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Corvino A, Catalano O, Wortsman X, Roldán FA, Cavallieri F, Gonzalez C, Tafuri D, Corvino F, Cocco G, Caruso M. High-Resolution Ultrasound of Odontogenic Cutaneous Sinus Tract: An International Multicentric Experience and a Review of the Literature. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1489-1499. [PMID: 38708914 DOI: 10.1002/jum.16471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES To investigate the role of high-resolution ultrasound (HR-US) in the initial and differential diagnosis of the Odontogenic Cutaneous Sinus Tract (OCST) in a multicentric setting. METHODS Skin HR-US examinations of OCSTs performed between January 2019 and June 2023 at different Institutions were retrospectively reviewed. Epidemiological and clinical data (age, gender, location of the skin lesion, causative tooth, and the clinical suspicion) as well as HR-US imaging findings (morphology and length of the sinus tract, Doppler signal, and cortical bone interruption of maxilla or mandible) were collected. US examinations were performed by expert radiologists using a high-performance US scanner, employing a high-frequency linear probe (15 MHz or higher frequencies). In only one patient the HR-US exam was integrated with strain elastography (SE). RESULTS Sixteen patients were enrolled with a median age of 37.6 years (range 16-70 years). The most frequent clinical suspicion was epidermal cyst, while OCST was suspected in only two cases. In all cases, HR-US depicted the sinus tract as a nodular, triangular or "champignon-shaped" lesion in the subcutaneous layer, which continued with a slightly tortuous band structure, up to the focally interrupted cortical bone plate. Furthermore, color Doppler evaluation showed color signals around and/or within the lesion, expression of inflammation. On SE, the sinus tract showed a hard pattern, due to fibrous and granulomatous tissue. CONCLUSIONS HR-US, thanks to its high spatial resolution, allows the evaluation of OCST, and play a crucial diagnostic role, mainly when the clinical suspicious is different.
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Affiliation(s)
- Antonio Corvino
- Medical, Movement and Wellbeing Sciences Department, University of Naples "Parthenope", Naples, Italy
| | | | - Ximena Wortsman
- Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues Clinic, University of Chile and Pontifical Catholic University of Chile, Santiago, Chile
| | - Fernando Alfageme Roldán
- Dermatologic Ultrasound and Hidradenitis Suppurativa Unit, Hospital Universitario Puerta De Hierro Majadahonda, Madrid, Spain
| | | | - Claudia Gonzalez
- Universidad del Rosario, Private Practice, Ultrasonido Altamente Especializado, Bogotá, Colombia
| | - Domenico Tafuri
- Medical, Movement and Wellbeing Sciences Department, University of Naples "Parthenope", Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Naples, Italy
| | - Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Martina Caruso
- Advanced Biomedical Sciences Department, University of Naples Federico II, Naples, Italy
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Silva EJNL, Pinto KP, Versiani MA, Sassone LM. Dental Pathophysiology of Odontogenic Sinusitis: Endodontic Infections. Otolaryngol Clin North Am 2024:S0030-6665(24)00092-6. [PMID: 39089983 DOI: 10.1016/j.otc.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
Bacterial odontogenic sinusitis (ODS) arises from maxillary dental issues or oral procedures, and affects at least the maxillary sinuses, with or without other paranasal sinus involvement. It has been historically underreported, in contrast to more recent findings attributing 25-40% of chronic maxillary sinusitis to dental causes. Endodontic infections represent one of the most common causes of ODS. Endodontic factors like root canal infection and microbial proximity to sinus cavities play pivotal roles. Host immunological responses further shape disease severity and progression. This article aims to explore the complexity of endodontic infections that cause ODS, elucidating anatomical, microbial, and immunological aspects.
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Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Integrated Clinical Procedures, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil; Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil.
| | - Karem Paula Pinto
- Department of Integrated Clinical Procedures, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | | | - Luciana Moura Sassone
- Department of Integrated Clinical Procedures, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
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Kim CY, Takeshita Y, Kugimoto T, Harada H, Park JS, Tubbs RS, Iwanaga J. Anatomy of the Buccal Space: Surgical and Radiological Perspectives. J Craniofac Surg 2024:00001665-990000000-01720. [PMID: 38885157 DOI: 10.1097/scs.0000000000010411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/18/2024] [Indexed: 06/20/2024] Open
Abstract
Among the anatomical spaces in the head and neck area, the buccal space has often been studied in dental/oral surgery and cosmetic surgery because it contains the facial vessels, mandibular and facial nerves, and adipose tissue called the buccal fat pad. In addition, as the space can communicate with other spaces, it can be significant in infections. Although the anatomy of the buccal space has been reported in several studies, there have been discrepancies concerning its boundaries, and its communications have often been overlooked. The aim of this review is to examine the anatomy of buccal space including its boundaries, contents, continuity with adjacent spaces, and clinical significance. A literature review was performed on Google Scholar and PubMed. The literature has depicted the anterior, medial, and lateral boundaries more or less consistently, but descriptions of the posterior, superior, and inferior borders are controversial. The buccal space includes the facial arteries, veins, facial nerves, parotid duct, and lymph nodes, which can be described differently depending on definitions and the extent of the space. As it communicates with other anatomical spaces including the masticatory space, it can be a reservoir and a channel for infections and tumors. Buccal fat pads have various clinical applications, from a candidate for flap reconstruction to a target for removal for cosmetic purposes. This review will help understand the anatomy of the buccal space including its boundaries, residing structures, and communication with other spaces from surgical and radiological perspectives.
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Affiliation(s)
- Chung Yoh Kim
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - Takuma Kugimoto
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jin Seo Park
- Department of Anatomy, Dongguk University School of Medicine, Gyeongju, Republic of Korea
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
- Department of Structural and Cellular Biology, Tulane University School of Medicine
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA
- University of Queensland, Brisbane, Australia
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
- Department of Structural and Cellular Biology, Tulane University School of Medicine
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Dental and Oral Medical Center, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
- Department of Anatomy, Division of Gross and Clinical Anatomy, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
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Wang A, Zhao C, Li Q, An Y, Xue J, Wang M. Repair of Oroantral Fistulas Using Free Bone and Mucoperiosteal Flaps After Endoscopic Removal of the Medial Wall of the Maxillary Sinus. J Craniofac Surg 2023:00001665-990000000-01236. [PMID: 37983370 DOI: 10.1097/scs.0000000000009911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 10/28/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION Oroantral fistula (OAF) refers to a pathological connection between the oral cavity and maxillary sinus. It may lead to symptoms that include purulent mucus, nasal congestion, facial swelling, bad breath, and nasal regurgitation of food, all of which negatively impact patients' quality of life. OBJECTIVE This study presents a novel approach for OAF repair using a 2-layered structure composed of free bone and a mucoperiosteal flap obtained from the medial wall of maxillary sinus. MATERIALS AND METHODS Ten OAF patients who underwent repair using this method were retrospectively reviewed between August 2015 and June 2022. RESULTS The extraction of maxillary molars was the most common cause of OAF. The size of the fistulas ranged from 1×2 mm to 5×8 mm. Nine of the 10 patients achieved successful OAF closure following the initial operation using the 2-layer structure composed of free bone and mucoperiosteal flag. One patient was lost to follow-up. The 9 patients were observed for 6 months to 1 year, and they exhibited no obvious complications or recurrence. CONCLUSION The use of free bone and mucoperiosteal flag from the medial wall of maxillary sinus through an endoscope was effective for OAF repair.
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Affiliation(s)
- Ai Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan
| | - Changqing Zhao
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan
| | - Qingfeng Li
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan
| | - Yunfang An
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan
| | - Jinmei Xue
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Hospital of Shanxi Medical University, Taiyuan
| | - Min Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University People's Hospital, Beijing, People's Republic of China
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Alghofaily M, Alsufyani N, Althumairy RI, AlSuhaibani A, Alfawzan F, AlSadhan L. Odontogenic Factors Associated with Maxillary Sinus Schneiderian Membrane Thickness and their Relationship to Chronic Sinonasal Symptoms: An Ambispective Cohort Study. Diagnostics (Basel) 2023; 13:2710. [PMID: 37627969 PMCID: PMC10453369 DOI: 10.3390/diagnostics13162710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/13/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Odontogenic sinusitis is a common maxillary sinus disease. It develops due to the violation of the Schneiderian membrane due to pathological, iatrogenic, or traumatic causes from dental and dentoalveolar structures. The aim of this cohort study was to investigate local and systemic factors associated with Schneiderian mucosal thickening (MT) in patients referred for evaluation of apical periodontitis (AP) and examine their relationship with chronic sinonasal symptoms. Cone-beam computed tomography (CBCT) scans of 197 patients referred for evaluation of endodontic diseases were reviewed. Mucosal thickening in relation to the affected tooth was measured in the coronal section in millimeters at the maximum area perpendicular to the bone. Based on this measurement, the sinus floor was categorized for MT as present (>1 mm) or absent (<1 mm). The sociodemographic and clinical characteristics of the study participants were assessed and compared according to the presence or absence of MT. Furthermore, the relationship between odontogenic sinusitis and chronic sinonasal symptoms was assessed using a chronic sinusitis survey. Male patients had a higher MT than female patients. The presence of periapical lesions and inadequate endodontic treatment were significantly associated with MT. The multivariate logistic regression model showed that the presence of AP increased the odds of MT by approximately 2.5 times (p = 0.028), and nasal obstruction was significantly higher in patients diagnosed with mucosal thickness at different times of their follow-up period (p = 0.018). MT was 2.5 times more likely in the presence of apical periodontitis, and nasal obstruction was the most significant factor associated with the presence of MT.
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Affiliation(s)
- Maha Alghofaily
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia
| | - Noura Alsufyani
- Oral & Maxillofacial Radiology, Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia
- School of Dentistry, Department of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Riyadh I. Althumairy
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia
| | - Amal AlSuhaibani
- College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia; (A.A.); (F.A.); (L.A.)
| | - Fatimah Alfawzan
- College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia; (A.A.); (F.A.); (L.A.)
| | - Lama AlSadhan
- College of Dentistry, King Saud University, Riyadh 11461, Saudi Arabia; (A.A.); (F.A.); (L.A.)
