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Med Oral Patol Oral Cir Bucal. 2010 Jan 1;15 (1):e70- Etiolo! o" odontoenic #a$illar! %inu%iti%Med Oral Patol Oral Cir Bucal. 2010 Jan 1;15 (1):e70- Etiolo! o" odontoenic #a$illar! %inu%iti%

e70 e70

 Journal sect ion: Oral Surgery doi:10.4317/medoral.15.e70

 Publication Tyes: !e"ie#

Meta-analisis of the etiology of odontogenic maxillary sinusitis

Oscar Arias-Irimia 1, Cristina Barona-Dorado 2, Juan A !antos-Marino 1, "atalia Mart#ne$-%odr#gue$ &,

Jos' M( Mart#ne$-)on$*le$ +

1 Oral &ureon o" t'e Oral and #lantoloical &urer! *eart#ent o" t'e +o%ital de Madrid2 ,%%ociate Pro"e%%or o" &urer! o" Madrid Co#luten%e nier%it!. &u/director o" t'e Ma%ter o" Oral &urer! and

#lantolo! o" t'e +o%ital de Madrid3 ,%%i%tant o" t'e Oral and #lantoloical &urer! *eart#ent o" t'e Madrid +o%ital ,%%i%tant Pro"e%%or o" &urer! o" Madrid Co#luten%e nier%it!. C'air#an o" t'e Oral and #lantoloical &urer! *e-

 art#ent o" t'e +o%ital de Madrid

$orresondence:$/ Jumilla% &7 

 'as !o(as &)&30 *+adrid,

d e nt o s car- o t m a i l .com

eceied: 1502200

,cceted: 3007200

,ria%-ri#ia O4 Barona-*orado C4 &anto%-Marino J,4 Martne6-odri-ue6 4 Martne6-8on69le6 JM. Meta-anal%i% o" t'e etiolo! o" odonto-

enic #a$illar! %inu%iti%. Med Oral Patol Oral Cir Bucal. 2010 Jan 1;15

(1):e70-3.' t t  : .# e d i c i na o r a l . c o # # e do r al " re e 0 1 1 5 i1 # e do r a l 1 5 i1 70 .  d " 

 rticle umber: &705 tt://## # .medicinaoral.com/ 

+edicina Oral S. '. $.2.. 66)336 2SS 16)4447 e2SS: 16)646 

e+ail: medicina-medicinaoral.com

Indexed in

-&C EP,*E*

-JO,< C=,=O EPO=&

-nde$ Medicu% ME*<E Pu/Med

-EMB,&E4 E$certa Medica

-&COP&-ndice M>dico E%a?ol

AstractO/@ectie: =o identi"! and ealuate t'e "reAuenc! o" t'e di""erent odontoenic condition% t'at #a! lead to #a$i-

llar! %inu%iti%. &tud! de%in: ,n o/%erational and retro%ectie #eta-anal!%i% a% carried out on 770 ca%e% o" 

#a$illar! %inu%iti% o/tained "ro# a literature reie o" 15 ar ticle%. e%ult%: Ma$illar! %inu%iti% #o%t co##onl!

#ani"e%t% it%el" a% c'ronic #a$illar! %inu%iti%. t i% #ore co##on in "e#ale% and i% #o%t o"ten diano%ed in t'e

"i"t' decade o" li"e. ='e teet' #o%t redo#inantl! a""ected are t'e #olar%4 it' t'e "ir%t #olar toot' /ein t'e

#o%t "reAuentl! inoled. ='e rincial etioloical "actor i% e$traction.

 Key words: +a8illary sinusitis% iatrogenia% ma8illary sinus% eriodontitis.

Introduction='e in"la##ation o" t'e %inu% #e#/rane t'at coer%

t'e arana%al %inu% i% re"ered a% #a$illar! %inu%iti%.

,#on t'e "our air o" arana%al %inu%4 t'e #a$illar!

