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Alrmali AE, Wang HL. Dental Pathophysiology of Odontogenic Sinusitis: Oral Surgical Complications. Otolaryngol Clin North Am 2024:S0030-6665(24)00103-8. [PMID: 39155170 DOI: 10.1016/j.otc.2024.07.006] [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: 08/20/2024]
Abstract
The article explores the understudied pathophysiology of odontogenic sinusitis (ODS) development as a result of oral surgical complications such as oroantral communication (OAC) or fistula (OAF), maxillary sinus bone grafting, and dental implantation. A temporary OAC presents most often after dental extraction, especially with posterior maxillary teeth, though can happen with any oral surgical intervention. Maxillary sinus augmentation can also cause ODS, and while the pathophysiology is incompletely understood, it may be related to OAC/OAF formation or bone graft infection. Dental implants may also lead to ODS either via displacement into the sinus, partial protrusion into the sinus, or peri-implantitis.
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Affiliation(s)
- Abdusalam E Alrmali
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 North University Avenue, Ann Arbor, MI 48109-1078, USA; Department of Oral Pathology, Oral Medicine and Oral and Maxillofacial Surgery, University of Tripoli, School of Dentistry, Tripoli, Libya
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 North University Avenue, Ann Arbor, MI 48109-1078, USA.
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Abstract
This article explores how to prevent and manage complications of dentoalveolar surgery. Many complications are avoidable. Surgical skills and knowledge of anatomy play an important role in prevention of complications. Prevention starts with detailed history and physical examination of the patient. Key to perioperative management of patients is risk assessment. Without a proper history and physical examination, the clinician is unable to assess the risk of performing surgery and anesthesia for each patient. Some illnesses and medications increase the risk of complications. The following complications are discussed: alveolar osteitis, displacement, fracture, hemorrhage, infection, nonhealing wound, oroantral communication, swelling, and trismus.
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Affiliation(s)
- Patrick J Louis
- Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, 1919 7th Avenue South, SDB 419, Birmingham, AL 35294, USA.
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Hasegawa T, Tachibana A, Takeda D, Iwata E, Arimoto S, Sakakibara A, Akashi M, Komori T. Risk factors associated with oroantral perforation during surgical removal of maxillary third molar teeth. Oral Maxillofac Surg 2016; 20:369-375. [PMID: 27624331 DOI: 10.1007/s10006-016-0574-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 09/05/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The relationship between radiographic findings and the occurrence of oroantral perforation is controversial. Few studies have quantitatively analyzed the risk factors contributing to oroantral perforation, and no study has reported multivariate analysis of the relationship(s) between these various factors. This retrospective study aims to fill this void. METHODS Various risk factors for oroantral perforation during maxillary third molar extraction were investigated by univariate and multivariate analysis. The proximity of the roots to the maxillary sinus floor (root-sinus [RS] classification) was assessed using panoramic radiography and classified as types 1-5. The relationship between the maxillary second and third molars was classified according to a modified version of the Archer classification. The relative depth of the maxillary third molar in the bone was classified as class A-C, and its angulation relative to the long axis of the second molar was also recorded. RESULTS Performance of an incision (OR 5.16), mesioangular tooth angulation (OR 6.05), and type 3 RS classification (i.e., significant superimposition of the roots of all posterior maxillary teeth with the sinus floor; OR 10.18) were all identified as risk factors with significant association to an outcome of oroantral perforation. CONCLUSION To our knowledge, this is the first multivariate analysis of the risk factors for oroantral perforation during surgical extraction of the maxillary third molar. This RS classification may offer a new predictive parameter for estimating the risk of oroantral perforation.
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Affiliation(s)
- Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Akira Tachibana
- Department of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, Kakogawa, Japan
| | - Daisuke Takeda
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Eiji Iwata
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Satomi Arimoto
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Akiko Sakakibara
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Takahide Komori
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Visscher SH, van Roon MR, Sluiter WJ, van Minnen B, Bos RR. Retrospective Study on the Treatment Outcome of Surgical Closure of Oroantral Communications. J Oral Maxillofac Surg 2011; 69:2956-61. [DOI: 10.1016/j.joms.2011.02.102] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 02/16/2011] [Accepted: 02/17/2011] [Indexed: 11/25/2022]
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Closure of Oroantral Communications: A Review of the Literature. J Oral Maxillofac Surg 2010; 68:1384-91. [DOI: 10.1016/j.joms.2009.07.044] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 06/05/2009] [Accepted: 07/25/2009] [Indexed: 11/17/2022]
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Visscher SH, van Minnen B, Bos RR. Closure of Oroantral Communications Using Biodegradable Polyurethane Foam: A Feasibility Study. J Oral Maxillofac Surg 2010; 68:281-6. [DOI: 10.1016/j.joms.2009.07.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 04/16/2009] [Accepted: 07/25/2009] [Indexed: 11/28/2022]
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Abstract
The maxilla may be involved by a wide range of pathologic conditions. Lesions originating in the maxilla may involve the adjacent orbit, oral cavity, or retroantral spaces. Recognition of this relationship plays an important role in diagnosis, prognosis, and presurgical planning.