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Grillo R, Balel Y, Brozoski MA, Ali K, Adebayo ET, Naclério-Homem MDG. A global science mapping analysis on odontogenic infections. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023:101513. [PMID: 37207960 DOI: 10.1016/j.jormas.2023.101513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVES Odontogenic infections are common and a topic of core interest for dentists, and maxillofacial surgeons. The aim of this study was to conduct a bibliometric analysis of the global literature on odontogenic infection and explore the top 100 most cited papers to identify the common causes, sequelae and management trends. METHODS Following a comprehensive literature search, a list of top 100 most cited papers was created. The VOSviewer software (Leiden University, The Netherlands) was used to create a graphical representation of the data, and statistical analyses were performed to analyze the characteristics of the top 100 most cited papers. RESULTS A total of 1,661 articles were retrieved with the first article published in 1947. There is an exponential upward trend on the number of publications (R2 = 0.919) and a majority of papers are in English language (n = 1,577, 94.94%). A total of 22,041 citations were found with a mean of 13.27 per article. The highest number of publications were recorded from developed countries. There was a male predilection in the reported cases and the most common sites included the submandibular and parapharyngeal spaces. Diabetes mellitus was identified as the commonest co-morbidity. Surgical drainage was ascertained to be the preferred method of management. CONCLUSIONS Odontogenic infections remain prevalent and have a global distribution. Although prevention of odontogenic infection through meticulous dental care is ideal, early diagnosis and prompt management of established odontogenic infections is important to avoid morbidities and mortality. Surgical drainage is the most effective management strategy. There is lack of consensus regarding the role of antibiotics in the management of odontogenic infections.
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Affiliation(s)
- Ricardo Grillo
- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Brazil; Department of Oral & Maxillofacial Surgery, Faculdade Patos de Minas, Brasília, Brazil.
| | - Yunus Balel
- Department of Oral and Maxillofacial Surgery, Gaziosmanpasa University, Gaziosmanpasa, Turkey
| | - Mariana Aparecida Brozoski
- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Brazil
| | - Kamran Ali
- College of Dental Medicine, Qatar University, Doha, Qatar
| | - Ezekiel Taiwo Adebayo
- Department of Oral and Maxillofacial Surgery, University of Medical Sciences, Ondo, Nigeria
| | - Maria da Graça Naclério-Homem
- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis - Faculty of Dentistry of the University of São Paulo, Brazil
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Hanaki S, Katayama S, Watanabe Y. Odontogenic Cutaneous Sinus Tract in a 10-Year-Old Girl: A Case Report of a Rare Entity. Cureus 2023; 15:e39156. [PMID: 37378112 PMCID: PMC10292100 DOI: 10.7759/cureus.39156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/29/2023] Open
Abstract
Odontogenic cutaneous sinus tract (OCST) is defined as pulp necrosis caused by dental caries or trauma that forms a fistula on the body surface as a drainage channel for the infected pulp. OCST can be difficult to diagnose because subjective symptoms, such as pain in the affected tooth, may be minimal. In addition, lesions in the cervical region are extremely rare. In this report, we discuss the case of a 10-year-old girl who presented with inflammation, edema, and purulent exudation on the right neck. Her symptoms resembled those of lateral cervical cysts and fistulas. However, upon evaluation, she was diagnosed with OCST. Although OCST is an important differential diagnosis for head and neck lesions, it is often overlooked. OCST should be considered in the differential diagnosis of neck masses and fistulas.
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Affiliation(s)
- Shojiro Hanaki
- Division of Pediatric Surgery, Department of General Surgery, Kurashiki Central Hospital, Kurashiki, JPN
| | - Shuichi Katayama
- Division of Pediatric Surgery, Department of General Surgery, Kurashiki Central Hospital, Kurashiki, JPN
| | - Yoshihisa Watanabe
- Division of Pediatric Surgery, Department of General Surgery, Kurashiki Central Hospital, Kurashiki, JPN
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CBCT Evaluation of Periapical Pathologies in Maxillary Posterior Teeth and Their Relationship with Maxillary Sinus Mucosal Thickening. Healthcare (Basel) 2023; 11:healthcare11060787. [PMID: 36981444 PMCID: PMC10048390 DOI: 10.3390/healthcare11060787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/23/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
In modern dentistry, radiographic imaging is crucial for examining the connection between the maxillary sinus floor and the root apices of the maxillary posterior teeth, particularly when the periapical region is affected by pathology that could result in infectious, inflammatory, or traumatic changes in the maxillary sinus. This study aimed to investigate the prevalence of periapical pathologies in the maxillary posterior teeth and their relationship with maxillary sinus mucosal thickening by using cone-beam computed tomography scans. This retrospective study was conducted on 420 digitized CBCT images which were scanned in sagittal, axial, and coronal views. Out of 420 total images, 223 (53.1%) were of males and 197 (44.9%) were of females. The data were analyzed using SPSS version 28. A total of 2936 posterior maxillary teeth were tested for periapical pathology (PP), 1477 on the right side and 1459 on the left side. In terms of gender, there was no significant relationship between PP in maxillary posterior teeth on both sides and mucosal thickness of the maxillary sinus (p > 0.05). A significant relationship was found between PP in maxillary posterior teeth on both sides and maxillary sinus mucosal thickening (p < 0.05). This study concluded that the prevalence of periapical pathology in the maxillary posterior teeth was significantly associated with a rise in the incidence of maxillary sinus mucosal thickening. Moreover, the primary causative factor for the pathophysiology of the odontogenic maxillary sinus was the periapical pathology in both maxillary first molars.
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Chourasia HR, Odabi AI, Owis AA, Dahas ZA, Bokhari AM, Mashyakhy M, Jabali AH. Evaluation of Root Canal Morphology of Maxillary Second Premolars and Its Relation to Maxillary Sinus in a Saudi Arabian Population. J Contemp Dent Pract 2023; 24:35-41. [PMID: 37189010 DOI: 10.5005/jp-journals-10024-3456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
AIM This study aimed to evaluate the root canal anatomy of maxillary second premolars, and its relation to the maxillary sinus in a Saudi Arabian population using cone-beam computed tomography. MATERIALS AND METHODS Records of 301 patients (602 Teeth) were obtained from a Cone-beam Computed Tomography Database of the College of Dentistry, Jazan University from February 2020 to January 2022. The number of roots, root canals, and the relationship between the root apices of maxillary second premolars and the floor of the maxillary sinuses were studied. The data was recorded, tabulated, and statistically analyzed. RESULTS A majority of maxillary second premolars were single-rooted (78.74%), followed by double-rooted (20.76%) and three-rooted (0.5%). Two canals (59.1%) were seen in the majority of the examined teeth, followed by one canal (40.4%) and three canals (0.5%). The roots of the maxillary second premolars were predominantly (69.17%) outside the sinus. Nineteen percent of roots were in contact with the floor of the maxillary sinus with no significant difference between buccal and palatal roots, and around twelve percent (11.73%) of roots were inside the maxillary sinus. CONCLUSIONS The root canal system morphology of maxillary second premolars showed a wide range of anatomical variations in the Saudi Arabian population with a predominance of single roots. Most of the roots were located outside the sinus followed by in contact and then inside the sinus. Three-rooted second premolars were exceedingly rare. CLINICAL SIGNIFICANCE The cognizance of maxillary second premolar root canal anatomy and its relation to maxillary sinus would be a valuable affirmation for dentists of different nationalities treating the Saudi Arabian population to ensure a successful endodontic treatment.
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Affiliation(s)
- Hemant Ramesh Chourasia
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia, Phone: +966509795107, e-mail:
| | - Ali I Odabi
- Dental Department, Sabya General Hospital, Ministry of Health, Jazan, Saudi Arabia
| | - Alhassan A Owis
- Resident in Endodontic, King Abdulaziz University Dental Hospital, Saudi Arabia
| | - Zarah A Dahas
- Resident in Endodontic, King Faisal Specialist Hospital & Research Centre, Saudi Arabia
| | - Ahmed M Bokhari
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
| | - Mohammed Mashyakhy
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
| | - Ahmad H Jabali
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
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Şanal Çikman A, Köse TE, Günaçar DN, Çene E, Arıcıoğlu B. Evaluation of endodontically treated teeth and related apical periodontitis using periapical and endodontic status scale: Retrospective cone-beam computed tomography study. AUST ENDOD J 2022; 48:431-443. [PMID: 35690589 DOI: 10.1111/aej.12638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 10/15/2021] [Accepted: 05/15/2022] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to evaluate the technical treatment quality and the status of apical pathology of endodontically treated teeth, as well as apical periodontitis (AP) prevalence, in a Turkish population using cone-beam computed tomography (CBCT). The CBCT images obtained between January 2018 and April 2020 were retrospectively examined. The quality of the endodontic treatments and the related periapical inflammatory lesions were classified according to the periapical and endodontic status scale (PESS). The data were statistically analysed using logistic regression, crosstabs and chi-square tests. AP was detected in 41% of 429 endodontically treated teeth. The prevalence of AP was significantly higher in teeth with inadequate root canal treatment compared with those with adequate treatment, 70.8% and 29.3%, respectively. Inadequate canal length and homogeneity, and complications were significantly associated with the prognostic periapical status scores of higher risk.
