Odontogenic sinusitis: treatment, causes and symptoms

Odontogenic sinusitis is an infectious-inflammatory process in the maxillary paranasal sinus (maxillary sinus) that develops in the result of the pathology of the teeth roots, bone tissue or gums of the upper jaw.

Odontogenic sinusitis can manifest for the first time only in adolescence, when milk teeth are replaced at the root. According to statistics, "dental" sinusitis, as it is often called, is found in 8% of cases among the General mass of sinusitis.

The mechanism of development of disease is caused by the anatomic proximity of the jaw and sinuses. The roots of the teeth of the upper jaw (4 to 8 tooth) maintain close contact with the bottom of the maxillary sinus. Between the sinus and the teeth is a bone plate. Sometimes the bottom is so thin that the roots of the teeth is limited to only soft tissues.

The content of the article:

• The causes of odontogenic sinusitis
• Symptoms of odontogenic sinusitis
• Treatment of odontogenic sinusitis

The causes of odontogenic sinusitis

The causes of odontogenic sinusitis are cut in the inflammatory process that occurs as a result of the breeding of pathological organisms that have penetrated the maxillary sinus from the mouth.

Experts identify the following factors that trigger onset of the disease:

• Perforation of the bottom of the sinus during the filling of the tooth. In contact with the filling material into the cavity of the maxillary sinus often develops fungal chronic odontogenic sinusitis.
• The penetration of other foreign bodies in the mandibular sinus. This happens most commonly during dental procedures. The cause of inflammation may be a broken dental instrument, turundy, the wreckage of the sunken roots of the teeth. Although not excluded, and penetrating wounds of the sinuses, which occurs less frequently.

• Teeth and gum disease can provoke the beginning of odontogenic sinusitis. This is such diseases as periodontitis, granulomas and cysts of the tooth root, subperiosteal abscess, fistula, apical periodontitis. Any purulent foci of large and small molar teeth adjacent to the maxillary sinus, can cause the development of the disease.

• Disease of the jawbone can also act as the cause of the inflammation is osteomyelitis or periostitis.

Independing on the causes of the disease distinguish between perforated and reperforating odontogenic sinusitis. In perforated sinusitis is a direct violation of the integrity of the bottom of the maxillary sinus, and when reperforating sinusitis, the inflammation manifests in the background of existing diseases of the teeth, gums or jaw bone.

Due to existing inflammation, aerazione-drainage function of the maxillary sinus is broken. This leads to stagnation of serous or Muco-serous discharge, which is a favorable environment for the growth and reproduction of pathogenic microorganisms: bacteria and fungi. Increase the time of contact of bacteria with cells of the maxillary sinus contributes to a violation of the movement of ciliated epithelium. If the disease is prolonged and untreated, the mucous membrane of the nasal sinus undergoes irreversible changes, and amid the festering begin to prevail the symptoms of an infectious inflammation of the paranasal sinuses mandibular.

Symptoms of odontogenic sinusitis

Symptoms of odontogenic sinusitis depend on what stage the disease is.

The acute phase is characterized by the following clinical picture:

• The body temperature increase to high values – up to 38-39 degrees.
• Headaches, General malaise.
• Nasal discharge from the inflammation.
• Stuffy nose, impaired sense of smell.
• Painful sensations of varying intensity. Possible irradiation of pain in whiskey, upper jaw, neck, ear.
• Pain in the tooth or the teeth that cause the development of sinusitis. Tooth pain while chewing food.
• May develop swelling of the soft tissues of the cheeks, although this is not always the case and depends on the reasons of development of inflammation.
• Sometimes there is submandibular lymphadenitis with swollen lymph nodes and soreness.
• Possible signs of periostitis, osteomyelitis, cysts, fistula or other dental diseases that caused the development of odontogenic sinusitis.

Odontogenic sinusitis often develops as a primary chronic disease, but can manifest and after acute inflammation. Patients complain of slight headaches, recurring feeling of heaviness in the upper jaw. May cause nasal discharge from the sidedefeat. Sometimes from the nose comes putrid-stinking smell.

The patient on the background of chronic infections suffer from reduced performance. Especially was this noticeable in people of mental labor.

If in the maxillary sinus accumulates a large amount of discharge, severe headaches and pain along the trigeminal nerve. There is a gradual transition from the chronic phase to the acute stage of the disease with the accession of bacterial infection.

Treatment of odontogenic sinusitis

Treatment of odontogenic sinusitis boils down to two tasks that need to be implemented as soon as possible:

• To eliminate the primary focus of infection (to save the patient from dental problem);
• To eliminate inflammation in the maxillary sinus.

If possible, the dentist to try to save a bad tooth, but to completely eliminate infection in the root system, in the soft tissues. Possibly treatment in hospital and outpatient settings.

Conservative therapy is to restore normal ventilation of the sinus. To do this, the patient is recommended vasoconstrictors local destination: Galazolin, Nazivin, Naphazoline, Sanorin and others. Otelin Possible taking antibiotics orally. In this case, the drugs of choice become antibacterial agents from the group of penicillins (Amoxiclav) or fluoroquinolones (Levofloxacin, Moxifloxacin, etc.).

To create the maximum concentration of antibiotic in nasal sinus use Antibacterials of local action, for example, Bioparox, Izofra.

If the sinusitis is complicated by severe headaches, swelling of soft tissues, intracranial disorders, mandatory hospitalization of the patient. Unsuccessful conservative therapy is the basis for surgical intervention. Thus, during the removal of the causative tooth has the possibility of unwanted opening of the adjacent sinuses. In this case, the resulting fistula may be closed independently on the background of treatment with tincture of iodine. If overgrowth occurs, will close the fistula by flap of gum tissue or palate.

To eliminate pus from the nasal sinuses it must be draining. For this purpose it is washed by the method of sine-evacuation or method called "cuckoo". For disinfection use a disinfectant solutions is Furatsilin, Rivanol, potassium Permanganate, and so into the nasal cavity directlyinjected antibiotics and proteolytic enzymes.

Chronic odontogenic sinusitis are also treated conservatively. The need for surgical intervention is caused by the formation of polosnogo odontogenic sinusitis, chronic necrotizing sinusitis and also for dental indications.