Maxillary sinusitis is inflammation of the sinus mucosa with the appearance of a purulent secretion inside the mucosa.
The sinuses are air-filled cavities in the cranial mass, which play a role in controlling the pressure created when breathing in and out.
Also, during the exercise of the respiratory function, the air in the sinuses is renewed each time during inspiration.
Sinusitis occurs through an evolution of a carious lesion
From the stage of caries, dental pathology evolves to pulpitis, with interest of deep structures and pulp chamber.
Once the inflammation spreads into the periodontal space, a granuloma or cyst forms at the root tip.
The volume of the cyst increases and with this process comes erosion of the cortical bone, with thinning of the bone protecting the maxillary sinus.
The bone walls will erode and the sinus mucosa will be perforated, with bacterial seeding rapidly advancing into the sinuses.
For bacterial inflammation to reach the maxillary sinuses, it is absolutely necessary that the teeth involved in the caries process are in the vicinity of the maxillary sinus.
For this, the teeth must be located in the lateral region of the upper jaw. Most often, this is the upper lateral premolars and molars.
Signs of maxillary sinusitis are as follows:
Pain – occurs early, shortly after the onset of sinusitis and can range from a simple sensation of pressure to intense pain, especially when bending the head.
Nasal congestion – secretions stop draining so nasal congestion occurs, with varying degrees of breathing impairment.
Coughing – due to purulent secretions that form inside the sinuses as a result of the penetration of bacterial agents, the body reflexively tries to remove them. Thus, coughing is present, as an attempt to clear the sinus cavities.
Dental pain – is present when sinusitis has dental pathology as its starting point.
Altered sense of smell and secretions – the sense of smell suffers and with it comes purulent, yellowish, viscous secretions that cause an unpleasant taste.
Acute sinusitis lasts up to three weeks, whereas chronic sinusitis lasts for more than three months.
In the absence of treatment for the dental caries that caused the sinusitis, the pathological process becomes chronic.
Most commonly, sinusitis affects only one sinus. The situation in which the pathological process involves all the sinus cavities is called parasinusitis and rarely occurs due to dental causes.
Symptomatology and diagnosis
In the diagnosis of sinusitis of the jaw caused by dental carious lesions both clinical examinations and radiographs are of great importance:
Anamnesis provides information about the character of the pain and the situations in which it is accentuated but also information about the secretions, in terms of color and odor.
Imaging, radiological examination and computer tomography can reveal the opacity of the sinuses, which are full of secretions, and inflammation of the mucosa lining the sinus cavity.
Treatment is primarily concerned with the tooth that has caused maxillary sinusitis and can be conservative, i.e. endodontic treatment with root canal sterilization, or surgical, i.e. extraction.
Always, curative treatment is accompanied by specific ENT interventions aimed at clearing the airways by applying decongestants or even surgical treatment.
