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167:Acute Maxillary Sinusitis of Odontogenic Origin: A Case Report[AAOM2021]
EP36066
Poster Title: 167:Acute Maxillary Sinusitis of Odontogenic Origin: A Case Report[AAOM2021]
Submitted on 29 Mar 2021
Author(s): Teng Kai Ong1, Ying W Sia2
Affiliations: 1: Endodontic Centre, Malaysia; 2: Oral Medicine Practice, Canada
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
Poster Views: 109
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Poster Information
Abstract: Maxillary sinuses are of greatest importance to dentists because of their contiguities to maxillary dentoalveolar structures and therefore, any potential disease arising from the maxillary dentoalveolar region could afflict the maxillary sinus. Maxillary sinusitis of odontogenic origin is a common condition, and it could be inadvertently diagnosed as common maxillary sinusitis. A combination of meticulous history taking and thorough clinical examination are primordial in rendering a diagnosis which reflects the origin of the disease. A 50 year-old female was referred to an Endodontic Centre for symptomatic tooth #14. Her symptoms consisted of an ongoing localized pain on #14 and left facial pain for the past 2 months with worsening symptoms over the last few days. She described the pain as sudden dull aching pain on #14 with occasional sharp shooting character during mastication and a background of dull aching pain on left malar region with no interference of daily activities and sleep. Food temperature variation could trigger and aggravate her symptoms. Medical history was non-contributory. Review of systems revealed only postnasal drip that coincided with the onset of symptoms. Clinical examination showed normal cranial nerves (II to XII), no limitation of mouth opening, tenderness upon percussion of #14 and upon palpation of buccal vestibule of #14, accentuated sensitivity of #14 and #15 upon cold test with no lingering pain and normal periodontium. Forwarded positional changes of head greatly increased her symptoms. Diagnostic anesthesia was performed on region of #14 and her symptoms completely resolved within minute. Periapical radiograph revealed a dome shape of radiopacity associated with the root tips #15 and was consistent with thickening of maxillary sinus mucosal lining. The diagnosis of #14 was symptomatic irreversible pulpitis with symptomatic apical periodontitis. Root canal treatment was initiated in the same visit and completed two weeks later. Her symptoms and postnasal drip were completely resolved. The post-op periapical radiograph revealed complete resolution of sinus mucosal thickening associated with #14. This case report highlighted an example of dental pain leading to symptomatic maxillary sinusitis and thus, dentists should consider including odontogenic origin in the differential diagnosis of acute maxillary sinusitis.Summary: This case report highlighted an example of dental pain leading to symptomatic maxillary sinusitis and thus, dentists should consider including odontogenic origin in the differential diagnosis of acute maxillary sinusitis upon appropriate history taking and clinical examination.

Ask the author questions about this poster:yws2012@gmail.com
References: 1. Kim, S.M., Definition and management of odontogenic maxillary sinusitis. Maxillofac Plast Reconstr Surg, 2019. 41(1): p. 13.
2.Bell, G.W., B.B. Joshi, and R.I. Macleod, Maxillary sinus disease: diagnosis and treatment. Br Dent J, 2011. 210(3): p. 113-8.
3. Pokorny, A. and R. Tataryn, Clinical and radiologic findings in a case series of maxillary sinusitis of dental origin. Int Forum Allergy Rhinol, 2013. 3(12): p. 973-9.
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