Contributors / Country - Intitution
Prof. D. Karakasis / School of Dentistry, Aristotle University of Thessaloniki, Greece
Prof. L. Todorovic
/ University of Beograd, Serbia
Title
The maxillary sinus and its implications in dentistry. Prevention and management
Summary
Coordinator: Prof. D. Karakasis
Quite frequently a dentist is faced with problems related to the
maxillary sinuses. They are diagnostic problems caused by maxillary
sinus pathology, either from primary sinus infections or from tumors.
They are also side effects caused by dental interventions, as are seen
after tooth extractions, endodontics and some oral surgery procedures.
Finally they are problems caused by dental operations extended into the
maxillary sinuses, as it happens in dental implantology or
preprosthetic and orthognathic surgery.
Some of these problems will be discussed in the round table,
emphasizing to the importance of diagnosing any underlined antral
pathology, before any operation, and describing the relevant diagnostic
work-up. Emphasis will be given also to treatment solutions, utilising
the recent endoscopic and the newest oromaxillofacial surgical
techniques, including guidelines to the treatment planning of antral
pathology and the consequences of the maxillary sinus operations.
Allocated time: 90 min
-
Prof. D. Karakasis, Thessaloniki: Introduction (10min)
-
Prof. Dr L. Todorovic, Belgrade: Philosophy of the oroantral
fistulae closure: A separate approach to the treatment of antral
pathology and plastics of the fistula (15min).
-
Dr M. Andric, Belgrade: Functional Endoscopic Sinus Surgery
for Treatment of Odontogenic Diseases of the Maxillary Sinus (15min).
Maxillary sinusitis of dental origin
(MSDO), also known as odontogenic sinusitis, is a well recognized condition,
which accounts for approximately 10-12% of cases of maxillary sinusitis. Besides common causes of MSDO, significant
number of cases is related to placement of dental implants and sinus
augmentation procedures.
In contrast to rhinogenic sinusitis,
vast majority of MSDO requires some kind of surgical treatment. Functional
endoscopic sinus surgery (FESS) is widely used for treatment of rhino-sinusitis
and nasal polyposis. Numerous studies have shown that FESS is safe and
effective option for those conditions. Despite this, significant number of MSDO
cases is still treated by Caldwell-Luc approach.
Recently, several studies reported
results of FESS used for treatment of odontogenic sinusitis. Although they
presented heterogeneous groups of patients, overall results were very good,
since success rate ranged from 94.7-100%. Besides this, incidence of
complications was remarkably low. Follow-up period lasted up to 3 years and
rarely there was a need to perform revision surgery.
Also, endoscopic sinus surgery might
be useful in sinus augmentation procedures. Two studies reported results of
endoscopic control during Summers' osteotome sinus lift operation. They
concluded that use of endoscopes, inserted into maxillary sinus, allows precise
diagnosis of possible sinus membrane perforations during this procedure.
Besides this, technique of endoscope-controlled sinus augmentation via lateral
antral wall has been described.
Although initial results of FESS for
treatment of odontogenic sinusitis are encouraging, numerous issues are still
unresolved. There is a paucity of data on long-term results in these cases and
there are not any prospective, randomized studies, comparing FESS with other
treatment options for MSDO. Particularly, there is a need for establishment of
diagnostic criteria for selection of appropriate treatment option for each
individual case of MSDO.
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Dr I. Tilaveridis, Thessaloniki: Plastic Closure of Oroantral fistulae (10min).
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Dr G. Venetis, Thessaloniki: Postoperative alterations in Physiology of Maxillary sinus (10min).
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Prof. Dr A. Creanga, Constanta: Clinical appearance, Diagnosis and Treatment guidelines of Maxillary sinus Tumors (15min)
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