Sinusitis Maksilaris2 (Drg Anang)

8/18/2019 Sinusitis Maksilaris2 (Drg Anang)

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MAXILLARY SINUSITIS CAUSED BY

DENTAL INFECTIONS

Anang Prasetiyono, drg SpBM



Introduction

-Inflammation of sinus mucosal lining

-10-15% dental origin

-dental symptom

Maxillary Sinusitis :

Serious Complications



Anatomy of maxiary !inu!



"at#o$#y!ioo%y

Trauma, infection,

allergic

Inflammation of mucosa

of maxillary sinus / nasal

Hyperplasia &

Hypertrophy

Sinonasal mucosa

Increase mucus

secretory

!struction of

Sinus stium

"ecrease drainage &

Accumulation of fluids

and de!ris

Accumulation

of !acteria

infection



"at#o$#y!ioo%y



Etioo%y

-Trauma, infection, allergic

dontogenic :

! acute" c#ronic periapical "periodontaldiseases

! iatrogenic : o$erfill endodontic material

! trauma from surgery of teet#" maxilla oroantral fistula



Etioo%y

acteriae :

Streptoccocus aero&, 'eptococcus

anaero&, 'eptostreptococcus,'orp#yromonas, 'ro$otella, (u&acterium

spp

C#ronic :

'orp#yromonas )acteroides* species,

+eillonela, Corine&acterium,

alp#a-#emolytic Streptococcus,

Stap#ylococcus, Streptopyogenes



Cinica !i%n!

Acute # rapidly de$eloping sense of pressure, pain,

fullness in affected sinus

- discomfort rapidly increase, facial selling,erytema, malaise, fe$er, drainage of foul-smelling mucopurulent material into t#e nasalca$ity nasop#aryng

- dental origin : unilateral pain, usually $ague inorigin, pain increase #en patient &ends o$er - $ital teet# may &e sensiti$e to percussion



Cinica !i%n!

$hronic # .ailed treatment from acute p#ase, recurence, /

mont#s

Symptoms lie acute

2ipersecretion mucopurulen

3arely caused &y odontogenic infection

'redisposition : allergic, nasal septum de$iation



Dia%no!i! maxiary

!inu!iti!

4namnesis Clinical examination :

- tapping of lateral alls of sinus externally- intraoral palpation on t#e lateralsurface of maxilla &eteen t#ecanine fossa and ygomatic&uttress



3adiograp#ic :

an air-fluid le$el in t#e sinus

t#icened mucosa on any or all of t#e sinus alls

complete opacification of t#e sinus ca$ity



T#&ra$y of maxiary !inu!iti!

6on-surgical :- &ed rest

- ade7uate fluid intae - drainage and irrigation

- painless it# analgetics - eliminate focal infection - nasal decongestants : pseudoep#edrin ep#edrine 5 %

- mucolitic agents- anti&iotic )4moxicillin, 4moxicillin-Cla$ulanat, Trimet#oprim,

Sulfamet#oxaole, Cep#alosporin, 8oxiciclin, (ryt#romycin,

Clindamycin*

Surgical :

- surgical drainage intranasal antrostomy - Caldell-9uc approac# - closure oroantral fistula



Cad'&(Luc



Co!ur& oroantra fi!tua



om$ication!

r!ita # (dematous reaction

r&ita cellulitis

Su&periosteal a&cess

r&ita a&cess

Sinus ca$ernosus t#rom&osis

$ranial # 4cute meningitis

8uramater a&cess



Concu!ion

Maxillary sinusitis : inflammatory of sinus

mucosal dental infection

Treatment : 4nti&iotic, irrigation drainage ofsinus, eliminating cause factors

6on-ade7uate treatment serious

complication at or&ita and cranial

T#e dentist s#ould no symptom clinicalexamination



THANK YOU

Sinusitis Maksilaris2 (Drg Anang)

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