%inu% are t'e /ie%t one% and t'o%e #o%t "reAuentl!da- #aed. Po%%i/le etioloie% co#ri%e local and

%!%te#ic condition% 'ic' can /e %u/diided into

acute4 %u/acute and c'ronic "or#% accordin to t'eir 

eolution. D'e- rea% t'e "ir%t to are u%uall!

 roduced /! in"ection% or alleric r'inoenou%

%ource%4 t'e c'ronic "or# i% u%ua- ll! a%%ociated it'

an odontoenic oriin.

 or#all! t'e root% o" t'e #a$illar! re#olar and#olar 

teet' are %earated "ro# t'e %inu% "loor /! a den%e cor-

tical /one it' a aria/le t'icne%%4 /ut %o#eti#e%

t'e! are %earated onl! /! t'e #ucoerio%teu#.

Clearl!4 t'i% anato#ical la!out can e$lain t'e %ource

and deelo- #ent o" an in"la##ator! roce%%4 and it

i% t'i% clo%e relation%'i t'e re%on%i/le "or t'e 37-

04FG (1) odon- toenic oriin o" t'e #a$illar!

%inu%iti% "or #an! au- t'or%.

='e 'i' incidence o" t'i% at'olo! reeal% t'e need

to reconi6e it a% an i#ortant di%ea%e e 'ae to /e

a/le to deal it' in order to reent it or een treat it

'eneer nece%%ar!.

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Material and Methods&tud! de%in: ,n o/%erational and retro%ectie

#eta- anal!%i% a% #ade o" t'e re%ult% o/tained " ro# a

Pu/- Med literature %earc'4 1 article% u/li%'ed

 /eteen

1HF and 2007. ,#on t'e#4 onl! 15 article% ere

c'o- %en (=a/le 1) a"ter al!in t'e inclu%ion criteria

%elec- ted: e$'i/it at lea%t ten ca%e% o" #a$illar!%inu%iti% o" odontoenic oriin on 'ic' t'eir 

etioloical aent a% included.

, total o" 770 ca%e% ere rei%tered "ro# t'e%e 15

ar- ticle% 'ic' ere %u/@ected to de%critie

%tati%tical anal!%i%4 it' ealuation o" t'e "olloin

 ara#eter%: ge: ='e ae o" eac' atient at t'e ti#e o"

t'e diano%i% a% rei%tered a% ell a% t'e aerae ae

and t'at %lit- ted into interal%.

9ender: ='e atient ender a% recorded and anal!6ed

to deter#ine 'et'er #a$illar! %inu%iti% 'ad a

 redilec- t ion "or one ender or t'e ot'er.

Toot in"ol"ed: De a%%e%%ed t'e di""erent teet'inoled

.ale 1 Etioloical "actor%

in t'i% di%ea%e in order to ealuate t'e "reAuenc! it'

'ic' t'e! cau%ed #a$illar! %inu%iti%.

Tye o sinusitis: De anal!6ed t'e "reAuenc! o" eac'

t!e o" #a$illar! %inu%iti%: acute4 %u/acute and c'ro-

nic.

 ;tiological origin: ='e etioloical aent re%on%i/le

"or t'e on%et o" t'i% di%ea%e a% recorded and anal!6ed

%o a% to e%ta/li%' it% "reAuenc!.

%esultseardin t'e ae4 t'e #ean atient ae at t'e ti#e o" 

t'e diano%i% o" #a$illar! %inu%iti% a% "ound to /e

247 !ear% (raned 1F-H0 !ear%) /ein t'e "ourt'

decade t'e #o%t "reAuentl! a""ected.

Concernin t'e anal!%i% o" t'e atient ender4 it a%

#ore realent in o#en (5747G) er%u% #en

(24H2G) it' a ratio 11433.

,/out t'e #ain antral toot' inoled4 t'e #olar reion

%tanded out it' a #a$illar! %inu%iti% "reAuenc! o" 

74FHG. ='e "ir%t #olar toot' a% t'e #o%t "reAuentl!a""ected it' an incidence o" 22451G4 "olloed /! t'e

t'ird #olar toot' (17421G) and t'e %econd #olar toot'

(347G). eardin t'e re#olar reion4 it a% onl!

a""ected in 54FG o" t'e ca%e%4 /ein t'e %econd

 re#o- lar toot' t'e #o%t "reAuentl! inoled (14HG).

