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International Journal of Oral and... Feb 2023The displacement of dental implants into the maxillary sinus is increasingly reported and may lead to serious complications. Better knowledge of this condition could... (Review)
Review
The displacement of dental implants into the maxillary sinus is increasingly reported and may lead to serious complications. Better knowledge of this condition could help clinicians improve their practice, but it is difficult to draw conclusions from the current literature. Therefore, a systematic review was performed to describe the main characteristics of dental implant displacement, as well as its management and temporal evolution over a 31-year period. This review was conducted according to the PRISMA methodology. The PubMed/Scopus electronic databases were searched to December 2021. Risk of bias was assessed using the Joanna Briggs Institute tools. A total of 73 articles reporting 321 patients with displaced dental implants were included. Implants located in the upper first molar site were the most frequently involved (23.7%). Displacement occurred mainly during the first 6 months after implant placement (62.6%). The majority became symptomatic (56.2%), most often due to maxillary sinusitis and/or oroantral communication (44.2%). The surgical approaches to remove displaced implants were the lateral approach (38.1%), the Caldwell-Luc approach (27.2%), and endoscopic nasal surgery (23.1%). This review highlights the importance of preventive measures: avoiding implant displacement by careful pre-implantation radiographic analysis, but also preventing infectious complications through early removal of the displaced implant (PROSPERO CRD42021279473).
Topics: Humans; Maxillary Sinus; Dental Implants; Maxillary Sinusitis; Molar; Endoscopy
PubMed: 35778233
DOI: 10.1016/j.ijom.2022.06.009 -
International Journal of Surgery Case... Aug 2022The oro-antral communication (OAC) is a pathological opening between the maxillary sinus and the oral cavity. When it does not close spontaneously or if it is not...
INTRODUCTION AND IMPORTANCE
The oro-antral communication (OAC) is a pathological opening between the maxillary sinus and the oral cavity. When it does not close spontaneously or if it is not treated, it remains permeable and epithelializes to develop into an oro-antral fistula (OAF) and can cause maxillary sinusitis.
CASES PRESENTATION
The authors present through 5 clinical cases the different steps of the surgical protocols opting for the buccal fat pad flap and the advanced buccal flap to treat OAF/OAC.
CLINICAL DISCUSSION
Surgical closure of the OAC within 48 h is recommended to avoid complications. Several alternative techniques have been described over the years for the management of the OAC and OAF, with their advantages and limitations. The most commonly used surgical flaps are of two types: the advanced buccal flap and the buccal fat pad (BFP) flap.
CONCLUSION
The adequate availability of the advanced buccal flap and the buccal fat pad (BFP) flap in the majority of patients, the easy handling, the minimal donor site morbidity as well as the excellent blood supply make them perfect flaps for the closure of OAF/OAC. However, follow-up remains a key point and very important to avoid complications. The present case series was limited by the small number of patients and the authors recommend a study with larger groups.
PubMed: 35917603
DOI: 10.1016/j.ijscr.2022.107436 -
International Journal of... 2023Mucormycosis is called as black fungus, which is caused by fungus belonged to Mucorales. If this fungus, effects healthy individuals it won't cause any serious...
Mucormycosis is called as black fungus, which is caused by fungus belonged to Mucorales. If this fungus, effects healthy individuals it won't cause any serious complications, but it may cause life-threatening issues when Mucorales affects individuals who have low immunity. The mortality rate of black fungus is more than 50%, and it may also range till 100% if the individual is having any preexisting or chronic disease. This was the case of a 55-year-old male patient complaint of having generalized pain in the maxillary teeth bilaterally and suffering fullness in the maxillary sinus. To check on other possible diseases, doctors have conducted other diagnosis tests, and orthopantomogram revealed in the diagnosis that there was the presence of haziness in the left maxillary sinus, which looked like an incompletely formed soap bubble and additionally he diagnosed with coronavirus disease positive. Then, doctors suggested a chest computerized tomography (CT) along with head CT excluding the brain and further investigation of this case was given below in detail. The report reveals acute necrotizing suppurative sinusitis with dead bony tissue, soft-tissue necrosis with fungal infestation showing broad hyphae with right-angle branching suggestive of mucormycosis.
