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Otolaryngology--head and Neck Surgery :... Apr 2022Odontogenic sinusitis (ODS) can cause infectious orbital, intracranial, and osseous complications. Diagnosis and management of complicated ODS have not been discussed in...
OBJECTIVE
Odontogenic sinusitis (ODS) can cause infectious orbital, intracranial, and osseous complications. Diagnosis and management of complicated ODS have not been discussed in recent sinusitis guidelines. The purpose of this systematic review was to describe epidemiological and clinical features, as well as management strategies of complicated ODS.
DATA SOURCES
PubMed, EMBASE, and Cochrane Library.
REVIEW METHODS
A systematic review was performed to describe various features of complicated ODS. All complicated ODS studies were included in qualitative analysis, but studies were only included in quantitative analysis if they reported specific patient-level data.
RESULTS
Of 1126 studies identified, 75 studies with 110 complicated ODS cases were included in qualitative analysis, and 47 studies with 62 orbital and intracranial complications were included in quantitative analyses. About 70% of complicated ODS cases were orbital complications. Only 23% of complicated ODS studies were published in otolaryngology journals. Regarding ODS-related orbital and intracranial complications, about 80% occurred in adults, and 75% were male. Complicated ODS occurred most commonly from apical periodontitis of maxillary molars. There were no relationships between sinusitis extent and orbital or intracranial complications. High rates of anaerobic and α-hemolytic streptococcal bacteria were identified in complicated ODS. Management generally included systemic antibiotics covering aerobic and anaerobic bacteria, and surgical interventions were generally performed to address both the complications (orbital and/or intracranial) and possible infectious sources (dentition and sinuses).
CONCLUSION
ODS should be considered in all patients with infectious extrasinus complications. Multidisciplinary management between otolaryngologists, dental specialists, ophthalmologists, and neurosurgeons should be considered to optimize outcomes.
Topics: Adult; Anti-Bacterial Agents; Humans; Male; Orbital Diseases; Otolaryngologists; Otolaryngology; Paranasal Sinuses; Sinusitis
PubMed: 34253072
DOI: 10.1177/01945998211026268 -
Biology Jun 2021The aim of this systematic review and meta-analysis was to analyze and compare the survival rate and prosthetic and sinus complications of zygomatic dental implants for... (Review)
Review
Survival Rate and Prosthetic and Sinus Complications of Zygomatic Dental Implants for the Rehabilitation of the Atrophic Edentulous Maxilla: A Systematic Review and Meta-Analysis.
UNLABELLED
The aim of this systematic review and meta-analysis was to analyze and compare the survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla.
MATERIALS AND METHODS
We conducted a systematic literature review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla. Four databases were consulted during the literature search: Pubmed-Medline, Scopus, Embase, and Web of Science. After eliminating duplicate articles and applying the inclusion criteria, 46 articles were selected for the qualitative analysis and 32 for the quantitative analysis.
RESULTS
Four randomized controlled trials, 19 prospective clinical studies, 20 retrospective studies, and 3 case series were included in the meta-analysis. Conventional dental implants failure ( = 3549) were seen in 2.89% (IC-95% 1.83-3.96%), while zygomatic dental implants failure ( = 1895) were seen in 0.69% (IC-95% 0.21-1.16%). The measure of the effect size used was the Odds Ratio, which was estimated at 2.05 with a confidence interval of 95% between 1.22 and 3.44 (z test = 2.73; -value = 0.006). The failure risk of conventional dental implants is 2.1 times higher than that of zygomatic dental implants. Slight heterogeneity was determined in the meta-analysis between 23 combined studies (Q test = 32.4; -value = 0.070; I = 32.1%). Prosthetic complications were recorded in 4.9% (IC-95% 2.7-7.3%) and mild heterogeneity was observed in a meta-analysis of 28 combined studies (Q test = 88.2; -value = 0.001; I = 69.4%). Sinus complications were seen in 4.7% (IC-95% 2.8-6.5%) and mild heterogeneity was observed in a meta-analysis of 32 combined studies (Q test = 75.3; -value = 0.001; I = 58.8%).