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Affiliation(s)
- Ahter Şanal Çikman
- Department of Endodontics, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Taha Emre Köse
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Dilara Nil Günaçar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Erhan Çene
- Department of Statistics, Faculty of Arts and Science, Yıldız Technical University, Istanbul, Turkey
| | - Banu Arıcıoğlu
- Department of Endodontics, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
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Are We Missing Something in the CT-PNS Report? – an Observational Study on the Rate of Reporting the Presence of Dental Disease and the Probable Etiology of Sinusitis on CT Scans. J Belg Soc Radiol 2022; 106:109. [DOI: 10.5334/jbsr.2740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
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Estrela CRA, Bueno MR, Estrela MRA, Estrela LRA, Guedes OA, Azevedo BC, Cintra LTA, Estrela C. Frequency and Risk Factors of Maxillary Sinusitis of Endodontic Origin evaluated by a Dynamic Navigation and a New Filter of Cone-Beam Computed Tomography. J Endod 2022; 48:1263-1272. [DOI: 10.1016/j.joen.2022.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
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Serindere G, Bilgili E, Yesil C, Ozveren N. Evaluation of maxillary sinusitis from panoramic radiographs and cone-beam computed tomographic images using a convolutional neural network. Imaging Sci Dent 2022; 52:187-195. [PMID: 35799961 PMCID: PMC9226235 DOI: 10.5624/isd.20210263] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/14/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Gozde Serindere
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Ersen Bilgili
- Department of Dentomaxillofacial Radiology, Izmir Education Dental Hospital, Izmir, Turkey
| | - Cagri Yesil
- Department of Computer Engineering, Faculty of Engineering, Yeditepe University, İstanbul, Turkey
| | - Neslihan Ozveren
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey
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Robaian A, Alqhtani NR, Alghomlas ZI, Alzahrani A, Almalki AK, Al Rafedah A, Al Abdulsalam A, Alzahrani KM. Vertical relationships between the divergence angle of maxillary molar roots and the maxillary sinus floor: A cone-beam computed tomography (CBCT) study. Saudi Dent J 2021; 33:958-964. [PMID: 34938038 PMCID: PMC8665178 DOI: 10.1016/j.sdentj.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/26/2021] [Accepted: 08/01/2021] [Indexed: 11/19/2022] Open
Abstract
AIM To assess the relations between the divergence angle of the maxillary molar roots and their proximity to the maxillary sinus floor using CBCT. METHOD This study comprised CBCT scans of the maxilla, including at least the inferior one-third of the maxillary sinus and at least one molar present in any quadrant with complete eruption and root formation. Evaluation included the vertical relations between the maxillary molar root apices and the maxillary sinus floor (MSF), and the root divergence was measured from the root apices to the floor of the pulp chamber. The chi-square test was used for the associations between the study parameters. For the correlation between root divergence angles and MSF vertical relationship types, the Spearman test was used. A P-value < 0.05 was considered significant. RESULTS A total of 100 scans were analyzed, including 316 permanent maxillary first and second molars. The MSF Type II vertical relationship was the most prevalent (39.6%), followed by Type I (31.3%). The highest divergence angle was found between the distobuccal and palatal roots (mean = 44.9 ± 10.5°). For the mesiobuccal-distobuccal angle groups, there were higher percentages of the MSF Type I and II relationships among the angle groups < 1° and 21-45°. For the mesiobuccal-palatal angle groups, a higher prevalence of the MSF Type II relationship was found in the <21⁰ and >45⁰ angle groups, and a higher prevalence of the Type I relationship was found in the 21-45⁰ angle group. For the distobuccal-palatal angle groups, higher percentages of the MSF Type II relationship were found in the three angle groups. For all teeth, there was a significant positive correlation between the MSF vertical relationship and the mesiobuccal-palatal angle (r = 0.116; P = 0.039). CONCLUSION There was a positive correlation between the divergence angle of the roots and their vertical relationship with the MSF. Clinicians should assess the divergence between the roots before performing extraction or endodontic treatments.
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Affiliation(s)
- Ali Robaian
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Nasser Raqe Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | | | - Adel Alzahrani
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Ali Al Rafedah
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | | | - Khaled M. Alzahrani
- Department of Prosthetic Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
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Shaul Hameed K, Abd Elaleem E, Alasmari D. Radiographic evaluation of the anatomical relationship of maxillary sinus floor with maxillary posterior teeth apices in the population of Al-Qassim, Saudi Arabia, using cone beam computed tomography. Saudi Dent J 2021; 33:769-774. [PMID: 34803332 PMCID: PMC8589617 DOI: 10.1016/j.sdentj.2020.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/07/2020] [Accepted: 03/10/2020] [Indexed: 11/29/2022] Open
Abstract
Background & objective In current clinical dental practice radiographic imaging plays a major role in exploring the relationship between the maxillary sinus floor (MSF) and maxillary posterior teeth root apices, especially when there is an involvement of pathology in the periapical area that may lead to infectious, inflammatory or traumatic changes in the maxillary sinus (MS). It is also essential for exact implant placement, and therapeutic and surgical plans. The prevalence of different forms of anatomic relationship of the MSF to posterior root apices from one population to another is large. Hence the current research was conceived to evaluate the horizontal and vertical relationship forms of posterior root apices to the MSF in the Al-Qassim population of Saudi Arabia using Cone Beam Computed Tomography (CBCT). Materials and methods To conduct the study, a total of 200 patients' data (100 male and 100 female) were taken from the archives. The linear distances of the root apices to the MSF were measured for maxillary posterior teeth. On cross-sectional CBCT images, the Kwak et al. criteria were used to assess the horizontal and vertical relationships between the root apices of maxillary posterior teeth and the MSF. Results The mean distance between the apices of the maxillary second premolar ranged from 4.63 mm to 6.49 mm. The mean value of the distance between the apices of the posterior teeth and the MSF had a range of 0.68 ± 0.39 mm on the disto-buccal root (DBR) of the maxillary right second molar to 3.93 ± 1.26 mm on the palatal root (PR) of the maxillary left first molar. A similar result was observed in the maxillary second molar DBR in the male group (0.68 ± 1.17 mm) and the female group (0.69 ± 1.17 mm). The most frequently observed vertical relations were type 2 and type 2H horizontal relations. Conclusion This study concludes that maxillary molar roots show greater proximity with the MSF when compared with premolars, and that the type 2 vertical and type 2H horizontal distribution suggests that the anatomy of each tooth and the maxillary sinus floor should be evaluated by CBCT prior to treatment planning.
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Affiliation(s)
- K Shaul Hameed
- Department of Oral and Maxiilofacial Radiology, College of Dentistry, Qassim University, Al-Qassim, Saudi Arabia
| | - Elsantawy Abd Elaleem
- Department of Oral and Maxiilofacial Radiology, College of Dentistry, Qassim University, Al-Qassim, Saudi Arabia
| | - Dhafer Alasmari
- Department of Periodontology & Oral Medicine, College of Dentistry, Qassim University, Saudi Arabia
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AKKEMİK KIPÇAK Ö. Maksiller Sinüs Patolojilerinin ve Schneider Membran Değişikliklerinin Odontojenik Faktörlerle İlişkisinin Konik Işınlı Bilgisayarlı Tomografi Kullanılarak Değerlendirilmesi. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.30934/kusbed.885882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Siqueira JF, Lenzi R, Hernández S, Alberdi JC, Martin G, Pessotti VP, Bueno-Camilo FG, Ferrari PH, Furtado MA, Cortes-Cid VO, Pérez AR, Alves FR, Rôças IN. Effects of Endodontic Infections on the Maxillary Sinus: A Case Series of Treatment Outcome. J Endod 2021; 47:1166-1176. [DOI: 10.1016/j.joen.2021.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 12/13/2022]
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Gürhan C, Şener E, Mert A, Şen GB. Evaluation of factors affecting the association between thickening of sinus mucosa and the presence of periapical lesions using cone beam CT. Int Endod J 2020; 53:1339-1347. [PMID: 32627204 DOI: 10.1111/iej.13362] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 12/27/2022]
Abstract
AIM To evaluate the effect of various parameters of periapical lesion(s) on the amount and type of mucosal thickening using cone beam CT images. METHODOLOGY CBCT scans of 1000 patients were evaluated retrospectively for the presence of apical lesions in maxillary posterior teeth associated with sinus mucosal thickening. The number of cases with pathological mucosal thickening was recorded and classified according to the amount and type of mucosal thickening. The parameters evaluated as the cause of mucosal thickening were the type and number of posterior teeth, number of root(s), diameter of the periapical lesion and distance between maxillary sinus and lesion. Descriptive statistics and multiple logistic regression was used for data analyses. Spearman's correlation coefficient was used for pair-wise comparisons. Intrarater reliability was tested by Cohen's kappa. RESULTS Mucosal thickening associated with periapical lesions was determined in 48% of 202 cases. The most frequently detected extent of mucosal thickening was type 3 (42%), whereas flat type thickening (59%) was the most frequent type. The tooth most frequently associated with mucosal thickening was the maxillary first molar (44%). Parameters significantly affecting the extent of mucosal thickening were gender, number of roots, number of teeth with periapical lesions and diameter of periapical lesions (P < 0.05). The single parameter with an association with the type of mucosal thickening was the number of roots with an apical lesion (P < 0.05). CONCLUSION Mucosal thickening associated with periapical lesions was observed in almost 50% of all mucosal thickening cases. Therefore, collaboration amongst endodontists and otolaryngologists is mandatory to provide successful treatment and prevent recurrence of maxillary sinusitis.
