Abstract
In the second of this 4-part series we will discuss the removal of teeth closely related to the maxillary sinus, with identification and reduction of risk factors for oro-antral communication and the management of complications.
References
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The Maxillary Sinus: What the General Dental Team Need to Know Part 2: Removal of Teeth; Avoidance and Management of Complications
From Volume 47, Issue 5, May 2020 | Pages 405-414
Article
In part 1 the accurate diagnosis of acute and chronic orofacial pain and headaches was discussed, with reference to the specific diagnostic criteria required for pain related to acute paranasal sinus infection. A variety of symptoms and signs were outlined to facilitate an accurate diagnosis of odontogenic causes of unilateral maxillary pain, thus avoiding incorrect and unnecessary treatment.
When an odontogenic cause is identified, either removal of the tooth or endodontic treatment is indicated. In this second paper of the series the removal of teeth that are intimately related to the maxillary sinus will be discussed, with emphasis on risk assessment and management.
The relation of posterior maxillary teeth to the maxillary sinus is variable for individual patients and specific teeth.1,2 Some patients will have many millimetres of bone between the apices of their posterior maxillary teeth and the maxillary sinus lining, while for some there is none.3 Risk is therefore best assessed for individual teeth, and discussed with the patient as part of the consent process before undertaking any operative procedure. While there is variation in the incidence of oro-antral communications following the removal of various posterior maxillary teeth, there is no percentage that may be reliably quoted to patients as an estimation of risk during the consenting process.
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