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Affiliation(s)
- Paul A Caruso
- Department of Radiology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.
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Abstract
Sixty nine pediatric patients with cystic lesions of the jaws were successfully diagnosed and treated. Thirty one (45%) were dentigerous cysts (D.C.), 15 (22%) were eruption cysts (E.C.), 12 (17.3%) were traumatic bone cysts (T.B.C.), nine (13.3%) were radicular cysts (R.C.), one (1.5%) was primordial cyst (P.C.) and one (1.5%) globulomaxillary cyst (G.M.C.). The mean age for E.C., R.C., D.C., T.B.C. was 4.7, 9.2, 11.5, and 13.3 years, respectively. The mean age of E.C. is significantly (P<0.05) younger than D.C. and T.B.C. but not from R.C. No significant age differences were found between R.C., D.C. and T.B.C. The differences in mean cyst diameter were not significant. Male to female ratio was 1. The treatment modalities were: marsupialization, enucleation or enucleation with bone grafting. The findings demonstrate that the distribution and characteristics of jaw cysts in children is unique and is different from the distribution in adults. The relatively high rate of developmental cyst and the fact that they occur in an area with rapid developmental changes, suggest the need for more conservative surgical management in this selected patient population.
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Affiliation(s)
- Lipa Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Center, Ben Gurion University of the Negev, PO Box 151, 84101, Beer-Sheva, Israel.
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Bodner L, Bar-Ziv J, Becker A. Image accuracy of plain film radiography and computerized tomography in assessing morphological abnormality of impacted teeth. Am J Orthod Dentofacial Orthop 2001; 120:623-8. [PMID: 11742307 DOI: 10.1067/mod.2001.118780] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study compares the image accuracy of computerized tomography (CT) with that of plain film radiography (PFR) in analyzing the 3-dimensional shape of impacted teeth suspected of being malformed. Eighteen patients with 22 malformed teeth were studied by PFR and CT. Crown shape, root shape, crown/root relationship, and tooth inclination and structure were assessed by PFR and CT. CT was found to be superior to PFR in showing the multiplanar shape of tooth crown and root, crown/root relationship, and tooth inclination (P <.001). No difference was found in the representation of tooth structures. The findings demonstrate that CT imaging is useful to diagnose and plan treatment for patients with unerupted and malformed teeth.
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Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva 84101, Israel.
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Bodner L, Bar-Ziv J. Cutaneous sinus tract of dental origin--imaging with a dental CT software programme. Br J Oral Maxillofac Surg 1998; 36:311-3. [PMID: 9762461 DOI: 10.1016/s0266-4356(98)90717-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Centre, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Bodner L, Bar-Ziv J, Reichenthal E. Trigeminal neuropathy: improved imaging with a dental computed tomography software program. J Oral Maxillofac Surg 1998; 56:545-8. [PMID: 9590335 DOI: 10.1016/s0278-2391(98)90448-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE This study evaluated the use of images obtained by a dental computed tomography (CT) software program in the diagnosis and treatment of trigeminal neuropathy associated with jaw abnormality. PATIENTS AND METHODS Twelve patients with jaw abnormality associated with trigeminal neuropathy as the presenting symptom were studied by plain film radiography (PFR) and by a dental CT software program (DS) that displays multiple panoramic and cross-sectional views of the mandible and maxilla. The two modalities were compared for delineation of the integrity of mandibular foramen, mandibular canal, mental foramen, incisive foramen, and incisive canal. Also, displacement of the neurovascular bundle was evaluated and scored. RESULTS The DS was superior to PFR in showing the bony integrity of the foramina and canals in the jaws, as well as the degree of displacement of the neurovascular bundle. CONCLUSION DS should be the study of choice for evaluating trigeminal neuropathy associated with abnormalities of the jaws.
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Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Abstract
PURPOSE To evaluate the images obtained by CT in diagnosis and treatment plan of teeth in the maxillary sinus. METHODS Twelve patients with teeth in the maxillary sinus were studied by plain film radiography (PFR) and by CT with a dental software programme, which displays multiple panoramic and cross-sectional views of the mandible and maxilla. The three-dimensional morphology of the tooth, its inclination, proximity to the sinus wall, surgical planning and prediction of prognosis and complications were estimated on both PFR and on CT scans and scored. RESULTS The radiographical features interpreted from PFR were fair or poorly diagnosed whereas CT provided excellent features. The surgical approach of choice was based on CT interpretation. CONCLUSION CT is useful for diagnosis and treatment planning of teeth in the maxillary antrum.
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Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Centre, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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