On t'e ot'er 'and4 t'e canine onl! articiated in

04FFG o" t'e ca%e% o" #a$illar! %inu%iti% (Ii. 1).

Bilateral ca%e% are rare. +oeer4 in t'i% %tud!4 e"ound

2G #ore ca%e% on t'e le"t #a$illar! %inu% co#ared to

t'e ri't one.

n relation to t'e etioloical aent4 t'e iatroenia a%

 /! "ar4 t'e #o%t "reAuent cau%e o" t'i% di%ea%e(5547G). Ot'er o%%i/le etioloie% included: t'e

 eriodontit i% (043HG) and t'e odontoenic c!%t%

(F4FFG). Be!ond iatroenia t'ere ere %eeral "actor%

'ic' led to de- eloin #a$illar! %inu%iti%.

Oroantral "i%tule% and t'e re#ainin root%4 taen

toet'er a% iatroenia a"ter toot' e$traction4 accounted

"or 745FG it'in iatroenic cau- %e% 'ere a% t'e

dre%%in% to clo%e t'e%e oroantral "i%- tule% and t'e

non%eci"ic "orein /odie% "or t'e 1472G.

80 72

60

4034

20

0

26

6 93 1

/ig 1 =oot' inoled.

Author 0tiological factor"umer

of cases

Broo .(2)

,cute uliti% 7

Periodontal di%ea%e 10

atroenia 2

adicular c!%t 2

Co%ta I.(3)

Perii#lantiti% 2

atroenia H

Odontoenic c!%t 7

<eent et al.() atroenia FH

&el#ani et al.(5) atroenia 13

inciu% et al.(F) atroenia 13F

Melen et al.(1)Periodontal di%ea%e H2

atroenia 17

<oatin et al.(7)atroenia F0

Odontoenic c!%t 10

 i%'i#ura i6ua.(H)Periodontal di%ea%e 73

atroenia 7

 i#iean K.. et al.()Periodontal di%ea%e

atroenia 2F

,/ra'a#% 8la%%-

 /er.(10)Periodontal di%ea%e 32

 i%'i#ura =.(11) Periodontal di%ea%e 15

='eo6 et al(12) atroenia 10

Ilin! et al.(13) atroenia 11

acic et al.(1) atroenia 32

*oud 8alli et al.(15) atroenia 1

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='e e$tru%ion o" endodontic o/turation #aterial% into

t'e #a$illar! %inu% rere%ented t'e 22427G4 t'e a#al-

a# re#ain% a"ter aicoecto#ie% t'e 5433G4 t'e #a$i-

llar! %inu% li" t rei#lantolo! %urer! t'e 417G4 and

 oorl! o%itioned dental i#lant% or t'o%e #irated to

t'e #a$illar! %inu% t'e 042G o" all ca%e% included un-

der a iatroenic %ource.

DiscussionMa$illar! %inu%iti% i% a di%ea%e t'at o"ten inole%

odontoloi%t%4 /ot' in it% diano%i% and it% reention.

,% e 'ae reorted it' our re%ult%4 iatroenia i% it%

#ain cau%e. +oeer4 de%ite it% 'i' realence4 t'e-

re i% er! little literature a#on odontoloi%t%4 'ic'

contra%t% it' t'e "act t'at 0G o" t'e reie% t'at are

intere%ted on t'i% di%ea%e co#e "ro# t'e "ield o" t'e

otor'inolar!noloi%t%.

n t'i% %tud!4 iatroenia i% #uc' #ore "reAuent t'an

ot'er etioloical "actor% %uc' a% c'ronic eriodontiti%4

'ic' 'a% /een con%idered /! #an! aut'or% a% t'e #o%tco##on a! o" %readin oral at'oen% to t'e

#a$illar! %inu%. ='i% di%aree#ent it' our re%ult%4 a%

di%cu%%ed /! +uo- %on et al. (1F) #a! /e o%%i/l!

attri/uted to a decrea%e in c'ronic eriodontiti% due to a

 /etter oral '!iene.