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Affiliation(s)
- C Gürhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - E Şener
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - A Mert
- Department of Statistics, Faculty of Science, Ege University, Izmir, Turkey
| | - G B Şen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ege University, Izmir, Turkey
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Souza-Nunes LAD, Verner FS, Rosado LDPL, Aquino SND, Carvalho ACP, Junqueira RB. Periapical and Endodontic Status Scale for Endodontically Treated Teeth and Their Association with Maxillary Sinus Abnormalities: A Cone-beam Computed Tomographic Study. J Endod 2019; 45:1479-1488. [PMID: 31630784 DOI: 10.1016/j.joen.2019.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 08/26/2019] [Accepted: 09/05/2019] [Indexed: 12/29/2022]
Abstract
INTRODUCTION This retrospective cross-sectional study investigated the applicability of the periapical and endodontic status scale (PESS) to determine the association of endodontically treated teeth with maxillary sinus (MS) abnormalities through cone-beam computed tomographic imaging. METHODS A total of 631 endodontically treated teeth were analyzed. MS abnormalities were classified as mucosal thickening, sinus polyp, antral pseudocyst, nonspecific opacification, periostitis, and antral calcification. The PESS was used to evaluate the quality of endodontic treatment as well as periapical tissue conditions. The data were analyzed by chi-square tests (P < .05). RESULTS MS abnormalities were detected in 70.52% of the sample, with a greater prevalence of mucosal thickening (38.19%), whereas periapical lesions were observed in 55.94% of the cases. Treated root canals with unsatisfactory filling, homogeneity, and coronal sealing had an odds Ratio (OR) of 2.21, 2.88, and 2.99, respectively (P < .001). Periapical lesions larger than 5 mm (OR = 314.95), in more than 1 root (OR = 3.72), involving the furcation region (OR = 5.21), in contact with important structures (OR = 7.37), and with cortical bone destruction (OR = 4.09) were significantly related to the presence of MS abnormalities (P < .001). An OR of 99,668 was observed in periostitis lesions greater than 5 mm (P < .001). CONCLUSIONS The PESS proved to be an important tool for the analysis of endodontic and periapical conditions and was applicable to determine potential associations with MS abnormalities.
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Affiliation(s)
| | - Francielle Silvestre Verner
- Department of Dentistry, Division of Oral Radiology, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Lucas de Paula Lopes Rosado
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Sibele Nascimento de Aquino
- Department of Dentistry, Division of Oral Pathology, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | | | - Rafael Binato Junqueira
- Department of Dentistry, Division of Endodontics, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
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20
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Weiss R, Read-Fuller A. Cone Beam Computed Tomography in Oral and Maxillofacial Surgery: An Evidence-Based Review. Dent J (Basel) 2019; 7:dj7020052. [PMID: 31052495 PMCID: PMC6631689 DOI: 10.3390/dj7020052] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 12/24/2022] Open
Abstract
Cone Beam Computed Tomography (CBCT) is a valuable imaging technique in oral and maxillofacial surgery (OMS) that can help direct a surgeon’s approach to a variety of conditions. A 3-dimensional analysis of head and neck anatomy allows practitioners to plan appropriately, operate with confidence, and assess results post-operatively. CBCT imaging has clear indications and limitations. CBCT offers the clinician 3-dimensional and multi-planar views for a more accurate diagnosis and treatment without the financial burden and radiation exposure of conventional computed tomography (CT) scans. Furthermore, CBCT overcomes certain limitations of 2-dimensional imaging, such as distortion, magnification, and superimposition. However, CBCT lacks the detailed depiction of soft tissue conditions for evaluation of pathologic conditions, head and neck infections, and temporomandibular joint (TMJ) disc evaluation. This review evaluates the evidence-based research supporting the application of CBCT in the various fields of oral and maxillofacial surgery, including dentoalveolar surgery, dental implants, TMJ, orthognathic surgery, trauma, and pathology, and will assess the value of CBCT in pre-operative assessment, surgical planning, and post-operative analysis when applicable. Additionally, the significant limitations of CBCT and potential areas for future research will be discussed.
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Affiliation(s)
- Robert Weiss
- Department of Oral and Maxillofacial Surgery, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
- Baylor Scott and White Health, Baylor University Medical Center-Dallas, Dallas, TX 75246, USA.
| | - Andrew Read-Fuller
- Department of Oral and Maxillofacial Surgery, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
- Attending Physician, Baylor Scott and White Health, Baylor University Medical Center-Dallas, Dallas, TX 75246, USA.
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Bajoria AA, Sarkar S, Sinha P. Evaluation of Odontogenic Maxillary Sinusitis with Cone Beam Computed Tomography: A Retrospective Study with Review of Literature. J Int Soc Prev Community Dent 2019; 9:194-204. [PMID: 31058071 PMCID: PMC6489515 DOI: 10.4103/jispcd.jispcd_435_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/21/2019] [Indexed: 12/20/2022] Open
Abstract
Aim and Objectives: The purpose of this study was to describe the radiographic characteristics of odontogenic maxillary sinusitis as seen on cone beam computed tomography (CBCT) scans and determine whether any tooth or any tooth root, was more frequently associated with this disease. Materials and Methods: The present study included 500 CBCT images that included the entire maxillary sinus of both the sides in all the three planes. The modified classification of Abrahams and Glassberg was used to assess maxillary sinusitis of odontogenic origin. Furthermore, the proximity of the tooth root to the sinus floor, periapical pathology, and the septae within the maxillary sinus were also assessed. Results: In the present study, 1000 hemimaxillas were analyzed. Majority of the cases (74.9%) the apex of either tooth was touching the floor of the sinus. While 16.9% were in close relationship to the sinus while 8.2% of the cases, the apices were present within the sinus. Furthermore, in the present study, 38 of the total cases had an odontogenic cause of maxillary sinusitis, whereas 273 of them had a nonodontogenic cause, 96 have an undetermined cause, and the rest 593 cases had healthy sinus. Conclusion: The incidence of odontogenic sinusitis is likely under-reported in the available literature. The introduction of low-dose CBCT is particularly useful to establish a definitive diagnosis to augment in the treatment of chronic maxillary sinusitis of odontogenic origin.
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Affiliation(s)
- Atul Anand Bajoria
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Shromona Sarkar
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Pallawi Sinha
- Consultant Prosthodontist, KIIT University, Bhubaneswar, Odisha, India
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Chang LS. Common pitfall of plastic surgeon for diagnosing cutaneous odontogenic sinus. Arch Craniofac Surg 2018; 19:291-295. [PMID: 30613093 PMCID: PMC6325334 DOI: 10.7181/acfs.2018.02110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 10/16/2018] [Indexed: 11/13/2022] Open
Abstract
Dental origins are a common cause of facial cutaneous sinus tracts. However, it can be easily overlooked or misdiagnosed if not suspected by a surgeon who is not familiar with dental origins. Cutaneous odontogenic sinuses are typically nodulocystic lesions with discharge and are most frequently located on the chin or jaw. This article presents two cases of unusual cutaneous odontogenic sinus presentations, as deep dimpling at the middle of the cheek. The patients were undergone surgical excision of sinus tract and dimpling immediate before and after treatment of causal teeth and the lesions resolved without recurrence. Surgeons should consider dental origins of facial dimpling lesions with discharge and provide appropriate treatment.
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Affiliation(s)
- Lan Sook Chang
- Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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23
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Murata M, Ariji Y, Ohashi Y, Kawai T, Fukuda M, Funakoshi T, Kise Y, Nozawa M, Katsumata A, Fujita H, Ariji E. Deep-learning classification using convolutional neural network for evaluation of maxillary sinusitis on panoramic radiography. Oral Radiol 2018; 35:301-307. [PMID: 30539342 DOI: 10.1007/s11282-018-0363-7] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/20/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To apply a deep-learning system for diagnosis of maxillary sinusitis on panoramic radiography, and to clarify its diagnostic performance. METHODS Training data for 400 healthy and 400 inflamed maxillary sinuses were enhanced to 6000 samples in each category by data augmentation. Image patches were input into a deep-learning system, the learning process was repeated for 200 epochs, and a learning model was created. Newly-prepared testing image patches from 60 healthy and 60 inflamed sinuses were input into the learning model, and the diagnostic performance was calculated. Receiver-operating characteristic (ROC) curves were drawn, and the area under the curve (AUC) values were obtained. The results were compared with those of two experienced radiologists and two dental residents. RESULTS The diagnostic performance of the deep-learning system for maxillary sinusitis on panoramic radiographs was high, with accuracy of 87.5%, sensitivity of 86.7%, specificity of 88.3%, and AUC of 0.875. These values showed no significant differences compared with those of the radiologists and were higher than those of the dental residents. CONCLUSIONS The diagnostic performance of the deep-learning system for maxillary sinusitis on panoramic radiographs was sufficiently high. Results from the deep-learning system are expected to provide diagnostic support for inexperienced dentists.
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Affiliation(s)
- Makoto Murata
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan.
| | - Yasufumi Ohashi
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Taisuke Kawai
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, Nippon Dental University, Tokyo, Japan
| | - Motoki Fukuda
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Takuma Funakoshi
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Yoshitaka Kise
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Michihito Nozawa
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Akitoshi Katsumata
- Department of Oral Radiology, Asahi University School of Dentistry, Mizuho, Japan
| | - Hiroshi Fujita
- Department of Electrical, Electronic and Computer Faculty of Engineering, Gifu University, Gifu, Japan
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
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Asgary S, Roghanizadeh L. Partial Necrosis Consequence of the Infection Spreading from an Adjacent Apical Periodontitis: A Case Report. IRANIAN ENDODONTIC JOURNAL 2018; 13:420-423. [PMID: 30083219 PMCID: PMC6064033 DOI: 10.22037/iej.v13i3.22089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
As the dental pulp could not be directly inspected before endodontic treatment, indirect evaluation of the pulp status via (para)/clinical tests should be performed which need careful inspection. This report presents a root-treated right maxillary first molar with recurrent abscess formation and a radiolucent periradicular lesion surrounding the distobuccal root of the right maxillary second molar. The patient underwent surgical retreatment, employing CEM root-end filling, which resulted in no relief from sign/symptoms. In the cone-beam computed tomography (CBCT), the relationship of the lesion with the mesio-buccal root of the second maxillary molar was detected. Despite the latest tooth showed positive responses to pulp sensibility tests, endodontic therapy was planned for it. During treatment, it became clear that the mesiobuccal canal pulp was necrotic, although vital pulp tissues were present in two other root canals. Following treatment, full recovery from all discomforts was obtained and the lesion healed after 18 months. This case showed that a more complicated evaluation such as CBCT should be used for diagnosis of perpetuated lesions. Furthermore, it might be probable that root canals of vital teeth become necrotic due to involvement in the adjacent apical lesion, a phenomenon known as anachoresis.