CONCLUSIONS
The high survival rate and low prosthetic and sinus complications related to zygomatic dental implants suggest the use of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla.
PubMed: 34209770
DOI: 10.3390/biology10070601 -
The Annals of Otology, Rhinology, and... Nov 2021Paranasal sinus fungus ball is a common non-invasive mycosis with excellent long-term surgical treatment results. The present systematic review and meta-analysis were... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Paranasal sinus fungus ball is a common non-invasive mycosis with excellent long-term surgical treatment results. The present systematic review and meta-analysis were undertaken to define current treatment concepts and success rates in paranasal sinus fungus ball treatment.
METHODS
Systematic searches were performed in multiple databases with criteria designed to include all studies published until May 2020 focusing on paranasal sinuses fungus ball treatment in humans. We selected studies including at least 10 patients, specifying treatment modalities, providing a minimum 6-month follow-up, and objectivating treatment success. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for treatment modalities and success rates. Success rates were pooled in a random effect meta-analysis and compared according to the use of intraoperative sinus lavages and postoperative antibiotics.
RESULTS
Among 740 unique citations, 14 studies were deemed eligible. Most (n = 11) were retrospective case series. All studies relied on endoscopic sinus surgery. Intraoperative lavages were proposed in 10 studies and postoperative antibiotics in 7 (for all patients in 5 studies and for selected patients in 2). No significant heterogeneity was observed between results (Cochran's Q = .639, test = 0). Treatment success rate was 98.4% (95% confidence interval 97.4%-99.3%). Intraoperative sinus toilette and postoperative antibiotics didn't significantly improve the success rate.
CONCLUSION
Endoscopic sinus surgery shows excellent results in fungus ball treatment. Further prospective studies might help further reducing antibiotics prescriptions in these patients and improve their management.
Topics: Humans; Maxillary Sinus; Mycoses; Natural Orifice Endoscopic Surgery; Paranasal Sinus Diseases; Perioperative Care; Treatment Outcome
PubMed: 33733891
DOI: 10.1177/00034894211002431 -
European Archives of... Oct 2021Odontogenic sinusitis (ODS) is underrepresented in the literature compared to other forms of rhinosinusitis, specifically in sinusitis guidelines and position...
PURPOSE
Odontogenic sinusitis (ODS) is underrepresented in the literature compared to other forms of rhinosinusitis, specifically in sinusitis guidelines and position statements. ODS publication characteristics could help explain why ODS has received less attention in sinusitis guidelines and position statements. The purpose of this study was to explore trends in the quantity and quality of ODS studies over 3 decades from 1990 to 2019.
METHODS
A systematic review was performed to identify all ODS studies from 1990 to 2019. The following variables from all ODS studies were compared between and across the 3 decades: authors' specialties, journal specialties, authors' geographic origins (continents), study topics, study designs, and evidence levels.
RESULTS
From 1990 to 2019, there were 254 ODS studies that met inclusion criteria. Numbers of publications increased each decade, with 161 being published from 2010 to 2019. Otolaryngologists and dental authors published over 75% of ODS studies each decade, with 60-75% of ODS articles being published in otolaryngology or dental journals. European and Asian authors published the most ODS studies each decade. Overall, 92-100% of ODS publications per decade were level 4 and 5 evidence, with no significant changes between or across decades.
CONCLUSION
While numbers of ODS publications increased each decade from 1990 to 2019, evidence levels remained low without significant changes over time. Otolaryngologists and dental authors published the majority of ODS studies each decade, with a minority of these studies being multidisciplinary. More ODS studies are needed across all aspects of the condition, and future projects would benefit from improved study designs and multidisciplinary collaboration.