+oeer /e!ond t'e ter# iatroenia t'ere i% a ide

rane o" "actor% 'ic' can /e taen into account. t i%

 /! all non t'at one o" t'e #o%t "reAuent actiitie%

done in a dental o""ice are teet' e$traction%; i" e are

aare o" t'e clo%e relation%'i /eteen t'e antral toot'

and t'e #a$illar! %inu% and o" t'e "act t'at oroantral

"i%tule% can /e con%idered a% a co#lication a"ter toot'

e$traction4 it i% "airl! rea%ona/le to /eliee (and in t'ata! it 'a% /een %'on in t'i% %tud!)4 t'at

 o%te$traction iatroenic %inu%iti% account% "or t'e

'i'e%t ercentae o" u/li%'ed ca%e%. n addition4 it

can al%o /e reealed 'o t'e rono%i% i% #aredl!

or%ed /! t'e "orein /od! reaction cau%ed a"ter #an!

atte#t% o" correctin t'e /uco%inu%al co##unication%

it' o%te$traction dre%%in% and /! unre#oed

"orein /odie%.

,not'er actiit! rone to deelo iatroenia i% t'e in-

crea%in de#and o" i#lantoloical treat#ent% e are

dealin noada!%4 %eciall! /! atient% it' er%i%tent

edentuli%# in t'e %u/antral reion% 'o%ere'a/ilitation co#licate% t'e tec'niAue %ince t'e!

reAuire %inu% "loor eleation. ='e%e tec'niAue% o" %inu%

li"t it' /one ra- "t% ere initiall! de%cri/ed in t'e 70

L% decade. ='eir ai# a% to %ort out t'e anato#ical

li#itation% 'ic' accoun- ted durin t'e lace#ent o"

i#lant% in t'e edentulou% near #a$illar! /one. ='ere

'ae /een %eeral reort% t'at a%%ociate t'e "loor %inu%

eleation it' t'e deelo- #ent o" %inu%iti% %uc' a% t'e

one de%cri/ed /! a'oe/ar et al. (17) in 'ic' t'e

%inu% #e#/rane a% drilled in 5 atient% it' onl!

to o" t'e# %u""erin "ro# %inu%iti%. ='e i#lant%

 lace#ent can al%o roduce %inu%iti% alt'ou' "or

#an! aut'or%4 t'i% i% er! rare. ,dell et al.

(1H) o/%ered no %inu%al co#lication% in 101 i#lant%

introduced /eteen 2 to ## in t'e %inu% a"ter 10

!ear% "ollo u illu%tratin t'at co#lication%

a%%ociated it' i#lant% 'ic' e#ere t'e #a$illar!

%inu% are not 'i- 'er t'an t'o%e 'ic' do not /rea 

t'rou' it.

,% reard% aicoecto#ie%4 it %ee#% o/iou% t'at it%

clo%e relation%'i it' t'e %inu% "loor #ae% it #oredi""icult to ac'iee ood re%ult% it'out co#lication%.

 eer- t'ele%%4 t'e! entail a co#lication le%% "reAuent

t'an e$- ected4 %ince t'e a%t #a@orit! o" t'e

 ro"e%%ional% rior toot' e$traction to t'i% tec'niAue4 a%

t'ere i% a 'i' ri% o" accidental e$o%ure o" t'e %inu%

 /ecau%e o" t'e clo%e relation%'i /eteen t'i% one and

t'e ae$. Een %o4 re- ort% %uc' a% t'e one u/li%'ed

 /! Ireed#an et al. (1) in 'ic' a"ter 72

aicoecto#ie%4 t'ere ere 23G o" drilled #olar%4 13G

o" drilled %econd re#olar% and 2G o" drilled "ir%t

#olar% it'out deeloin %inu%iti% an! o" t'e#4

reeal t'at t'ere i% no contradiction in #ain

aicoecto#! oer antral teet'4 de%ite it% ro$i#it! to

t'e #a$illar! %inu% (20). On t'e ot'er 'and4 a "orein

 /od! reaction #a! deelo i" a#ala# re#ain% are le"t

on t'e /one cait! reared "or aicoecto#!.