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Affiliation(s)
- Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leyla Roghanizadeh
- Dental Research Center, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Fu B, McGowan K, Sun H, Batstone M. Increasing Use of Intensive Care Unit for Odontogenic Infection Over One Decade: Incidence and Predictors. J Oral Maxillofac Surg 2018; 76:2340-2347. [PMID: 29958865 DOI: 10.1016/j.joms.2018.05.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/01/2018] [Accepted: 05/16/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE To determine whether intensive care unit (ICU) admissions for odontogenic infections have increased during the past decade and whether certain clinical features are associated with a greater rate of ICU admission. MATERIALS AND METHODS The data from patients undergoing surgery for odontogenic infections at the Royal Brisbane and Women's Hospital in the 24 month from January 2003 to December 2004 were compared with those from patients treated from January 2013 to December 2014. A χ2 analysis was used to compare the demographic, admission, and clinical patient data in each cohort. A multiple logistic regression model was used to determine which clinical features were associated with greater rates of ICU admission. RESULTS The rate of ICU admission increased significantly from 7 to 24% during the decade (χ2 = 12.74; P = .000), although the clinical presentation of patients admitted to the ICU was similar in both cohorts. The mean number of days spent in the ICU increased significantly from 1.7 ± 0.5 to 3.24 ± 2.5 days (t = -3.63; P = .001), and the overall length of stay increased from 1.7 ± 0.5 to 3.5 ± 4.1 days (t = 2.99; P = .004). The use of preoperative computed tomography (CT) increased significantly from 42.9 to 93.3% (χ2 = 13.25; P = .000). The most significant predictors of ICU admission were lower third molar involvement (P = .026), dysphagia (P = .020), and C-reactive protein (CRP) levels exceeding 150 mg/L (P = .039). CONCLUSIONS The use of the ICU in the management of odontogenic infection has increased significantly at the Royal Brisbane and Women's Hospital over 1 decade. The demographic data and clinical presentation of the patients admitted to the ICU did not change significantly. However, the length of ICU stay and the total length of stay have both increased. A significant increase in CT usage for odontogenic infections also occurred. Third molar infections, dysphagia, and elevated CRP might be relevant clinical predictors of a more complicated course of care requiring ICU admission. More judicious use of CT scanning, combined with prompt surgical consultation and intervention, might reduce the rate of ICU admissions for odontogenic infections.
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Affiliation(s)
- Benjamin Fu
- Registrar, Department of Oral and Maxillofacial Surgery, Royal Melbourne Hospital, Melbourne, VIC, Australia and Masters Candidate, School of Medicine, University of Queensland, QLD, Australia.
| | - Kelly McGowan
- Associate Lecturer, School of Dentistry, University of Queensland, QLD, Australia and PhD Candidate, School of Dentistry and Oral Health, Griffith University, QLD, Australia
| | - Hansen Sun
- Adjunct Associate Professor, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Martin Batstone
- Director, Department of Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
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Silva AALS, Franco A, Fernandes Â, Costa C, Barbosa JS, Westphalen FH. Accuracy of linear measurements performed with two imaging software in cone-beam computed tomography scans of dry human mandibles. AN ACAD BRAS CIENC 2017; 89:2865-2873. [PMID: 29236870 DOI: 10.1590/0001-3765201720170227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 05/30/2017] [Indexed: 11/21/2022] Open
Abstract
The present study aimed to assess the accuracy of linear measurements performed with two software packages in multislice (MSCT) and cone beam (CBCT) computed tomography (CT) images. The sample consisted of 10 human mandibles marked standardly 8 times with metallic orthodontic wires. The mandibles underwent both MSCT and CBCT scanning and were measured linearly and digitally with two software packages, namely Studio 3.1® (Anne Solutions®, SP, Brazil) (ST) and Implant Viewer 2.817® (Anne Solutions®, SP, Brazil) (IV). The linear measurements were the mandibular height (MH) and width (MW), and the distance from the alveolar ridge to the mandibular canal (AC). To validate the measurements, the mandibles were sectioned in the marked regions and measured with a digital caliper. Statistically significant differences were not observed between the measurements (MH, MW, and AC) taken digitally with the two software packages from images obtained from the two scanning modalities (MSCT and CBCT) and the measurements taken manually with a digital caliper (p>0.05). MSCT and CBCT images measured digitally with ST and IV software packages resulted in reliable outcomes when compared to measurements obtained manually. Both software and imaging modalities are reliably useful for planning surgical procedure in the dental practice.
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Affiliation(s)
- Alessandro A L S Silva
- Departamento de Odontologia, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná/PUCPR, Rua Imaculada Conceição, 1155, Prado Velho, 80215-901 Curitiba, PR, Brazil.,Departamento de Educação Tecnológica, Centro Universitário de Várzea Grande/UNIVAG, Av. Dom Orlando Chaves, 2655, Cristo Rei, 78118-900 Várzea Grande, MT, Brazil
| | - Ademir Franco
- Departamento de Estomatologia, Universidade Federal do Paraná /UFPR, Av. Lothário Meissner, 632, Jardim Botânico, 80210-170 Curitiba, PR, Brazil
| | - Ângela Fernandes
- Departamento de Estomatologia, Universidade Federal do Paraná /UFPR, Av. Lothário Meissner, 632, Jardim Botânico, 80210-170 Curitiba, PR, Brazil
| | - Claudio Costa
- Departamento de Estomatologia, Universidade de São Paulo/USP, Av. Professor Lineu Prestes, 2227, Butantã, 05508-000 São Paulo, SP, Brazil
| | - Jorge S Barbosa
- Departamento de Estomatologia, Universidade de São Paulo/USP, Av. Professor Lineu Prestes, 2227, Butantã, 05508-000 São Paulo, SP, Brazil
| | - Fernando H Westphalen
- Departamento de Odontologia, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná/PUCPR, Rua Imaculada Conceição, 1155, Prado Velho, 80215-901 Curitiba, PR, Brazil.,Departamento de Estomatologia, Universidade Federal do Paraná /UFPR, Av. Lothário Meissner, 632, Jardim Botânico, 80210-170 Curitiba, PR, Brazil
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Vidal F, Coutinho TM, Carvalho Ferreira DD, Souza RCD, Gonçalves LS. Odontogenic sinusitis: a comprehensive review. Acta Odontol Scand 2017; 75:623-633. [PMID: 28877613 DOI: 10.1080/00016357.2017.1372803] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Odontogenic sinusitis (OS) is a highly prevalent, underappreciated and underdiagnosed disease that has been known for over 100 years. Apical periodontitis, periodontal disease and iatrogenic extrusion of foreign bodies into the sinus are the main causes of OS. Although the prevalence of sinus pathosis of dental origin is still controversial, otolaryngologists recognize that in the presence of recalcitrant sinusitis, a dental origin should be considered and properly treated. Currently, cone-beam computed tomography is the gold-standard imaging technique to assess the relationship between dental conditions, especially apical periodontitis and sinus diseases, and whenever this association is detected, patients should be seen by both a dentist and an otolaryngologist in order to achieve complete recovery. This article reviews the current concepts regarding the definitions, diagnosis and management of OS from a clinical point of view.
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Affiliation(s)
- Fábio Vidal
- PostGraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | | | - Dennis de Carvalho Ferreira
- PostGraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
- Oral Medicine, Veiga de Almeida University, Rio de Janeiro, Brazil
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Brea Álvarez B, Esteban García L, Tuñón Gómez M, Cepeda Ibarra Y. Nontraumatic head and neck injuries: A clinical approach. Part 2. RADIOLOGIA 2017. [DOI: 10.1016/j.rxeng.2017.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brea Álvarez B, Esteban García L, Tuñón Gómez M, Cepeda Ibarra Y. Nontraumatic head and neck injuries: a clinical approach. Part 2. RADIOLOGIA 2017; 59:182-195. [PMID: 28408041 DOI: 10.1016/j.rx.2017.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 02/02/2017] [Accepted: 02/16/2017] [Indexed: 12/01/2022]
Abstract
Nontraumatic emergencies of the head and neck represent a challenge in the field of neuroradiology for two reasons. As explained in the first part of this update, these entities affect an area where the thorax joins the cranial cavity and can thus compromise both structures; second, they are uncommon, so they are not well known. Maintaining the same approach as in the first part, focusing on the clinical presentations in the emergency department rather than on the anatomic regions affected, we will study the entities that present with two patterns: those that present with a combination of cervical numbness, dysphagia, and dyspnea and those that present with acute sensory deficits. In the latter group, we will specifically focus on visual deficits, because this is the most common symptom that calls for urgent imaging studies.
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Affiliation(s)
- B Brea Álvarez
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España.
| | - L Esteban García
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - M Tuñón Gómez
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - Y Cepeda Ibarra
- Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
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Estrela C, Pécora JD, Estrela CR, Guedes OA, Silva BS, Soares CJ, Sousa-Neto MD. Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment. Braz Dent J 2017; 28:179-190. [DOI: 10.1590/0103-6440201702451] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/06/2017] [Indexed: 01/23/2023] Open
Abstract
Abstract Operative procedural errors must be well analyzed in order to avoid influence negatively the root canal treatment (RCT) prognosis. The successful RCT prevents tooth loss and avoids pain and apical periodontitis. This review aimed to categorize common operative procedure errors and clinical factors associated with RCT. Based on this, will be approached common errors of procedures within the clinical operative sequence: endodontic treatment planning, pulp and periapical disease diagnosis, anaesthesia, access cavity preparation, isolation with rubber dam, root canal preparation, root canal filling and retreatment, restoration of endodontically treated teeth, postoperative pain, follow up of endodontically treated teeth. The professional must remind that in each phase of RCT an operative error may have adverse implication on prognosis, and these errors characterize risk factors to failure. The knowledge of probable operative procedural errors and its consequences are essentials to avoid future problems to the tooth health.
