In medical practice, there are cases when a person turns to the ENT with complaints of nasal congestion, purulent discharge from it, fever and pulling pain in the cheekbones, but he also needs to undergo treatment at the dentist. This happens if the patient is given odontogenic sinusitis, that is, inflammation of the maxillary sinuses caused by problems with the upper teeth.
Why unhealthy teeth can cause sinusitis
It is very easy to understand why acute odontogenic sinusitis occurs. It is enough to know some of the anatomical features of the human skull. The fact is that the roots of the second premolar, the first and second molars (5, 6 and 7 teeth, respectively) of the upper jaw are located close enough to the maxillary sinuses, and sometimes they enter them. In the presence of odontog
of the infection, the bone layer between the tops of the roots of the teeth and the maxillary sinuses becomes thinner or destroyed, the pathogen easily penetrates the sinuses, and inflammation begins.
Odontogenic sinusitis may occur for the following reasons:
- Periodontitis The connective tissue between the tooth and the alveoli is inflamed, the infection finds its way into the maxillary sinuses.
- Osteomyelitis. Necrotic processes in the bones of the maxilla can move into the maxillary sinuses.
- Cyst of the root of the upper tooth. As it expands, it can erupt in the cranial cavity and cause an inflammatory process.
- Perforation of the maxillary sinus when removing the upper tooth (usually 6-ki). If the root of the tooth enters the maxillary cavity, when it is removed, a fistula remains, which is a gate for infection. With such a complication of tooth extraction, it makes sense to appeal to the maxillofacial surgeon who “closes” the fistula.
- Hit in the sinus filling material. This can happen when ineptly sealing the canals of the upper second premolar, first and second molars. The rejection of a foreign body in the cranial cavity is accompanied by an inflammatory process.
Signs of odontogenic sinusitis
Since the symptoms of the disease are mostly non-specific, it is very difficult to determine odontogenic antritis from them. Often the patient complains of:
- violation of nasal breathing (congestion);
- copious mucous discharge of putrefactive nature with a characteristic color and persistent unpleasant odor;
- pain in the nose and cheekbones;
- pain in the upper jaw in the area of 5, 6 and 7 teeth;
- temperature rise;
- signs of intoxication (general weakness, chills, nausea).
Obviously, these symptoms are very similar to the symptoms of sinusitis, which was a complication of ARVI, for example. In order to correctly diagnose and prescribe the correct treatment, the doctor must take into account the following:
- whether the patient has problems with the upper teeth;
- Has he been treated by a dentist in the recent past (filling or extraction of teeth)?
In addition, the disease has distinctive features.
First, odontogenic sinusitis is diagnosed most often in adults. If symptoms of the disease are found in children, it most likely has a different etiology.
Secondly, the inflammation of the maxillary sinus of odontogenic nature is most often one-sided.
Thirdly, the pus in the cranial cavity has a specific smell, since the inflammatory process is accompanied by bone necrosis.
After analyzing the symptoms and history of the patient, the doctor prescribes a complete blood count, ultrasound or x-ray of the skull. As a rule, the results of blood tests indicate leukocytosis, accelerated ESR. In the picture, the maxillary sinus appears dark.
Odontogenic sinusitis is an insidious disease, the symptoms of which may appear long after the patient has had problems with his teeth.
As soon as the first symptoms have been felt, the patient should consult a doctor and undergo a comprehensive treatment.
How to overcome sinusitis, which arose for odontogenic reasons
This type of sinusitis is treated quite difficult, but, as a rule, the prognosis is favorable.
Comprehensive treatment of the disease is as follows:
- At the first stage it is necessary to eliminate the cause of infection of the maxillary sinus. If the cause of sinusitis has become a problem tooth, it should be removed. The cyst is usually removed simultaneously with the tip of the tooth root. If there is a perforation, carry out a revision of the mucous membrane of the sinus, remove the modified areas of the mucous membrane. In the presence of a foreign body (tooth shard, filling material), it is extracted.
- If perforation is present, surgical intervention is necessary. Measures are being taken to free the maxillary sinus from mucus and pus (exudate). The puncture in this case is done through the upper jaw. After suction of the exudate, the sinus should be washed with a solution of antibacterial and antiseptic agents. Often the procedure has to be repeated. In order not to puncture again, a catheter may be left in the jaw.
- Treatment of sinusitis odontogenic nature without perforation occurs in the same way as if he were rhinogenous. Puncture is done through the nose.
- In parallel, antibiotic treatment is carried out.
- As in the case of antritis of a different etiology, with odontogenic use various ways to eliminate the symptoms: washing and instillation of the nose, physiotherapy and restorative procedures.
In order to avoid odontogenic sinusitis, it is necessary to sanitize the oral cavity in time and trust the dental treatment only to qualified dentists.