Topics: Humans; Maxillary Sinusitis; Otolaryngologists; Otolaryngology; Research Design; Sinusitis
PubMed: 33609178
DOI: 10.1007/s00405-021-06688-7 -
The International Journal of Oral &... 2021To assess the postoperative complications and outcome (implant survival) of quad zygomatic implants inserted in patients with edentulism and severely atrophic maxillae. (Meta-Analysis)
Meta-Analysis
PURPOSE
To assess the postoperative complications and outcome (implant survival) of quad zygomatic implants inserted in patients with edentulism and severely atrophic maxillae.
MATERIALS AND METHODS
Two independent reviewers conducted an electronic search of the literature (PubMed, Scopus, EBSCO, Web of Science) from January 2000 to February 2019. The inclusion criteria were articles published in English reporting data of at least five patients with severely atrophic edentulous maxillae undergoing placement of four zygomatic implants without additional insertion of standard implants, with a minimum of 6 months of follow-up. Data extracted included number of patients, characteristics of the maxillary defect, number of zygomatic implants, implant details, surgical procedure, prosthetic rehabilitation, postoperative complications, survival rate, and length of follow-up after definitive prosthesis delivery.
RESULTS
Eleven studies with 166 patients were included. The heterogeneity among studies was not significant. The pooled incidence rates of complications were as follows: sinusitis 12% (95% confidence interval [CI]: 4% to 23%), malposition and surgical guiding failure 11% (95% CI: 3% to 21%), local infection/injury 10% (95% CI: 3% to 18%), and prosthetic complications 5% (95% CI: 0% to 13%). The implant survival rate ranged between 95.8% and 100%, and the pooled implant survival rate in the meta-analysis was 98% (95% CI: 97% to 99%).
CONCLUSION
Quad zygomatic implants inserted in patients with severely atrophic edentulous maxillae have a high implant survival rate, but the incidence of complications should not be underestimated.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Follow-Up Studies; Humans; Jaw, Edentulous; Maxilla; Treatment Outcome; Zygoma
PubMed: 33600519
DOI: 10.11607/jomi.8417 -
American Journal of Otolaryngology 2021Endodontic disease is one of the most common causes of bacterial odontogenic sinusitis (ODS). Diagnosing ODS of endodontic origin involves otolaryngologists confirming... (Review)
Review
PURPOSE
Endodontic disease is one of the most common causes of bacterial odontogenic sinusitis (ODS). Diagnosing ODS of endodontic origin involves otolaryngologists confirming sinusitis, and dental specialists confirming endodontic sources. The purpose of this study was to conduct a multidisciplinary literature review to highlight clinical and microbiological features of ODS, and the most optimal diagnostic modalities to confirm endodontic disease.
METHODS
An extensive review of both medical and dental literature was performed by rhinologists, endodontists, and an infectious disease specialist. Frequencies of various clinical and microbiological features from ODS studies were collected, and averages were calculated. Different endodontic testing and imaging modalities were also evaluated on their abilities to confirm endodontic disease.
RESULTS
ODS patients most often present with unilateral sinonasal symptoms for over 3 months, purulence on nasal endoscopy, and overt dental pathology on computed tomography (CT). Subjective foul smell, and maxillary sinus cultures demonstrating anaerobes and α-streptococci (viridans group) may be more specific to ODS. For endodontic evaluations, cold pulp testing and cone-beam CT imaging are most optimal for confirming pulpal and periapical disease.
CONCLUSION
Diagnosing ODS requires collaboration between otolaryngologists and dental specialists. Clinicians should suspect ODS when patients present with unilateral sinonasal symptoms, especially foul smell. Patients will generally have purulent drainage on nasal endoscopy, and both sinus opacification and overt dental pathology on CT. However, some patients will have subtle or absent dental pathology on CT. For suspected endodontic disease, endodontists should be consulted for at least cold pulp testing, and ideally cone-beam CT.