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Estrela C, Nunes CABCM, Guedes OA, Alencar AHG, Estrela CRA, Silva RG, Pécora JD, Sousa-Neto MD. Study of Anatomical Relationship between Posterior Teeth and Maxillary Sinus Floor in a Subpopulation of the Brazilian Central Region Using Cone-Beam Computed Tomography - Part 2. Braz Dent J 2017; 27:9-15. [PMID: 27007338 DOI: 10.1590/0103-6440201600679] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 12/10/2015] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the anatomical relationship between posterior teeth root apices and maxillary sinus floor (MSF) on 202 cone beam computed tomography (CBCT) exams. The distance between the root apices and the MSF, as well as the MSF thickness of the cortical bone closest to root apices and furcation regions were measured. The vertical and horizontal relationships of the MSF with the molar roots were classified into categories adapted from the criteria proposed by Kwak et al. (14). The shortest distances between MSF and the root apices were observed in the mesiobuccal root of the second molar (0.36±1.17 mm) and the palatal root of the first molar (0.45±1.10 mm) and the widest in buccal roots of the first premolars (5.47±4.43 mm). Significant differences were observed between the distance of MSF to the root apices of single-rooted first and second premolars. The cortical thickness ranged from 0.65±0.41 mm over the mesiobuccal root of the second molar to 1.28±0.42 mm over the buccal root of the first premolar. The most observed vertical and horizontal relationships were type II and 2H, respectively. The maxillary molar roots showed greater proximity to the MSF. The thickness of the MSF cortical bone closest to the apices and furcation regions was found to be similar only for premolars.
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Affiliation(s)
- Carlos Estrela
- Department of Stomatologic Sciences, Dental School, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Carla A B C M Nunes
- Department of Stomatologic Sciences, Dental School, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | | | - Ana Helena G Alencar
- Department of Stomatologic Sciences, Dental School, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Cynthia R A Estrela
- Department of Stomatologic Sciences, Dental School, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Ricardo Gariba Silva
- Department of Restorative Dentistry, Dental School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Jesus Djalma Pécora
- Department of Restorative Dentistry, Dental School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, Dental School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Malamos D, Scully C. Sore or Swollen Lips Part 2: Systemic Causes. DENTAL UPDATE 2016; 43:971-980. [PMID: 29155539 DOI: 10.12968/denu.2016.43.10.971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This series of three papers reviews the causes, diagnosis and differential diagnosis, and outlines the management of sore and/or swollen lips. Clinical relevance: Sore and/or swollen lips are not uncommon, often have a local cause, but may reflect a systemic disease. The previous article reviewed important causes, from actinic to contact cheilitis, while this paper starts with drug-induced cheilitis and completes that alphabetical list.
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Wagner F, Dvorak G, Nemec S, Pietschmann P, Figl M, Seemann R. A principal components analysis: how pneumatization and edentulism contribute to maxillary atrophy. Oral Dis 2016; 23:55-61. [PMID: 27537271 DOI: 10.1111/odi.12571] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/04/2016] [Accepted: 08/08/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this retrospective cohort study was to investigate the role of sinus pneumatization and residual ridge resorption in maxillary bone loss in 400 computed tomography (CT) scans. MATERIALS AND METHODS In 200 dentate and 200 edentulous patients, both sinuses were analysed using CT scans. The image analysis sequence consisted of manual placement of 24 reference points, followed by automated segmentation and final manual refinement. Finally, a principal components analysis was performed. RESULTS A total of 788 sinuses were included into the analysis. The edentulous group (98 female: 67.77 ± 11.28 years, 99 male: 65.22 ± 9.87) was significantly older than the group with teeth (99 female: 46.89 ± 16.77 years, 96 male: 49.74 ± 16.2). Female and male patients did not differ regarding age. The alveolar height differed significantly between the groups (edentulous: 7.1 ± 4.3 mm, with teeth: 9.7 ± 4.1 mm), but not between gender (female: 8.3 ± 4.4 mm, male: 8.5 ± 4.4 mm). Principal components analysis was able to explain 90% of the variation in sinus morphology. CONCLUSIONS Prolonged edentulism in the maxillary molar region leads to centripetal and to minor degrees centrifugal ridge resorption. Minor pneumatization occurs in the sinus walls, but the sinus depth underlies the anatomical variation independent of dentition.
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Affiliation(s)
- F Wagner
- University Clinic for Cranio- and Maxillofacial Surgery, Medical University Vienna, Vienna, Austria
| | - G Dvorak
- University Clinic of Dentistry, Medical University Vienna, Vienna, Austria
| | - S Nemec
- University Clinic for Radiology, Medical University Vienna, Vienna, Austria
| | - P Pietschmann
- Centre for Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria
| | - M Figl
- Centre for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria
| | - R Seemann
- University Clinic for Cranio- and Maxillofacial Surgery, Medical University Vienna, Vienna, Austria
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Eggmann F, Connert T, Bühler J, Dagassan-Berndt D, Weiger R, Walter C. Do periapical and periodontal pathologies affect Schneiderian membrane appearance? Systematic review of studies using cone-beam computed tomography. Clin Oral Investig 2016; 21:1611-1630. [PMID: 27585589 DOI: 10.1007/s00784-016-1944-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/15/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This systematic review analyzed the relationship between periapical and periodontal pathologies in the posterior maxilla and the appearance of the Schneiderian membrane in cone-beam computed tomography (CBCT) compared with sound dentitions. METHODS Five electronic databases (Cochrane Library, Embase, OpenGrey, PubMed, Web of Science), complemented by hand searching, were screened up to May 9, 2016. Human clinical studies that used CBCT and contained information on the periapical/periodontal status in the posterior maxilla and Schneiderian membrane appearance were included. A weighted vote counting (WVC) method was applied to summarize results across studies. RESULTS Out of 413 records, 20 studies were included. In the WVC, the studies that observed a positive association between periapical lesions and the appearance of the Schneiderian membrane outweighed those that found no such association (WVC 51 % and WVC 33 %, respectively), with some studies yielding indeterminate results (WVC 16 %). Regarding the relation between periodontal pathologies and the appearance of the Schneiderian membrane, WVC produced a tie between studies demonstrating a positive association (WVC 46 %) and those showing no association (WVC 44 %); one study (WVC 10 %) reported indeterminate results. CONCLUSIONS On CBCT scans, periapical lesions in the posterior maxilla are likely to be associated with Schneiderian membrane thickening. In contrast, current evidence regarding the relation between periodontal diseases and the appearance of the Schneiderian membrane in CBCT is inconclusive. CLINICAL RELEVANCE Incidental maxillary sinus findings on CBCT scans warrant thorough differential diagnosis. Frequently, they may be related to dental pathologies.
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Affiliation(s)
- Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Julia Bühler
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Dorothea Dagassan-Berndt
- Department of Oral Surgery, Oral Radiology and Oral Medicine, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Hebelstrasse 3, CH-4056, Basel, Switzerland.
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Association between Odontogenic Conditions and Maxillary Sinus Disease: A Study Using Cone-beam Computed Tomography. J Endod 2016; 42:1509-15. [PMID: 27522456 DOI: 10.1016/j.joen.2016.07.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/02/2016] [Accepted: 07/03/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION The maxillary sinus can be affected by dental infections because of its close relationship with upper teeth. This study aimed to assess the most common types of maxillary sinus alterations and to associate them with odontogenic conditions using cone-beam computed tomographic (CBCT) images. METHODS CBCT scans of 400 patients showing sinus disease in 1 or both maxillary sinuses were evaluated. Sinus alteration was considered as follows: generalized or localized mucosal thickening (MT), maxillary sinusitis (MS), and retention cysts (RCs). The odontogenic conditions evaluated were inadequate endodontic treatment, periapical lesions, and periodontal bone loss. Descriptive and multiple logistic regression analyses were performed. RESULTS Sinus diseases were observed in 85.9% of the maxillary sinuses. The most prevalent condition was generalized MT (65.2%) followed by localized MT (24.8%), MS (6.4%), and RCs (3.6%). Generalized MT was more related to males (odds ratio = 1.45, P < .05) and periodontal bone loss (P < .05). Localized MT was associated with periapical lesions (odds ratio = 3.09, P < .05) and showed a close anatomic relationship between teeth and the sinus floor (odds ratio = 2.77, P < .05). There were no statistically significant associations between either MS or RCs and the odontogenic conditions studied. CONCLUSIONS The most prevalent sinus diseases were the generalized and localized MT, and they were the only ones related to odontogenic conditions (periodontal bone loss and periapical lesions, respectively). We emphasize that CBCT imaging is an appropriate method for evaluating the maxillary sinus findings and their associated odontogenic conditions.