n t'e endodontic "ield4 it i% t'e e$tru%ion o" an! o" t'e

#aterial% u%ed in t'e rocedure t'e re%on%i/le "or t'e

in"la##ation o" t'e %urroundin ti%%ue%4 includin t'e

antral #uco%a. ='ere"ore4 not #ain a correct aical

%to 'eneer doin a root canal t'era! on an antral

toot'4 'a% a 'i' ri% o" roducin #a$illar! %inu%iti%.

Periodontal di%ea%e a% an etioloical aent o" %inu%iti%

'a% /een reorted lon ao4 "or e$a#le Bauer in 13

de#on%trated a"ter %tudie% done on cor%e%4 t'e directdi%%e#ination o" a /ucal %e%i% to t'e #a$illar! %inu%.

More recentl!4 ,/ra'a#% et al. (10) 'ae o/%ered

t'at %inu%iti% incidence on atient% it' eriodontal

di%ea%e i% dou/le to t'at on atient% it'out eriodontal

di%ea%e. ='e relation%'i /eteen t'e in"la##ation o"

t'e eriai- cal ti%%ue% and t'e da#ae to t'e %inu%

#e#/rane ended u in t'e non %!ndro#e o" Endo-

antral %!ndro#e. +oeer4 in t'e la%t "e !ear%4 t'e

incidence o" t'i% ur- o%e 'a% decrea%ed ro/a/l! in

relation to #an! "actor% alread! di%cu%%ed4 ointin out

t'e i#roe#ent o" oral '!iene and t'e reentie

tec'niAue% concernin t'e eriodontal di%ea%e. ='i%i#roe#ent o" oral '!iene i% o" out%tandin

releance %ince t'e current con%eratie trend lead% in

#an! ti#e% to re%ere teet' it' erio- dontal di%ea%e

a% t'e! 'ae a %lo and c'ronic eolution inducin

%!#to#% onl! a"ter !ear% o" illne%%.

='e lo incidence o" %inu%iti% concernin c!%t% i%

#ainl! due to t'e "act t'at durin t'eir deelo#ent4

t'e! u%' t'e %inu% %tructure% cau%in t'e# no da#ae

unle%% an in"ection account% or t'e o%tiu# o/%truct%

 reentin t'e natural drainae o" t'e %inu%. n eit'er 

%ituation a% in t'e ca%e% u/li%'ed /! Co%ta (3) or 

<oatin et al. (7) a #a$illar! %inu%iti% ill deelo4

'oeer it i% %till a rare etiolo!.

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%eferences1. Mel>n 4 <inda'l <4 ,ndr>a%%on <4 undcrant6 +. C'ronic #a$il-

lar! %inu%iti%. *e"inition4 diano%i% and relation to dental in"ection%

and na%al ol!o%i%. ,cta Otolar!nol. 1HF;101:320-

7.

2. Broo . Micro/iolo! o" acute and c'ronic #a$illar! %inu%iti%

a%- %ociated it' an odontoenic or iin. <ar!no%coe.

2005;115:H23-5.

3. Co%ta I4 E#anuelli E4 o/ion! M4 er#an 4 Polini I4 Politi M.

Endo%coic %urical treat#ent o" c'ronic #a$illar! %inu%iti% o" den-tal oriin. J Oral Ma$illo"ac &ur. 2007;F5:223-H.

. <eent I4 Billet J4 Beauillain C4 Bonnet J4 Mieeille M. ='e

role o" dental canal "illin% in t'e deelo#ent o" ,%erillu%

%inu%iti%. , reor t o" H5 ca%e%. ,rc' Otor'inolar!nol.

