Sinusitis in Dentistry
(Part 2)
In continuation about the interest of dentistry in sinusitis, we are going to discuss a case.
There is this case of a 35-year-old patient whose main complaint was pain in the maxillary right second molar area. The patient had a tenderness to palpation of the right cheek. The patient was diagnosed with maxillary sinusitis five years ago. The patient was previously treated by an otorhinolaryngologist. The patient took analgesics when the symptoms appeared and the symptoms appeared after some time.
It was reported that the patient started to feel the pain in the maxillary about three months ago prior to her consultation with a dentist.
It was revealed in the dental examination that a full metal crown is on the affected tooth.
A panoramic radiograph revealed a root canal treated with periapical radiolucency featuring a well-defined gap, around a radiopaque mass approximating the maxillary sinus.
A CT scan shows a “mucoperiosteal thickening with air-fluid level and the right maxillary sinus, paranasal sinuses are clear. The bony sinuses are intact.”
A provisional diagnosis was made that this is a case of odontogenic sinusitis and the patient was given antibiotic and clavulanic acid for a week.
The medicines are meant to cover the dental and antral flora. The patient was then scheduled for surgery.
On surgery day, the patient was asked to gargle a povidone iodine mouthrinse for a minute prior to the administration of the anesthesia.
The tooth was then luxated with a straight elevator. After the tooth was luxated, the tooth was extracted. The extracted tooth revealed a vertical fracture.
At this point, a curette was used to remove the periapical lesion in the socket. A generous amount of normal saline solution was used for debriding the operative side.
The patient was given postoperative medication.
Postoperative follow up happened after a week and the patient claimed some improvement. There were no post operative complications and a CT scan after three months was taken. The scan showed a marked reduction in the radio density of the right maxillary sinus, as the patient is now asymptomatic.
Next week, we will discuss this case in detail together with the conclusion to this case.