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Uraba S, Ebihara A, Komatsu K, Ohbayashi N, Okiji T. Ability of Cone-beam Computed Tomography to Detect Periapical Lesions That Were Not Detected by Periapical Radiography: A Retrospective Assessment According to Tooth Group. J Endod 2016; 42:1186-90. [DOI: 10.1016/j.joen.2016.04.026] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/20/2016] [Accepted: 04/24/2016] [Indexed: 11/28/2022]
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Evaluation of the relationship between maxillary sinus floor position and maxillary sinusitis using cone beam computed tomography. Oral Radiol 2016. [DOI: 10.1007/s11282-016-0241-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Ohashi Y, Ariji Y, Katsumata A, Fujita H, Nakayama M, Fukuda M, Nozawa M, Ariji E. Utilization of computer-aided detection system in diagnosing unilateral maxillary sinusitis on panoramic radiographs. Dentomaxillofac Radiol 2016; 45:20150419. [PMID: 26837670 DOI: 10.1259/dmfr.20150419] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES It is unclear whether computer-aided detection (CAD) systems for panoramic radiography can help inexperienced dentists to diagnose maxillary sinusitis. The aim of this study was to clarify whether a CAD system for panoramic radiography can contribute to improved diagnostic performance for maxillary sinusitis by inexperienced dentists. METHODS The panoramic radiographs of 49 patients with maxillary sinusitis and 49 patients with healthy sinuses were evaluated in this study. The diagnostic performance of the CAD system was determined. 12 inexperienced dentists and 4 expert oral and maxillofacial radiologists observed the total of 98 panoramic radiographs and judged the presence or absence of maxillary sinusitis, under conditions with and without the support of the CAD system. The receiver operating characteristic curves of the two groups were compared. RESULTS The CAD system provided sensitivity of 77.6%, specificity of 69.4% and accuracy of 73.5%. The diagnostic performance of the inexperienced dentists increased with the support of the CAD system. When the inexperienced dentists diagnosed maxillary sinusitis with CAD support, the area under the curve (AUC) was significantly higher than that without CAD support. When the focus was only on panoramic radiographs in which CAD support led to a correct diagnosis, the AUC of the inexperienced dentists increased to an equivalent level to that of the experienced radiologists. CONCLUSIONS The CAD system supported the inexperienced dentists in diagnosing maxillary sinusitis on the panoramic radiographs. If the accuracy of the CAD system can be increased, the benefits of CAD support will be further enhanced.
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Affiliation(s)
- Yasufumi Ohashi
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Yoshiko Ariji
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Akitoshi Katsumata
- 2 Department of Oral Radiology, Asahi University School of Dentistry, Mizuho, Japan
| | - Hiroshi Fujita
- 3 Department of Intelligent Image Information, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Miwa Nakayama
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Motoki Fukuda
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Michihito Nozawa
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Eiichiro Ariji
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
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Bozdemir E, Gormez O, Yıldırım D, Aydogmus Erik A. Paranasal sinus pathoses on cone beam computed tomography. J Istanb Univ Fac Dent 2016; 50:27-34. [PMID: 28955552 PMCID: PMC5573450 DOI: 10.17096/jiufd.47796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/09/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose: The aim of this study was to investigate
paranasal sinus pathoses detected on cone-beam
computed tomography (CBCT) in an adult population. Patients and Methods: Three observers retrospectively
inspected 353 consecutive CBCT scans obtained in a
dentomaxillofacial radiology department for paranasal sinus
pathoses. Descriptive statistics and chi-square tests were
used to determine the prevalence of categorical parameters. Results: The age of the patients ranged from 18 to 85 years
(mean 41.27±16.76). There were 172 (48.7%) females and
181 (51.3%) males. There was a significant difference between
the genders (p=0.02), with males (53.5%) having more sinus
pathoses than females (46.5%). When the left and right sinuses
were considered together, pathoses were most commonly seen
in the maxillary sinuses (57.1%), followed by the ethmoid (53.7
%), frontal (22.6%), and sphenoid sinuses (15.8%). Mucosal
thickening was the most frequently observed abnormality
(51.7%), followed by hypoplasia (17.5%) and sinusitis (17.3%). Conclusion: CBCT is a preferable imaging method for
evaluation of paranasal sinuses. Dentomaxillofacial
radiologists should examine the whole volume of CBCT images
to ensure they do not overlook paranasal sinus pathoses.
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Affiliation(s)
- Esin Bozdemir
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
| | - Ozlem Gormez
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
| | - Derya Yıldırım
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
| | - Ayse Aydogmus Erik
- Department of Dentomaxillofacial Radiology Faculty of Dentistry Süleyman Demirel University Turkey
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Roque-Torres GD, Ramirez-Sotelo LR, Vaz SLDA, Bóscolo SMDAD, Bóscolo FN. Association between maxillary sinus pathologies and healthy teeth. Braz J Otorhinolaryngol 2016; 82:33-8. [PMID: 26727608 PMCID: PMC9444634 DOI: 10.1016/j.bjorl.2015.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 12/09/2014] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The proximity of the roots to the maxillary sinus can create a variety of risks. OBJECTIVE To evaluate the relationship between the roots of healthy teeth and the maxillary sinus, as well as the occurrence of sinus pathologies. METHODS Three radiologists analyzed 109 cone beam computed tomography (CBCT) images. The Kappa test was used to assess the intra- and inter-rater agreement. The chi-squared test and prevalence ratio were used to test the hypothesis that roots of healthy teeth in the maxillary sinus favored the occurrence of sinus pathologies (p=0.01). RESULTS Intra- and inter-rater agreement ranged from good to excellent. The chi-squared test demonstrated a statistically significant difference (p=0.006) between the tooth roots in diseased maxillary sinuses (6.09%) and those in normal sinuses (3.43%). The prevalence ratio test showed a statistically significant higher prevalence of tooth roots in diseased sinuses than in normal sinuses (p<0.0001). Roots in the maxillary sinus were 1.82 times more associated with diseased sinuses. CONCLUSION Dental roots in the maxillary sinus are almost twice as likely to be associated with diseased sinuses than normal sinuses. Healthy teeth whose roots are inside the maxillary sinus may induce an inflammatory response in the sinus membrane. It is suspected that dental procedures may exacerbate the condition.
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Affiliation(s)
- Gina D Roque-Torres
- Department of Oral Diagnosis, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil.
| | - Laura Ricardina Ramirez-Sotelo
- Department of Oral Diagnosis, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Sergio Lins de Azevedo Vaz
- Dental Radiology, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Department of Dental Clinic, School of Dentistry, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | | | - Frab Norberto Bóscolo
- Department of Oral Diagnosis, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil
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Kasikcioglu A, Gulsahi A. Relationship between maxillary sinus pathologies and maxillary posterior tooth periapical pathologies. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0231-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nunes CABCM, Guedes OA, Alencar AHG, Peters OA, Estrela CRA, Estrela C. Evaluation of Periapical Lesions and Their Association with Maxillary Sinus Abnormalities on Cone-beam Computed Tomographic Images. J Endod 2015; 42:42-6. [PMID: 26521148 DOI: 10.1016/j.joen.2015.09.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/21/2015] [Accepted: 09/23/2015] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Periapical inflammation is often responsible for distinct maxillary sinus (MS) changes. This retrospective, cross-sectional study evaluated the association between the clinical characteristics of periapical lesions (presence, size, and distance) in maxillary posterior teeth and the presence of sinus abnormalities by evaluating cone-beam computed tomographic (CBCT) images obtained from an archived collection. Apart from sex, no other patient information was available. METHODS The study sample was composed of CBCT images of 143 MSs of patients with at least 1 maxillary posterior tooth with a periapical lesion and 178 MSs of patients without periapical radiolucent lesions. Sinus abnormalities were classified as mucosal thickening, sinus polyp, antral pseudocyst, nonspecific opacification, periostitis, and antral calcification; periapical radiolucent areas were classified using the CBCT periapical index, and the distance between the periapical lesion edge and the MS floor was measured. Data were analyzed using chi-square tests at a level of significance set at α = 0.05. RESULTS Most sinus abnormalities were associated with at least 1 maxillary posterior tooth with a periapical lesion (P > .05). The most frequent sinus abnormality in the presence of a periapical lesion was mucosal thickening. All teeth with a CBCT periapical index score of 5 were associated with sinus abnormalities. The highest frequency of abnormalities was found when the radiolucent area was subjacent to the sinus floor. CONCLUSIONS Maxillary posterior teeth with periapical radiolucent lesions had the highest frequency of sinus abnormalities. The size of a periapical lesion was not associated with the frequency of sinus abnormalities. A close spatial relationship between periapical lesions and sinuses resulted most frequently in sinus abnormalities.
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Affiliation(s)
- Carla A B C M Nunes
- Department of Stomatology, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | | | - Ove A Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California
| | - Cyntia R A Estrela
- Department of Oral Sciences, University of Cuiabá, Cuiabá, Mato Grosso, Brazil
| | - Carlos Estrela
- Department of Stomatology, Federal University of Goiás, Goiânia, Goiás, Brazil.
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43
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Ren S, Zhao H, Liu J, Wang Q, Pan Y. Significance of maxillary sinus mucosal thickening in patients with periodontal disease. Int Dent J 2015; 65:303-10. [PMID: 26453062 DOI: 10.1111/idj.12186] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM To characterise and measure the Schneiderian membranes of individuals with periodontal diseases in China and to analyse the factors impacting maxillary sinus mucosal thickness using cone-beam computed tomography (CBCT). MATERIAL AND METHOD A cohort of 221 patients with periodontal disease was subjected to cross-sectional CBCT examination. Various parameters, including age, sex, alveolar bone loss, furcation lesions and vertical infrabony pockets, were analysed as correlates of mucosal thickening (MT). Sinus mucosal thickness ≥ 2 mm qualified as MT. RESULTS MT was detected in 103 (48.9%) patients, increasing in frequency as the degree of alveolar bone loss advanced (mild, 14.5%; moderate, 29.5%; severe, 87.9%). The association between MT and vertical infrabony pockets was statistically significant (P < 0.001). The likelihood of MT increased with moderate [odds ratio (OR) = 1.02] and severe (OR = 4.62) periodontal bone loss (P < 0.001), as well as with furcation lesions (OR = 2.76) and vertical infrabony pockets (OR = 13.58). CONCLUSIONS Relative to the case in patients with periodontitis and normal mucosa, the probability of MT increased dramatically as alveolar bone loss worsened. Periodontal pathologies (i.e. furcation lesions and vertical infrabony pockets) were also more likely to coincide with MT.
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Affiliation(s)
- Song Ren
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, Shenyang, China.,Dalian Stomatological Hospital, Dalian, China
| | - Haijiao Zhao
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, Shenyang, China
| | - Jingbo Liu
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, Shenyang, China
| | - Qingxuan Wang
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, Shenyang, China
| | - Yaping Pan
- Department of Periodontics and Oral Biology, School of Stomatology, China Medical University, Shenyang, China
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Abstract
The teeth are unique in that they provide a direct pathway for spread of infection into surrounding osseous and soft tissue structures. Periodontal disease is the most common cause of tooth loss worldwide, referring to infection of the supporting structures of the tooth, principally the gingiva, periodontal ligament, cementum, and alveolar bone. Periapical disease refers to an infectious or inflammatory process centered at the root apex of the tooth, usually occurring when deep caries infect the pulp chamber and root canals. We review the pathogenesis, clinical features, and radiographic findings (emphasis on computed tomography) in periodontal and periapical disease.