Topics: Adult; Bacterial Infections; Cone-Beam Computed Tomography; Female; Humans; Male; Maxillary Sinusitis; Middle Aged; Pulpitis; Tomography, X-Ray Computed; Viridans Streptococci
PubMed: 33486208
DOI: 10.1016/j.amjoto.2021.102925 -
Journal of Dental Sciences Jan 2021Artificial intelligence (AI) has made deep inroads into dentistry in the last few years. The aim of this systematic review was to identify the development of AI... (Review)
Review
BACKGROUND/PURPOSE
Artificial intelligence (AI) has made deep inroads into dentistry in the last few years. The aim of this systematic review was to identify the development of AI applications that are widely employed in dentistry and evaluate their performance in terms of diagnosis, clinical decision-making, and predicting the prognosis of the treatment.
MATERIALS AND METHODS
The literature for this paper was identified and selected by performing a thorough search in the electronic data bases like PubMed, Medline, Embase, Cochrane, Google scholar, Scopus, Web of science, and Saudi digital library published over the past two decades (January 2000-March 15, 2020).After applying inclusion and exclusion criteria, 43 articles were read in full and critically analyzed. Quality analysis was performed using QUADAS-2.
RESULTS
AI technologies are widely implemented in a wide range of dentistry specialties. Most of the documented work is focused on AI models that rely on convolutional neural networks (CNNs) and artificial neural networks (ANNs). These AI models have been used in detection and diagnosis of dental caries, vertical root fractures, apical lesions, salivary gland diseases, maxillary sinusitis, maxillofacial cysts, cervical lymph nodes metastasis, osteoporosis, cancerous lesions, alveolar bone loss, predicting orthodontic extractions, need for orthodontic treatments, cephalometric analysis, age and gender determination.
CONCLUSION
These studies indicate that the performance of an AI based automated system is excellent. They mimic the precision and accuracy of trained specialists, in some studies it was found that these systems were even able to outmatch dental specialists in terms of performance and accuracy.
PubMed: 33384840
DOI: 10.1016/j.jds.2020.06.019 -
American Journal of Rhinology & Allergy Sep 2021Odontogenic sinusitis affects a significant proportion of patients with paranasal sinus infections. Nevertheless, no shared diagnostic criteria for this condition have...
BACKGROUND
Odontogenic sinusitis affects a significant proportion of patients with paranasal sinus infections. Nevertheless, no shared diagnostic criteria for this condition have yet been implemented and published studies differ in their definition of the disease.
OBJECTIVE
The present systematic review of the literature was undertaken to characterize and analyze the different diagnostic criteria currently employed for odontogenic sinusitis.
METHODS
Systematic searches for studies published between 2009 and 2019 were performed in Medline, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov databases. Search criteria were designed to identify all studies focusing, even partially, on odontogenic sinusitis. Human original studies except single case reports published in the English, French, German, Spanish, or Italian language were included. We removed duplicate abstracts and conducted full-text reads, data extraction, and quality assessment procedures (using the Oxford Centre for Evidence-based Medicine levels of evidence and National Heart Lung and Blood Institute Study Quality Assessment Tools). We reviewed articles for diagnostic criteria, both in terms of definition and etiology identification.
RESULTS
Among 1,000 unique citations, 63 studies were deemed eligible. Most articles (n = 45) were retrospective case series; a single randomized clinical trial was available. Only 49 studies reported diagnostic criteria, yet relied marginally on published guidelines (n = 10 articles) for identifying sinusitis, often choosing instead to develop their own clinical (n = 15 articles), endoscopic (n = 12 articles), and/or radiologic (n = 30 articles) criteria. For odontogenic focus identification, 14 papers required a multidisciplinary evaluation, 11 papers required a time relationship between dental procedures and sinusitis, 24 papers required oroscopy and/or dental evaluation, and 53 papers required computed tomography.
CONCLUSIONS
Current diagnostic criteria for odontogenic sinusitis are extremely heterogeneous. Establishing shared diagnostic criteria aimed at defining both sinusitis and related odontogenic foci would spur collaboration between investigators and support more comprehensive outcomes evaluations together with a better understanding of treatment options.
