MAXILLARY

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MAXILLARY
SINUSITIS
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MAXILLARY SINUSITIS
FROM
DENTAL ORIGIN
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ANATOMY
Pyramid shape

Pseudostratified columnar Ciliated epithelium
Maxillary nerve
Maxillary arteries Facial arteries Infraorbital
arteries Greater palatine arteries
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Wall of maxillary sinus
Superior
Orbit , infraorbital nerve
Alveolar process of maxilla , root of molar
premolar 7,6,8,5,4,3
Inferior
Nasal cavity , middle meatus
Medial
Anterior
Canine fossa, Infraorbital foramen
Posterior
Pterygopalatine fossa
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FUNCTION
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MAXILLARY SINUS
TOOTH
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MAXILLARY SINUSITIS
Infection or Inflammation of the maxillary sinus
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CLINICAL SYMPTOMS
ACUTE SINUSITIS lt 3
weeks SUBACUTE SINUSITIS 3 weeks-3
months CHRONIC SINUSITIS gt 3
months
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SYMPTOMS
Bloked nose Headache Fever Yellow or
green-coloured mucus from the nose Swelling of
the face Aching teeth in the upper jaw Loss of
the senses of smell and taste Persistent
cough Generally feeling unwell
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ETIOLOGY

Allergic responses chemical
irritation Infections
mechanical obstruction Infected maxillary
tooth
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RISK FACTORS
Frequent cold Cigarette smoking Regular use of
nasal decongestant sprays Untreated hay fever or
other allergies Structural abnormalities of the
nose Nasal polyps Dental disease
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MAXILLARY SINUSITIS
FROM
DENTAL ORIGIN
1.Periapical abscess 2.Periodontal
diseases 3.Infected dental cyst 4.Dental material
in antrum 5.Oroantral communication
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1.Periapical abscess
Acute sinusitis Anaerobic organisms
2.Periodontal diseases
Lane ONeal Chronic sinusitis 5 years
irrigation antibiotics
examination communication with the
maxillary sinus via
a periodontal pocket
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3.Infected dental cyst
Periapical cyst Most common of all cysts of
the oral region Epithelium rest of Malassez
The cyst enlarges in to the maxillary sinus

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4.Dental material in antrum
1.Displacement of root extraction third
molar gt second molar gt canine Pa or occlusal
film loss of lamina dura 2.Implant 3.Root
canal overfilling
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5.Oroantal communication
Cause Extraction Trauma
Tumour Cyst
Examination
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SYMPTOMS
1.???????????? ????????????????????????????????? 2
.????????????????????????? 3.???????????????? 4.??
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Treatment
1.????????????????????????? 2. ?????
3.???????????????????????
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1.??????????????????????
Periapical abscess
OCD Extraction
Periodontal diseases
Extraction periodontal surgery
Periapical cyst
enucleation cyst RCT extraction
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1.??????????????????????
Dental material in antrum
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??????
Caldwell luc operation
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1.??????????????????????
Oroantral communication
????????????????????????? ?????????????????
?????????????????????????????????? 7-10 ??? blood
clot ?????????????????? heal ???????????????
??????????????????? (gt 5 ?.?.)????? flap ???
1.Immediate repair 2.Delayed
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???????????? OAC
1.Buccal flap
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???????????? OAC
2.Palatal flap
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Use of third molar transplantation for
closure of the oroantral communication after
tooth extraction Kitagawa et al , ORAL SURGERY


ORAL MEDICIEN ORAL PATHOLOGY,2003,vol 95,409-415

Methods
1. ??????????????????????? 5.??third
molar????????socket???????????? 2.???????????OAC
6.???????????????????????????
???????? 3.??????socket
7.?????????? suture splint ,adhesive
resin 4.???third molar
8.???????????(1????????? transplantation )
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CASE REPORTS
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CASE REPORTS
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conclusions
Tooth transplantation of a mature third molar for
closure of the OAC is a simple and excellent
method because the transplanted tooth not only
closes the communication to the maxillary sinus,
but it also satisfactorily functions at the
recipient site during mastication,even in adult
patients.
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2. ?????
1.antibiotics penicillins ,
ampicillin amoxicilin
500 ??. ????? 3-4 ?????

2.nasal decongestants
Topical agents phenylephrine
HCl 0.5
oxymetazoline HCl 0.05 Oral systemic agents
phenyl propanolamine
pseudoephedrine
2.
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2. ?????
3.????????????????????????
??????? ??????? ???????????? ???????????
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3.???????????????????????

1. Antral puncture and sinus irrigation
2. Intranasal antrostomy or Nasoantral Window
3. Caldwell luc operation

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1.Antral puncture and sinus irrigation
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2.Intranasal antrostomy or Nasoantral Window
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3.Caldwell luc operation
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3.Caldwell luc operation
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conclusions
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References

• David A. Mcgowan, Prudence W. Baxter,
  Jacqueline Jame The maxillary sinus and its
  dental implication , British library cataloguing
  in publication data 1993
• Yoshimasa Kitagawa, Use of third
  molartransplantation for closure of the
  oroantral communication after tooth extraction
  , ORAL SURGERY
  
  ORAL MEDICIEN ORAL PATHOLOGY
  2003,95,409-414
• www.dentalgentlecare.com/sinus_headaches_and_denta
  l_health.htm
• ????????? ???????????????????????????????????????
  ???,????260-274
• ???????? ??????????? ????????????????????????????
  ?????????????????,2542,391-408

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