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Affiliation(s)
- Vahe M Zohrabian
- Department of Radiology, Yale School of Medicine, New Haven, CT.
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Troeltzsch M, Pache C, Troeltzsch M, Kaeppler G, Ehrenfeld M, Otto S, Probst F. Etiology and clinical characteristics of symptomatic unilateral maxillary sinusitis: A review of 174 cases. J Craniomaxillofac Surg 2015; 43:1522-9. [PMID: 26319958 DOI: 10.1016/j.jcms.2015.07.021] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/05/2015] [Accepted: 07/20/2015] [Indexed: 11/19/2022] Open
Abstract
The purpose of the study was to analyze the causative pathology associated with symptomatic unilateral maxillary sinusitis requiring surgical treatment. A retrospective review of all patients that have been treated surgically for unilateral symptomatic maxillary sinusitis between 2006 and 2013 at a single institution was performed. Demographic, anamnesis, clinical, radiological, microbiological and histological data were gathered and analyzed. The patients were allocated into groups depending on the underlying cause of the disease. Descriptive and inferential statistics were computed (level of significance: p ≤ 0.05). The study sample was composed of 174 patients (72 female; 102 male) with a mean age of 52.7 years (SD 16.9). Most cases (130; 75%) were triggered by odontogenic pathology following dentoalveolar surgical interventions (83/130 patients; 64%). Other etiological factors for odontogenic unilateral sinusitis were periapical (23/130 cases; 18%) and periodontal pathology (13/130 cases; 10%). Rhinogenic factors for sinusitis were detected in 13 patients (7.5%) and dental implant-associated unilateral maxillary sinusitis was diagnosed in nine patients (5.2%). Four patients (2.3%) had undergone previous sinus augmentation surgery. A leading cause for the sinus infection could not be identified in 18 patients (10%) who all had a history of midfacial surgery. Medication-related osteonecrosis of the jaw (8) and squamous cell carcinoma (2) were incidental findings. There were no differences in the clinical appearance of the disease with respect to its etiology. Odontogenic causes for maxillary sinusitis must be considered especially in unilateral cases. Maxillary dental implants may induce symptomatic unilateral maxillary sinusitis.
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Affiliation(s)
- Matthias Troeltzsch
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany.
| | - Christoph Pache
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Markus Troeltzsch
- Department of Oral and Maxillofacial Surgery, Georg-August University of Göttingen, Göttingen, Germany
| | - Gabriele Kaeppler
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany; Department of Dentomaxillofacial Radiology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Michael Ehrenfeld
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Florian Probst
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany
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Guerra-Pereira I, Vaz P, Faria-Almeida R, Braga AC, Felino A. CT maxillary sinus evaluation--A retrospective cohort study. Med Oral Patol Oral Cir Bucal 2015; 20:e419-26. [PMID: 25858084 PMCID: PMC4523254 DOI: 10.4317/medoral.20513] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/26/2015] [Indexed: 11/08/2022] Open
Abstract
Background Proximity of the dental roots to the sinus floor makes dental disease a probable cause of maxillary sinusitis. The aim of this study was to find out if maxillary sinus pathologic changes were more prevalent in patients with dental disease and to evaluate the performance of computed tomography (CT) in analyzing and detecting apical periodontitis and other odontogenic causes on the maxillary sinusitis etiology in a Portuguese Caucasian population. Material and Methods Retrospective cohort study. The total sample of 504 patients and their CT was included in this study. The patients were from a private dental clinic, specializing in oral surgery, where the first complaint was not directly related to sinus disease, but with dental pathology. For each patient, the etiological factors of maxillary sinusitis and the imaging CT findings were analyzed. All the axial, coronal and sagittal CT slices were evaluated and general data were registered. The latter was selected based on the maxillary sinus CT published literature. Results 32.40% of patients presented normal sinus (without any etiological factor associated), 29.00% showed presence of etiological and imaging findings in the maxillary sinus, 20.60% had only imaging changes in the maxillary sinus and 18.00% of patients presented only etiological factors and no change in the maxillary sinus. Conclusions Radiological imaging is an important tool for establishing the diagnosis of maxillary sinus pathology. These results indicate that the CT scan should be an excellent tool for complement the odontogenic sinusitis diagnosis. Key words:
Maxillary sinusitis/etiology, odontogenic, computed tomography, maxillary sinus.
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Affiliation(s)
- InêsI Guerra-Pereira
- Department of Oral Surgery, Faculty of Dentistry of Oporto University, Rua Dr. Manuel Pereira da Silva, 4200 - 393 Porto - Portugal,
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Perforating Internal Root Resorption Repaired with Mineral Trioxide Aggregate Caused Complete Resolution of Odontogenic Sinus Mucositis: A Case Report. J Endod 2015; 41:274-8. [DOI: 10.1016/j.joen.2014.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 09/29/2014] [Accepted: 10/09/2014] [Indexed: 11/18/2022]
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Rare periodontal ligament drainage for periapical inflammation of an adjacent tooth: a case report and review of the literature. Case Rep Dent 2015; 2014:879562. [PMID: 25587462 PMCID: PMC4283423 DOI: 10.1155/2014/879562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 12/03/2014] [Indexed: 11/17/2022] Open
Abstract
Aim. To report a case with an unusual drainage route of periapical inflammation exiting through the gingival sulcus of an adjacent vital tooth and review probable factors determining the diversity of the discharge routes of periapical inflammation. Summary. An 18-year-old male patient presented with periodontal abscess of tooth 46, which was found to be caused by a periapical cyst with an acute abscess of tooth 45. During endodontic surgery, a rarely reported drainage route for periapical inflammation via the gingival sulcus of an adjacent vital tooth was observed for the first time. Complete periodontal healing of the deep pocket of tooth 46 and hiding of the periapical cyst of tooth 45 followed after root canal treatment and periapical surgery with Bio-Oss Collagen implantation on tooth 45. The drainage routes of periapical inflammation are multivariate and the diversity of drainage pathways of periapical inflammation is mainly related to factors such as gravity, barriers against inflammation, and the causative tooth itself.
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Raghav M, Karjodkar FR, Sontakke S, Sansare K. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent 2014; 5:361-5. [PMID: 25191074 PMCID: PMC4147814 DOI: 10.4103/0976-237x.137949] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The aim of the present study was to infer and to record the prevalence of incidental maxillary sinus pathologies in patients presenting with dental problems using the cone-beam computed tomography (CBCT) scans performed for maxillofacial diagnostic purposes. MATERIALS AND METHODS This retrospective study has evaluated 201 patients (402 maxillary sinuses consecutive CBCT) for various incidental maxillary sinus pathologies by two observers. Pathologic findings were categorized as mucosal thickening (MT), opacification (OPA), polypoidal-mucosal thickening (PT), others (antrolith and discontinuity of the sinus floor) and no pathologic findings. Correlations for pathologic findings and the factors of age and gender were calculated. RESULTS The prevalence for total incidental findings is 59.7%. The present study showed MT (35.1%) as most prevalent finding followed by OPA in (16.6%), PT in 7.2% and others in 0.7%. There was no statistically significant difference between gender and between the age groups. There was no statistically significant difference between different indications groups for CBCT scans. CONCLUSIONS The incidental maxillary sinus abnormalities are highly prevalent in the asymptomatic dental patients; hence oral radiologists should be aware of these incidental findings and comprehensively evaluate the entire captured CBCT volume, which can help in early diagnosis, treatment and follow-up of the patient.
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Affiliation(s)
- Mamta Raghav
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Freny R Karjodkar
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Subodh Sontakke
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Kaustubh Sansare
- Department of Oral Medicine and Radiology, Nair Hospital and Dental College, Mumbai, Maharashtra, India
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Rastogi S, Arora P, Devi P, Wazir SS, Kapoor S. Importance of ultrasonography and magnetic resonance imaging in diagnosis of cysticercosis of temporalis muscle mimicking temporal space infection. Contemp Clin Dent 2014; 4:504-8. [PMID: 24403797 PMCID: PMC3883332 DOI: 10.4103/0976-237x.123059] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Cysticercosis cellulosae, caused by the larval stage of Taenia solium is a common parasitic infection in Indian subcontinent. Although cysticercosis is common in other parts of the human body, its involvement with temporalis muscle is an extremely rare entity and demands documentation. This paper reports a case of cysticercosis cellulosae in a 35-year-old male patient within the temporalis muscle mimicking temporal space infection; due to the presence of concomitant dental infection, which was diagnosed with the help of high resolution ultrasonography and magnetic resonance imaging and managed conservatively using oral antiparasitic medication. Here, in this case report, we are emphasizing the importance of imaging modalities in diagnosing space infection and cysticercosis.
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Affiliation(s)
- Sameer Rastogi
- Department of Oral Medicine and Maxillofacial Radiology, Kalka Dental College and Hospital, Meerut, India
| | - Pallak Arora
- Department of Oral Medicine and Maxillofacial Radiology, Kalka Dental College and Hospital, Meerut, India
| | - Parvathi Devi
- Department of Oral Medicine and Maxillofacial Radiology, Teerthanker Dental College and Hospital, Mooradabad, Uttar Pradesh, India
| | - Sartaj Singh Wazir
- Department of Oral Medicine and Maxillofacial Radiology, M. B. Kedia Dental College and Teaching Hospital, Birgunj, Nepal
| | - Shalini Kapoor
- Department of Periodontics, SGT Dental College and Research Centre, Gurgaon, Haryana, India
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