Odontogenic pain originating from the maxillary sinus can pose a diagnostic challenge for the clinician. As the roots of the maxillary posterior teeth are close to the floor of the sinus, along with common innervation, there is a probable reason for pathosis of the sinus to cause dental symptoms.
It is believe the breach of the Schneiderian membrane owing to microbial incursion in periapical infections; so periodontal disease or iatrogenic factors increases the risk of maxillary sinusitis. The progress of a periapical lesion in maxillary posterior teeth can give rise to inflammatory changes; so in the mucosal lining of the maxillary sinus and subsequently, the development of sinusitis.
Sections of human teeth
The extension of periapical inflammation into the maxillary sinus; which was first describe in 1943 by Bauer. This was a cadaveric study; so with microscopic evaluation of sections of human teeth, alveolus, and sinus. Periapical inflammation was found to be proficient for affecting the sinus mucosa; so with or without perforation of the cortical bone of the sinus floor.
Radiographic imaging has always play an imperative role in establishing the odontogenic etiology of (mostly chronic); so maxillary sinusitis and complement results of the clinical examination. The purpose of this retrospective study was to describe the radiographic characteristics; hence of odontogenic maxillary sinusitis as on cone beam compute tomography (CBCT) scans; also to determine whether any tooth or any tooth root, was more frequently associate with this disease.
In the present study, 1000 hemimaxillas were analyzed. A total of 500 participants including 314 males and 186 females participate in the study. All the participants in the present study were adults and were between the ages of 25–65 years. In the present study, descriptive statistics was use to summarize the features of odontogenic and nonodontogenic sinusitis.
Maxillary sinus infection
Statistical Package for the Social Sciences (SPSS; IBM, California, USA) version 20.0 was use to perform the statistical analysis. Student’s t-test was use to assess the relation (P < 0.05 was consider to be statistically significant) between the odontogenic pathology and maxillary sinus infection.
Several studies have report a great variability in the prevalence of incidental findings in the maxillary sinus of asymptomatic subjects when multiplanar images are use. Multislice CT scan studies have find abnormalities in the maxillary sinus in 30% of the cases. Whereas, CBCT studies have find abnormalities in maxillary sinus in 24.6% to 56.3% of the cases.
In the present study, the prevalence of abnormalities in the maxillary sinus was 39.4% which was in accordance with the previous studies. However, a study done by Rege et al. the prevalence was as high as 68.3%. The discrepancy could be due to the sampling criteria select for the study, the study design, variations in image interpretation, diagnostic criteria for maxillary sinusitis, and the influence of the climate in different geographical areas.
The incidence of odontogenic sinusitis is likely under report in the available literature. Radiographic analysis plays a pivotal role in the diagnosis of odontogenic sinusitis. It has establish in the publish literature that 2D-imaging modalities may obscure the origin of odontogenic maxillary sinusitis. 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.