Treatment Strategy for Odontogenic Sinusitis

2020 ◽  
pp. 194589242094696 ◽  
Author(s):  
Byung Joon Yoo ◽  
Seon Min Jung ◽  
Ha Na Lee ◽  
Hyung Gu Kim ◽  
Jae Ho Chung ◽  
...  

Background The treatment options for odontogenic sinusitis (OS) include medical management including antibiotics and saline nasal irrigation, endoscopic sinus surgery (ESS), and dental treatment. Objective The purpose of this study was to evaluate whether OS caused by dental caries and periapical abscess can be cured by dental treatment alone and which patients should consider surgery early. Methods A total of 33 patients with OS caused by dental caries and periapical abscess were enrolled. Patients with OS caused by dental implants, trauma, surgery, or tooth extraction were excluded. All patients were initially treated with dental treatment and medical management without ESS. The patients were divided into two groups according to the results of dental treatment and multiple clinical parameters were compared between the two groups. Results Among the 33 enrolled patients, 22 patients (67%) were cured with dental and medical management, and 11 patients (33%) required ESS after the failure of dental and medical management. Based on the multivariate analysis results, patients who were smokers (OR 33.4) and had a higher Lund-Mackay score on CT (OR 2.0) required ESS after the failure of dental and medical treatment. Conclusions Two-thirds of the patients with OS caused by dental caries and periapical abscess were cured with dental treatment and medical management without ESS. We recommend dental treatment and medical management first in OS caused by dental caries and periapical abscess. However, we recommend early ESS in patients with smoking habits and severe CT findings of the sinus.

2021 ◽  
Vol 10 (12) ◽  
pp. 2712
Author(s):  
Anda Gâta ◽  
Corneliu Toader ◽  
Dan Valean ◽  
Veronica Elena Trombitaș ◽  
Silviu Albu

Background: Odontogenic sinusitis (ODS) is frequently encountered in ENT practice; however, there are no guidelines regarding its management. This study aims to analyse the results of endoscopic sinus surgery versus dental treatment in ODS. Additionally, we aim to demonstrate the benefit of associating endoscopic sinus surgery (ESS) to surgical closure of chronic oroantral fistulas (OAF) by comparing mean time to healing in patients who opted or not for concurrent ESS. Methods: Records of patients with ODS were reviewed. Group one consisted of patients with ODS caused by periapical pathology undergoing either endoscopic sinus surgery (ESS) or dental treatment. Resolution of ODS was considered treatment success and was compared between the two treatment strategies. Group two included patients with ODS and associated chronic oroantral communication. Time to healing was compared between patients undergoing OAF closure alone versus patients receiving associated ESS, using the Log-Rank test to correlate Kaplan–Meier curves. Results: 25 patients from a total of 45 in group one underwent dental treatment alone, and 20 opted for exclusive ESS treatment. The failure rate was 40% for patients treated with ESS compared to 4% (one patient) for dental treatment. ODS resolved in all patients in the second group, but the mean time to healing was half (10 days) when ESS was complementary to OAF closure. Conclusion: The present study represents the first estimator of the role ESS plays in OAF treatment. Nonetheless, it provides proof of the importance of first addressing dental problems in odontogenic sinusitis.


2019 ◽  
Vol 66 (1) ◽  
pp. 30-32
Author(s):  
Rumiko Hosokawa ◽  
Masanori Tsukamoto ◽  
Saki Nagano ◽  
Takeshi Yokoyama

Hereditary angioedema (HAE) is a rare genetic disease that results from deficiency or dysfunction of C1 inhibitor (C1-INH). This disease is characterized by sudden attacks of angioedema. When edema occurs in the pharynx or larynx, it can lead to serious airway compromise, including death. Physical and/or psychological stress can trigger an attack. Dental treatment, including tooth extraction, is also a recognized trigger. We report a case of a 20-year-old male with HAE who required impacted third molar extractions. C1-INH concentrate was administered 1 hour before surgery, which was completed under deep intravenous sedation. This report describes the anesthetic management of a patient with HAE and reviews treatment options and concerns.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A185-A186
Author(s):  
Aytan Siraj Mammadova ◽  
MaKenzie Hodge ◽  
Kehinde Matilda Folawewo ◽  
Elizabeth Cobbs ◽  
Gail Louise Nunlee-Bland ◽  
...  

