Odontogenic sinusitis due to radix perforation into the maxillary sinus on CBCT radiograph: a case report
Abstract
Objectives: The purpose of this article was to provide an overview and examination guide in identifying odontogenic sinusitis due to radix perforation into the maxillary sinus by dental action or iatrogenic in dentistry using the CBCT modality.Case Report: A 33-year-old female patient presented to the Radiology Installation of RSGM Andalas University with a referral for CBCT, following a diagnosis of odontogenic sinusitis. According to the patient’s medical history, she had been experiencing headache and dizziness for five months after a tooth extraction. The CBCT scan revealed remnants of a tooth root (radix) perforating into the right maxillary sinus, surrounded by a radiopaque intermediate area. Sinus perforation is a known occurrence in dentistry, and it requires thorough diagnostic imaging for proper evaluation. The tooth root remnants are typically located in the premolar and molar regions, near the base or medial wall of the sinus. The size of the tooth fragments within the sinus can be precisely measured, and the relationship of the remaining fragments to the maxillary sinus anatomy can be clearly defined. This detailed information enables clinicians to assess the extent of the lesion and its impact on surrounding structures, allowing for the development of an appropriate treatment plan for the patient.
Conclusion: CBCT is a very adequate modality for supporting the examination of cases of residual tooth roots perforated to the sinuses because it can provide detailed information about the position, size, and relationship with the surrounding anatomy.
References
Whyte A, Boeddinghaus R. Imaging of odontogenic sinusitis. Clin Radiol. 2019;7:503-16.
Seigneur M, Cloitre A, Malard O, Lesclous P. Teeth roots displacement in the maxillary sinus: characteristics and management. J Oral Med Oral Surg. 2020;26(34):1-9.
Bajoria AA, Sarkar S, Sinha P. Evaluation of odontogenic maxillary sinusitis with cone beam computed tomography: A retrospective study with review of literature. J Int Soc Prevent Communit Dent. 2019;9:194-204.
Lopes LJ, Gamba TO, Bertinato JVJ, Freitas DQ. Comparison of panoramic radiography and CBCT to identify maxillary posterior roots invading the maxillary sinus. Dentomaxillofac Radiol. 2016;45:20160043.
Seo MH, Sodnom-Ish B, Eo MY, Myoung H, Kim SM. Radiographic evaluation before surgical extraction of impacted third molars to reduce maxillary sinus-related complications. J Korean Assoc Oral Maxillofac Surg. 2023;49:192-7.
White SC, Pharoah MJ. Oral Radiology Principles and Interpretations. 7th ed. Mosby Canada; 2014.
Jung YH, Cho BH. Assessment of maxillary third molars with panoramic radiography and cone-beam computed tomography. Imaging Sci Dent. 2015;45:233-40.
Ramadhan FR, Wulansari DP, Epsilawati L. Canalis sinuosus approximation on an impacted maxillary canine: A case report. J Radiol Dentomaxillofac Indones. 2021;5(3):118-21.
Rangics A, Répássy GD, Gyulai-Gaál S, Dobó-Nagy C, Tamás L, Simonffy L. Management of odontogenic sinusitis: Results with single-step FESS and dentoalveolar surgery. J Pers Med. 2023;13:1291.
Widyastuti V, Azhari, Epsilawati L. Sensitivity of panoramic radiographs in diagnosing maxillary sinusitis: A scoping review. J Radiol Dentomaxillofac Indones. 2021;5(3):136-41.
Beech NA, Farrier NJ. The importance of prompt referral when tooth roots are displaced into the maxillary antrum. Dent Update. 2016;43:760-5.
Hamed E, Seyed HZ, Langaroodi AJ. Diagnostic efficacy of digital Waters' and Caldwell’s radiographic views for evaluation of sinonasal area. J Dent Med Tehran. 2016;13(5):357-64.
Serindere G, Bilgili E, Yesil C, Ozveren N. Evaluation of maxillary sinusitis from panoramic radiographs and cone-beam computed tomographic images using a convolutional neural network. Imaging Sci Dent. 2022;52:187-95.
Cavalcanti MC, Guirado TE, Sapata VM, Costa C, Pannuti CM, Jung RE, et al. Maxillary sinus floor pneumatization and alveolar ridge resorption after tooth loss: A cross-sectional study. Braz Oral Res. 2018;32:64.
Psillas G, Papaioannou D, Petsali S, Dimas GG, Constantinidis J. Odontogenic maxillary sinusitis: A comprehensive review. J Dent Sci. 2021;16:474-81.
Sabatino L, Lopez MA, Di Giovanni S, Pierri M, Lafrati F, De Benedetto L, et al. Odontogenic sinusitis with oroantral communication and fistula management: Role of regenerative surgery. Medicina. 2023;59:937.
