting that a collaboration between the two would be suitable for this task.

Odontogenic Sinusitis: Clinical Aspects at Ambulatory Care Services

“…As some reports suggest that dentists cannot distinguish odontogenic sinusitis through dental symptoms, such as pain and dental hypersensitivity, it may also be difficult for otolaryngologists to diagnose using only nasal symptoms (3,11) . Our data showed the 1st molar was most infiltrated to the maxillary sinus, though various other reports showed the 2nd molar was most infiltrated to the maxillary sinus (10,12,13) . Both 1st and 2nd molars were recognized as the origin of infection in two patients.…”

“…Our data suggested that multiple molars could be the cause of the odontogenic sinusitis simultaneously. Dental doctors could not distinguish that either one was specific for the infection site because both molars' inflammation sites were obviously seen to involve the floor of the maxillary sinus (10) .…”

“…Diagnosis of odontogenic sinusitis should depend on the radiology examination like CT and OPG. Although the percussion of causal tooth has possibility to detect abnormal sensitivity of periodontal disease and OPG shows high sensitivity to detect it (10,15) , it is diffi-cult to diagnose odontogenic sinusitis as OPG might underestimate the bone loss due to soft tissue generation (9,17) . CT demonstrates the relationship between odontogenic sinusitis and dental source.…”

Curved Planar Reformation: A Useful Method for Screening Dental Pathologies in Chronic Rhinosinusitis via Paranasal Sinus Computed Tomography

“…These symptoms are nonspecific and would not help in the diagnosis of odontogenic sinusitis [ 27 ]. Although odontogenic sinusitis usually presents as unilateral maxillary rhinosinusitis, Matsumoto et al found odontogenic infections in 45.3% of bilateral rhinosinusitis patients [ 28 ]. Therefore, screening for a possible odontogenic focus in CRS is extremely important.…”

Prevalence of incidental pathologies in the maxillary sinus among a sample of asymptomatic dental patients using CBCT—a retrospective analysis

“…The septa of the maxillary sinus are composed of cortical bone that divides the floor of the sinus into multiple chambers known as recesses. 1 During surgical procedures like implants, the risk of perforation of the floor increases if there are anatomic variations within the maxillary sinuses, such as septa, mucosal thickening of the sinus floor, or others. A study conducted by Raghav et al, 2 recorded the presence of a high rate of incidental maxillary sinus abnormalities in a sample of asymptomatic dental patients.…”