1H;2F:31H-20.

5. &el#ani 4 ,%'a##a'i . &urical treat#ent o" a#ala# "ill-

in% cau%in iatroenic %inu%iti%. J Cranio"ac &ur. 200F;17:3F3-5.

F. inciu% P4 Nu/iliu% 4 8erica% ,4 Kaitu% &. C'ronic odon-

toenic #a$illar! %inu%iti%. &to#atoloi@a. 200F;H:-H.

7. <oatin ,&4 &!%ol!atin &P4 &!%ol!atin P84 Melnio M. C'ron-

ic #a$illar! %inu%iti% o" dental oriin: i% e$ternal %urical aroac'

#andator!. <ar!no%coe. 2002;112:105F-.

H. i%'i#ura =4 i6ua =. Ealuation o" t'e at'o'!%iolo! o" 

odon- toenic #a$illar! %inu%iti% u%in /one %cintira'!. nt J Oral

Ma$il- lo"ac &ur. 2002;31:3H-F.. i#iean K4 i#iean K4 Maru 4 ,ndre%%ai% *4 Balat%oura%

*84 *anielidi% K. ='e #a$illar! %inu% and it% endodontic i#lica-

tion%: clinical %tud! and reie. B-E=. 200F;2:1F7-75.

10. ,/ra'a#% JJ4 8la%%/er M. *ental di%ea%e: a "reAuentl! unrec-

oni6ed cau%e o" #a$illar! %inu% a/nor#alitie%. ,J ,# J oent-

enol. 1F;1FF:121-23.

11. i%'i#ura =4 i6ua =. Ealuation o" odontoenic #a$illar! %i-

nu%iti% a"ter con%eratie t'era! u%in C= and /one &PEC=. Clin

#ain. 2002;2F:153-F0.

12. ='>o6 I4 ,r6a ,4 JaAue% B. *ental "orein /od! %inu%iti%. &c'-

ei6 Med Doc'en%c'r. 2000;&ul 125:30&-3&.

13. Ilin! 4 <a#a% 84 ou'ani I4 &oudant J. C'ronic #a$illar! %i-

nu%iti% o" dental oriin and na%o%inu%al a%erillo%i%. +o to #an-

ae intra%inu%al "orein /odie%. ,nn Otolar!nol C'ir Cerico"ac.

11;10H:F5-H.

1. aci ,4 *otli J4 Jano%ei <. Oral %urer! a% ri% "actor o" odon- toenic #a$illar! %inu%iti%. &r ,r' Celo <e.

200F;13:11-.

15. *oud 8alli &N4 <e/oit6 ,4 8iacc'i J4 8lic#an 4 Jaco/%

JB. C'ronic %inu%iti% co#licatin %inu% li"t %urer!. ,# J 'inol.

2001;15:1H1-

F.

1F. +uo%on ,4 order!d O4 &lotte C4 ='or%ten%%on +. *i%tr i/ution

o" eriodontal di%ea%e in a &edi%' adult oulation 1734 1H3 and

13. J Clin Periodontol. 1H;25:52-H.

17. a'oe/ar 8M4 Kan Dei%%en/ruc' 4 Ki%%in ,. 'ino-

%inu%iti% related to endo%%eou% i#lant% e$tendin into t'e na%al

cait!. , ca%e reort. nt J Oral Ma$illo"ac &ur. 200;33:312-.

1H. ,dell 4 <e'ol# 4 ocler B4 BrQne#ar P. , 15-!ear %tud!

o" o%%eointerated i#lant% in t'e treat#ent o" t'e edentulou% @a.

nt J Oral &ur. 1H1;10:3H7-1F.1. Ireed#an ,4 +oroit6 . Co#lication% a"ter aicoecto#! in

#a$illar! re#olar and #olar teet'. nt J Oral Ma$illo"ac &ur.

1;2H:12-.

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Oral Patol Oral Cir Bucal. 200F;11:E1F-50.