Shahrour R, Shah P, Withana T, Jung J, Syed AZ. Oroantral communication, its causes, complications, treatments, and radiographic features: A pictorial review. Imaging Sci Dent. 2021;51:307-11.
Suntana MS, Trisusanti R, Quasima SZ. Hubungan antara dasar sinus maksilaris dengan apikal akar gigi M1 maksila ditinjau menggunakan radiograf panoramik. e-GiGi. 2024;12(2):213-20.
Seigneur M, Cloitre A, Malard O, Lesclous P. Teeth roots displacement in the maxillary sinus: characteristics and management. J Oral Med Oral Surg. 2020;26(34):1-9.
Bajoria AA, Sarkar S, Sinha P. Evaluation of odontogenic maxillary sinusitis with cone beam computed tomography: A retrospective study with review of literature. J Int Soc Prevent Communit Dent. 2019;9:194-204.
Lopes LJ, Gamba TO, Bertinato JVJ, Freitas DQ. Comparison of panoramic radiography and CBCT to identify maxillary posterior roots invading the maxillary sinus. Dentomaxillofac Radiol. 2016;45:20160043.
Seo MH, Sodnom-Ish B, Eo MY, Myoung H, Kim SM. Radiographic evaluation before surgical extraction of impacted third molars to reduce maxillary sinus-related complications. J Korean Assoc Oral Maxillofac Surg. 2023;49:192-7.
White SC, Pharoah MJ. Oral Radiology Principles and Interpretations. 7th ed. Mosby Canada; 2014.
Jung YH, Cho BH. Assessment of maxillary third molars with panoramic radiography and cone-beam computed tomography. Imaging Sci Dent. 2015;45:233-40.
Ramadhan FR, Wulansari DP, Epsilawati L. Canalis sinuosus approximation on an impacted maxillary canine: A case report. J Radiol Dentomaxillofac Indones. 2021;5(3):118-21.
Rangics A, Répássy GD, Gyulai-Gaál S, Dobó-Nagy C, Tamás L, Simonffy L. Management of odontogenic sinusitis: Results with single-step FESS and dentoalveolar surgery. J Pers Med. 2023;13:1291.
Widyastuti V, Azhari, Epsilawati L. Sensitivity of panoramic radiographs in diagnosing maxillary sinusitis: A scoping review. J Radiol Dentomaxillofac Indones. 2021;5(3):136-41.
Beech NA, Farrier NJ. The importance of prompt referral when tooth roots are displaced into the maxillary antrum. Dent Update. 2016;43:760-5.
Hamed E, Seyed HZ, Langaroodi AJ. Diagnostic efficacy of digital Waters' and Caldwell’s radiographic views for evaluation of sinonasal area. J Dent Med Tehran. 2016;13(5):357-64.
Serindere G, Bilgili E, Yesil C, Ozveren N. Evaluation of maxillary sinusitis from panoramic radiographs and cone-beam computed tomographic images using a convolutional neural network. Imaging Sci Dent. 2022;52:187-95.
Cavalcanti MC, Guirado TE, Sapata VM, Costa C, Pannuti CM, Jung RE, et al. Maxillary sinus floor pneumatization and alveolar ridge resorption after tooth loss: A cross-sectional study. Braz Oral Res. 2018;32:64.
Psillas G, Papaioannou D, Petsali S, Dimas GG, Constantinidis J. Odontogenic maxillary sinusitis: A comprehensive review. J Dent Sci. 2021;16:474-81.
Sabatino L, Lopez MA, Di Giovanni S, Pierri M, Lafrati F, De Benedetto L, et al. Odontogenic sinusitis with oroantral communication and fistula management: Role of regenerative surgery. Medicina. 2023;59:937.
Shahrour R, Shah P, Withana T, Jung J, Syed AZ. Oroantral communication, its causes, complications, treatments, and radiographic features: A pictorial review. Imaging Sci Dent. 2021;51:307-11.
Suntana MS, Trisusanti R, Quasima SZ. Hubungan antara dasar sinus maksilaris dengan apikal akar gigi M1 maksila ditinjau menggunakan radiograf panoramik. e-GiGi. 2024;12(2):213-20.
Published
2025-01-01
How to Cite
GUNAWAN, Gunawan et al.
Odontogenic sinusitis due to radix perforation into the maxillary sinus on CBCT radiograph: a case report.
Jurnal Radiologi Dentomaksilofasial Indonesia (JRDI), [S.l.], v. 8, n. 3, p. 129-132, jan. 2025.
ISSN 2686-1321.
Available at: <http://jurnal.pdgi.or.id/index.php/jrdi/article/view/1302>. Date accessed: 08 jan. 2025.
doi: https://doi.org/10.32793/jrdi.v8i3.1302.
Section
Case Report
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