Topics: Male; Humans; Middle Aged; Mucormycosis; Coronavirus; Mucorales; Sinusitis
PubMed: 36926770
DOI: 10.4103/ijmy.ijmy_207_22 -
Indian Journal of Otolaryngology and... Oct 2022Ethmoidal infundibulum (EI) is an important part of the osteomeatal complex, which provides the main pathway for the maxillary sinus drainage. This study aimed to...
Ethmoidal infundibulum (EI) is an important part of the osteomeatal complex, which provides the main pathway for the maxillary sinus drainage. This study aimed to compare the length, width, and angulation of EI in patients with/without maxillary sinusitis using computed tomography (CT). This cross-sectional study evaluated 818 spiral CT scans of patients with/without maxillary sinusitis (n = 409 maxillary sinuses in each group) classified according to the clinical symptoms and the Lund-Mackay score for mucosal thickening. The degree of mucosal thickening (on axial and coronal sections), anatomical variations namely concha bullosa (CB), ethmoidal bulla (EB), and Haller cells (HCs), the form of EI (on coronal sections), the length, width and angulation of EI, and degree of nasal septal deviation (on coronal sections) were all evaluated. Data were analyzed by parametric and non-parametric tests (alpha = 0.05). The frequency of EB ( < 0.001), EI form ( < 0.001) and HC ( = 0.011), and the length and width of EI ( < 0.001) were significantly different in patients with and without maxillary sinusitis. The length and width of EI were significantly correlated with the degree of mucosal thickening ( < 0.01). The frequency of CB ( = 0.002), EB ( < 0.001), and HC ( = 0.002), and the EI form ( < 0.001) were significantly different in groups with different degrees of mucosal thickening. EI was wider and shorter in patients with maxillary sinusitis. By an increase in mucosal thickness, the length of EI decreased while its width increased. Also, the frequency of EB and HC, and the EI form were significantly different in the two groups.
PubMed: 36452627
DOI: 10.1007/s12070-020-02290-1 -
International Journal of Paleopathology Jun 2024To assess the differences between endoscopic and radiological methods of analysis for diagnosing chronic maxillary sinusitis (CMS) in archaeological skeletal remains. (Comparative Study)
Comparative Study
OBJECTIVE
To assess the differences between endoscopic and radiological methods of analysis for diagnosing chronic maxillary sinusitis (CMS) in archaeological skeletal remains.
MATERIALS
32 crania from a Dutch post-medieval rural population.
METHODS
We assessed the presence of bone changes indicative of CMS (i.e., bone growth and bone resorption) both endoscopically and through computed tomography (CT), and then compared results.
RESULTS
We observed moderate agreement between bone growth scores obtained through endoscopy and CT, and fair agreement when assessing bone resorption.
CONCLUSIONS
CMS prevalence rates observed through CT may be comparable to rates assessed endoscopically, although caution is needed when making direct comparisons.
SIGNIFICANCE
This is the first study comparing data obtained through endoscopy and radiological methods in the study of CMS, informing paleopathologists about potential biases in data comparison.
LIMITATIONS
Our small sample size likely impacted results.
SUGGESTIONS FOR FURTHER RESEARCH
Further research is advised to fully explore the comparability of endoscopic and radiological method of analysis in the study of sinusitis.
DATA AVAILABILITY
The datasets generated and analyzed during the current study are available upon request.
Topics: Humans; Maxillary Sinusitis; Tomography, X-Ray Computed; Chronic Disease; Male; Endoscopy; Female; Netherlands; Adult; Paleopathology; Middle Aged
PubMed: 38643685
DOI: 10.1016/j.ijpp.2024.04.001 -
The Kobe Journal of Medical Sciences Apr 2021The purpose of this study was to evaluate the usefulness of adding Waters' projection to panoramic imaging compared with panoramic imaging or Waters' projection alone....
