Shanghai Perio-Implant Innovation Center, Institute for Integrated Oral-Craniofacial and Multisensory Research, Shanghai Ninth People Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center of Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China; European Research Group on Periodontology, Genova, Italy.
Otolaryngol Clin North Am. 2024 Dec;57(6):957-975. doi: 10.1016/j.otc.2024.07.020. Epub 2024 Sep 2.
Periodontitis is a highly prevalent oral microbial biofilm-driven chronic inflammatory disease. If unmanaged, periodontitis leads to progressive destruction of the ligamentous attachments of teeth to the alveolar bone and resorption of the alveolar bone. It eventually leads to tooth hypermobility and loss. Periodontitis commonly causes overlying maxillary sinus inflammation (mucositis), reflected on radiographic imaging as maxillary sinus mucosal thickening. While uncommon, advanced periodontitis (stage III/IV) or chronic perio-endo lesions can lead to purulent odontogenic sinusitis (ODS). This article describes periodontitis pathophysiology, diagnostic features, and its potential to cause ODS. Clinical practice guideline conform therapy is very successful in managing periodontitis and enabling long-term tooth retention. Localized tooth extration is reserved to end-stage disease.
牙周炎是一种高度流行的口腔微生物生物膜驱动的慢性炎症性疾病。如果不加以治疗，牙周炎会导致牙齿与牙槽骨的韧带附着处逐渐破坏和牙槽骨吸收，最终导致牙齿过度松动和脱落。牙周炎常引起上颌窦炎症（黏膜炎），在影像学上表现为上颌窦黏膜增厚。虽然不常见，但晚期牙周炎（III/IV 期）或慢性牙周-牙髓病变可导致化脓性牙源性鼻窦炎（ODS）。本文描述了牙周炎的病理生理学、诊断特征及其导致 ODS 的潜力。符合临床实践指南的治疗方法对治疗牙周炎和长期保留牙齿非常成功。局部拔牙仅用于终末期疾病。