Topics: Endoscopy; Humans; Maxillary Sinusitis; Paranasal Sinuses; Randomized Controlled Trials as Topic; Retrospective Studies; Sinusitis; Tomography, X-Ray Computed
PubMed: 33236664
DOI: 10.1177/1945892420976766 -
American Journal of Rhinology & Allergy May 2021RARS is a challenging clinical phenomenon that affects many patients, and diagnostic criteria for this condition are not fully characterized in the literature.
BACKGROUND
RARS is a challenging clinical phenomenon that affects many patients, and diagnostic criteria for this condition are not fully characterized in the literature.
OBJECTIVE
To examine diagnostic criteria for recurrent acute rhinosinusitis (RARS).
STUDY DESIGN
Systematic review.
METHODS
Cochrane, PubMed (MEDLINE), clinicaltrials.gov, EMBASE, Google Scholar, and Web of Science databases were queried for articles related to RARS dating from 1990 to present, according to PRISMA statement guidelines. Full text articles pertinent to the diagnostic criteria of RARS were included in this review. Inclusion criteria included articles specifically addressing RARS; studies with 3 or more patients; and articles in English.
RESULTS
A total of 1022 titles/abstracts potentially related to RARS were identified. Of these, sixty-nine full texts were selected for review, and 22 of these ultimately met inclusion criteria. The level of evidence was generally low. Studies and guidelines have used many different definitions for RARS diagnosis over the years based on symptomatology, physical examination, nasal endoscopy, imaging, and laboratory domains. Clinically important RARS has been defined most commonly as 4 or more discrete episodes of ARS per year, but this frequency is typically based on expert opinion. Additionally, radiologic anatomic associations such as concha bullosa, accessory maxillary os, and narrowed infundibular distance may be associated with RARS. Endoscopic visualization and imaging are sometimes used to confirm the presence of sinus disease during exacerbations of RARS, but there is variability in this practice.
CONCLUSION
The diagnostic definition for RARS has developed over time and is currently based on low level 4 and 5 evidence. Because of the migratory definition of RARS, comparing inter-study results of RARS management remains difficult, and future studies should aim to follow current expert guidelines on diagnostic criteria of RARS.
Topics: Acute Disease; Humans; Recurrence; Retrospective Studies; Rhinitis; Sinusitis
PubMed: 32954839
DOI: 10.1177/1945892420956871 -
Revista Paulista de Pediatria : Orgao... 2020To carry out a systematic literature review on the surgical treatment of chronic rhinosinusitis in the pediatric population.
OBJECTIVE
To carry out a systematic literature review on the surgical treatment of chronic rhinosinusitis in the pediatric population.
DATA SOURCES
A bibliographic review methodology was used, based on data from National Library of Medicine (Medline), PubMed, Latin American and Caribbean Health Sciences Literature (LILACS) and Scientific Electronic Library Online (SciELO), of the indexed works from 2006 to 2016, including the pediatric population from zero to 13 years of age. The search keywords according to Medical Subject Heading (MESH) and Health Sciences Descriptors (DeCS) were: child, surgery, sinusitis and chronic disease. A total of 318 articles were collected, five of which met the inclusion criteria and were used as a basis for this review. All articles were prospective cohort studies, level of evidence 2B, according to the criterion used by evidence-based medicine.
DATA SYNTHESIS
The literature agreed that the next step for the cases refractory to drug treatment in chronic rhinosinusitis in childhood would be surgery. Adenoidectomy would be the initial method, for the safety of the procedure and improvement in about 50% of the cases, although more significant results were found in patients who associated this procedure with facial sinus surgery.
CONCLUSIONS
Surgical treatment should be indicated for chronic rhinosinusitis in childhood after treatment failure. The results pointed out that adenoidectomy, when associated with some type of approach to the facial sinus, present better results.
Topics: Adenoidectomy; Adolescent; Case-Control Studies; Child; Child, Preschool; Chronic Disease; Combined Modality Therapy; Female; Humans; Infant; Infant, Newborn; Male; Maxillary Sinus; Prospective Studies; Rhinitis; Safety; Sinusitis; Therapeutic Irrigation
PubMed: 31939504
DOI: 10.1590/1984-0462/2020/38/2018068