The purpose of this study was to evaluate the usefulness of adding Waters' projection to panoramic imaging compared with panoramic imaging or Waters' projection alone. Maxillary sinusitis in 106 patients (206 sinuses) was retrospectively assessed with panoramic imaging, Waters' projection, and computed tomography imaging by two oral radiologists. The diagnostic performance was assessed with computed tomography imaging as the gold standard. Receiver operating characteristic curves and area under the curve values were obtained. Inter- and intra-observer agreement was quantified using weighted kappa coefficients. Observer A performed the same procedure twice (A1 and A2 for the first and second observations, respectively). The accuracies of observers A1, B, and A2 with combination imaging were 0.699, 0.636, and 0.718, respectively. Their area under the curve values with combination imaging were 0.746, 0.640, and 0.771, respectively. Inter-observer agreement was good for Waters' projection (κ, 0.650), and poor for panoramic imaging (κ, 0281). Intra-observer agreement was good for Waters' projection (κ, 0.752), and moderate for panoramic imaging (κ, 0.597). Panoramic imaging was equivalent to Waters' projection for diagnosing maxillary sinusitis. Combination imaging comprising panoramic imaging and Waters' projection can contribute to the diagnosis of odontogenic maxillary sinusitis because of its high sensitivity.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cone-Beam Computed Tomography; Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Middle Aged; Predictive Value of Tests; ROC Curve; Radiography, Dental; Radiography, Panoramic; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed; Tooth Diseases; Young Adult
PubMed: 34001686
DOI: No ID Found -
Head & Face Medicine Jan 2016The management of bisphosphonate related necrosis of the jaw has become clinical routine. While approximately two thirds of the lesions are in the mandible, one third is...
BACKGROUND
The management of bisphosphonate related necrosis of the jaw has become clinical routine. While approximately two thirds of the lesions are in the mandible, one third is located in the maxilla. In 40-50 % of maxillary necrosis the maxillary sinus is involved, leading to maxillary sinusitis and oro-antral communications.
METHODS
This retrospective single center study includes all patients with diagnosis of BP-ONJ of the maxilla and concomitant maxillary sinusitis. The information collected includes age, gender, primary disease, bisphosphonate intake, involving type of bisphosphonate, route of administration and duration of BP treatment previous to surgical treatment and treatment outcome.
RESULTS
A total of 12 patients fulfill the criteria of the diagnosis of maxillary sinusitis associated to maxillary necrosis, of which 6 Patients showed purulent sinusitis. All patients underwent surgical treatment with complete resection of the affected bone and a multilayer wound closure. A recurrence appeared in one patient with open bone and no sign of sinusitis and was treated conservatively.
CONCLUSIONS
Purulent maxillary Sinusitis is a common complication of bisphosphonate-related necrosis of the maxilla. The surgical technique described can be suggested for the treatment of these patients.
Topics: Aged; Aged, 80 and over; Bisphosphonate-Associated Osteonecrosis of the Jaw; Female; Humans; Male; Maxilla; Middle Aged; Retrospective Studies; Sinusitis; Surgical Flaps; Treatment Outcome
PubMed: 26732879
DOI: 10.1186/s13005-015-0099-0 -
Journal of the Chinese Medical... Oct 2018The aim of this study was to evaluate the diagnostic efficacy of sinus ultrasound for acute and subacute maxillary sinusitis (ASMS) by investigating the agreement...
BACKGROUND
The aim of this study was to evaluate the diagnostic efficacy of sinus ultrasound for acute and subacute maxillary sinusitis (ASMS) by investigating the agreement between different tools. We also proposed a confirmatory tool directed protocol for adult acute sinusitis, to enhance diagnostic accuracy.
METHODS
This prospective cohort study enrolled patients who were older than 18 years, with a diagnosis of maxillary sinusitis. The duration of symptoms was confined to less than 12 weeks. Rigid nasal endoscopy, sinus ultrasound, and plain sinus film were performed for all patients on the same day to confirm the diagnosis. Kappa statistics were used to test interrater reliability.
RESULTS
A total of 148 maxillary sinuses in 74 patients (38 men, 36 women) were evaluated. Sinus ultrasound and rigid nasal endoscopy disclosed the best agreement (agreement = 0.78, κ = 0.556). The agreement of rigid nasal endoscopy and plain sinus film was relatively poor (agreement = 0.72, κ = 0.446). Sinus ultrasound and plain sinus film had the poorest diagnostic consistency (agreement = 0.67, κ = 0.338).
CONCLUSION
Sinus ultrasound is a quick, safe, cost effective, and relatively easy-to-use technique for clinicians to evaluate the maxillary sinus. Sinus ultrasound and rigid nasal endoscopy are complementary tests to confirm the diagnosis of ASMS.
Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Middle Aged; Prospective Studies; Tomography, X-Ray Computed; Ultrasonography; Young Adult
PubMed: 29779998
DOI: 10.1016/j.jcma.2018.03.005 -
Archives of Craniofacial Surgery Mar 2016Absorbable plates are used widely for fixation of facial bone fractures. Compared to conventional titanium plating systems, absorbable plates have many favorable traits.... (Review)
Review
Absorbable plates are used widely for fixation of facial bone fractures. Compared to conventional titanium plating systems, absorbable plates have many favorable traits. They are not palpable after plate absorption, which obviates the need for plate removal. Absorbable plate-related infections are relatively uncommon at less than 5% of patients undergoing fixation of facial bone fractures. The plates are made from a mixture of poly-L-lactic acid and poly-DL-lactic acid or poly-DL-lactic acid and polyglycolic acid, and the ratio of these biodegradable polymers is used to control the longevity of the plates. Degradation rate of absorbable plate is closely related to the chance of infection. Low degradation is associated with increased accumulation of plate debris, which in turn can increase the chance of infection. Predisposing factors for absorbable plate-related infection include the presence of maxillary sinusitis, plate proximity to incision site, and use of tobacco and significant amount of alcohol. Using short screws in fixating maxillary fracture accompanied maxillary sinusitis will increase the rate of infection. Avoiding fixating plates near the incision site will also minimize infection. Close observation until complete absorption of the plate is crucial, especially those who are smokers or heavy alcoholics. The management of plate infection is varied depending on the clinical situation. Severe infections require plate removal. Wound culture and radiologic exam are essential in treatment planning.
PubMed: 28913243
DOI: 10.7181/acfs.2016.17.1.1 -
International Journal of Implant... Mar 2021During implant treatment in the maxillary molar area, maxillary sinus floor augmentation is often performed to ameliorate the reduced alveolar bone height attributable...
BACKGROUND
During implant treatment in the maxillary molar area, maxillary sinus floor augmentation is often performed to ameliorate the reduced alveolar bone height attributable to bone remodeling and pneumatization-induced expansion of the maxillary sinus. However, this augmentation may cause complications such as misplaced implants, artery damage, and maxillary sinus mucosal perforation; infections like maxillary sinusitis; and postsurgical complications such as bone graft leakage and postoperative nasal hemorrhaging. To reduce the complications during maxillary sinus floor augmentation and postoperative infections, we performed retrospective investigations of various systemic and local factors that influence pre-operative sinus mucosal thickness (SMT) by using cone-beam computed tomography (CBCT). Subjects included patients who underwent maxillary sinus floor augmentation in an edentulous maxillary molar area with a lateral approach. Pre-operative SMT, existing bone mass, and nasal septum deviation were measured using CBCT images. Relationships between SMT and the following influencing factors were investigated: (1) age, (2) sex, (3) systemic disease, (4) smoking, (5) period after tooth extraction, (6) reason for tooth extraction, (7) residual alveolar bone height (RBH), (8) sinus septa, and (9) nasal septum deviation. Correlations were also investigated for age and RBH (p < 0.05).
RESULTS
We assessed 35 patients (40 sinuses; 11 male, 24 female). The average patient age was 58.90 ± 9.0 years (males, 57.9 ± 7.7 years; females, 59.9 ± 9.4 years; age range, 41-79 years). The average SMT was 1.09 ± 1.30 mm, incidence of SMT > 2 mm was 25.0%, incidence of SMT < 0.8 mm was 50.0%, and the average RBH was 2.14 ± 1.02 mm. The factors that influenced SMT included sex (p = 0.0078), period after tooth extraction (p = 0.0075), reason for tooth extraction (p = 0.020), sinus septa (p = 0.0076), and nasal septum deviation (p = 0.038).
CONCLUSIONS
Factors associated with higher SMT included male sex, interval following tooth extraction < 6 months, periapical lesions, sinus septa, and nasal septum deviation. Factors associated with SMT > 2 mm were sex and reason for tooth extraction, while factors associated with SMT < 0.8 mm were time following tooth extraction and nasal septum deviation. Despite the limitations of this study, these preoperative evaluations may be of utmost importance for safely conducting maxillary sinus floor augmentation.
Topics: Adult; Aged; Cone-Beam Computed Tomography; Female; Humans; Male; Maxillary Sinus; Middle Aged; Mouth, Edentulous; Retrospective Studies; Sinus Floor Augmentation
PubMed: 33649993
DOI: 10.1186/s40729-021-00298-y