From Volume 47, Issue 6, June 2020 | Pages 500-509
This paper, part 3 of the series, discusses the variation in maxillary sinus mucosal thickening when seen on radiographic images and the relation to disease. The role of apical periodontitis in disease of the maxillary sinus and its lining, the stages of endodontic treatment at which problems can arise and how these can be prevented, are considered. Complications involving extruded endodontic materials will also be discussed.
In this third paper on the maxillary sinus and the importance to the Dental Team, the role that chronic apical periodontitis contributes to maxillary sinus disease of endodontic origin is examined, and the modifications to endodontic technique needed to avoid maxillary sinus involvement are discussed.
It is frequently reported that approximately 12% of cases of unilateral maxillary sinusitis are of dental origin.1 Some authors report as high as 75% prevalence.2,3 Considering the prevalence of apical periodontitis in the population, the relatively high proportion of unilateral cases of maxillary sinusitis attributed to odontogenic causes is not reflected in the work load of most Ear Nose and Throat surgeons, or the Oral/Oral and Maxillofacial surgeons who work alongside them. It is therefore quite probable that, while there is an ample supply of case reports and case series of endodontic and periodontal disease contributing to inflammation of the maxillary sinus lining, or suppurative chronic maxillary sinusitis, there may have been bias in patient selection such that the cases presented may not accurately reflect the prevalence within the greater population.
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