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牙源性上颌窦炎的治疗:病例系列

Treatment of Maxillary Sinusitis of Odontogenic Origin: A Case Series.

作者信息

Starkey Jenna L, Mortman Rory E

机构信息

Private Practice, Jacksonville, Florida.

Private Practice specializing in Endodontics, West Palm Beach, Florida; Diplomate, American Board of Endodontics.

出版信息

Compend Contin Educ Dent. 2019 Sep;40(8):516-522.

Abstract

Odontogenic infection is a possible cause of maxillary sinusitis. In this case series, the authors evaluated patients who presented with maxillary sinusitis symptoms before and after dental treatment. Intraoral periapical radiographs and cone-beam computed tomography (CBCT) scans were performed on three patients whose maxillary sinusitis symptoms included pain, sinus congestion, respiratory complaints, and what appeared on CBCT to be sinus mucosal thickening. In the first of the three cases, root canal treatment was done. The second case entailed root canal treatment and extraction of the second molar, and in the third case endodontic retreatment was performed. Each patient had a pretreatment CBCT taken and one again at a 4- to 12-month post-treatment follow-up visit. All three patients who presented with moderate-severe sinusitis had reduced symptoms after odontogenic treatment. Post-treatment CBCT confirmed near to complete resolution of sinus mucosal thickening in all patients. These cases show that maxillary sinusitis of odontogenic origin can respond favorably to dental treatment. This case series emphasizes the importance of a medical and dental collaboration when determining treatment for patients who present with maxillary sinusitis. Additionally, the use of CBCT was essential for evaluating the maxillary sinus and its associated odontogenic conditions.

摘要

牙源性感染是上颌窦炎的一个可能病因。在这个病例系列中,作者评估了在牙科治疗前后出现上颌窦炎症状的患者。对三名上颌窦炎症状包括疼痛、鼻窦充血、呼吸道不适且锥形束计算机断层扫描(CBCT)显示鼻窦黏膜增厚的患者进行了口腔根尖片和CBCT扫描。在这三个病例中的第一个病例,进行了根管治疗。第二个病例进行了根管治疗并拔除了第二磨牙,第三个病例进行了根管再治疗。每个患者在治疗前都进行了CBCT检查,并在治疗后4至12个月的随访中再次进行检查。所有三名患有中重度鼻窦炎的患者在牙源性治疗后症状均有所减轻。治疗后的CBCT证实所有患者的鼻窦黏膜增厚几乎完全消退。这些病例表明,牙源性上颌窦炎对牙科治疗反应良好。这个病例系列强调了在为患有上颌窦炎的患者确定治疗方案时,医学与牙科合作的重要性。此外,使用CBCT对于评估上颌窦及其相关牙源性状况至关重要。

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