Abstract Introduction: A 200% increase in population growth among those over 85 is projected in the United States by 2050. Approximately half of women over 50 will experience an osteoporotic fracture in their lifetime. Osteoporosis disproportionately affects old-old adults (those between 85 and 95) as more than half of those admitted to the hospital for hip fracture are over 80 years of age. Older adults are also likely to need dental care. The American Dental Association guidelines offer preventive recommendations for those over 60 years of age but do not address the nuances of treatment options for nonagenarian persons. This case illustrates the treatment dilemma of nonagenarians wishing to optimize both bone and dental health. Case: We have a 95-year-old performance artist, who seeks to optimize bone health in the face of recommended dental work. She has been physically active her whole life and consumes adequate quantities of calcium and Vitamin D. She doesn’t smoke but has needed periodic glucocorticoids for exacerbations of chronic lung disease. At age 84 she began ibandronate but stopped due to worsening of esophageal reflux. She was then treated with teriparatide for 2 years. DEXA scans have shown declining hip T scores from -2.8 at age 88 to -3.5 at age 94 (osteoporotic bone density: T-score lower than -2.5). Her dentist recommended the extraction of several teeth before beginning zoledronate. She refused tooth extraction and sought treatment options to enhance her bone density. Discussion: Persons of advanced age are likely to have oral health problems requiring dental treatment. Bone health treatments such as bisphosphonates and denosumab are generally safe but can potentially cause osteonecrosis of the jaw even with simple tooth extraction in old-old population. Specific guidelines are lacking for treatment to maintain bone and dental health. The American Association of Oral and Maxillofacial Surgeons suggests that extractions and implants can be conducted as usual in patients who have been treated with oral bisphosphonates for less than four years and lack other clinical risk factors. A delay of two months is suggested for those who have been treated for more than four years or has taken glucocorticoids concomitantly. The approach is uncertain for old-old adults who are taking treatment but develop a need for dental surgery. More research is needed about options for optimizing dental health while enhancing bone density in aging population.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hosam Alraqiq ◽  
Ahmid Eddali ◽  
Reema Boufis

Abstract Background In many developing countries, the prevalence of dental caries has increased due to lifestyle changes, lack of preventive services, and inadequate access to dental care. In Arab countries, the increased prevalence of caries has correlated with economic growth over the past decades, resulting in greater access to unhealthy foods and higher consumption of sugar, particularly among children. However, few studies have assessed caries prevalence among pediatric populations in Arab countries. The objective of this study was to assess the prevalence of dental caries and factors associated with caries among children in Tripoli, Libya. Methods This cross-sectional study included a convenience sample of 1934 children in first grade (age 6–7 years, n = 1000) and seventh grade (age 11–12 years, n = 934). Four health centers in Tripoli were selected for screening based on location and participation in school-entry health examinations. Data were collected through self-administered parent surveys and visual dental screenings by trained examiners from September 24 to October 15, 2019. The survey comprised questions about socioeconomic characteristics and oral health behaviors, including toothbrushing, sugar consumption, and dental care history. During screenings, untreated decay, missing teeth, and filled teeth (DMFT or dmft) were recorded. Prevalence of tooth decay was calculated as the proportion of children with high DMFT/dmft scores. Binary logistic and negative binomial regression analyses (with significance at p ≤ 0.05) were used to assess factors associated with caries. Results Among 1000 first-grade children, 78.0% had decay in their primary teeth, with a mean dmft of 3.7. Among 934 seventh-grade children, 48.2% had caries in their permanent teeth, with a mean DMFT of 1.7. The most significant factors associated with caries prevalence were socioeconomic, such as screening site (first grade, p = 0.02; seventh grade, p < 0.001) and maternal employment (seventh grade, p = 0.02), and behavioral, such as toothbrushing duration (seventh grade, p = 0.01), past dental treatment (both grades, p < 0.001), and past emergency visit (both grades, p < 0.001). Conclusions Caries prevalence was associated with several behavioral and socioeconomic factors, including screening site, maternal employment, toothbrushing duration, past dental treatment, and past emergency visit. Efforts should be made to address these factors to minimize barriers and improve oral health behavior and care utilization. These findings can be used to evaluate current public health initiatives and inform future planning.


1940 ◽  
Vol 19 (6) ◽  
pp. 571-584 ◽  
Author(s):  
Virgil D. Cheyne ◽  
Charles L. Drain

2009 ◽  
Vol 12 (3) ◽  
pp. 313-324 ◽  
Author(s):  
João Luiz Bastos ◽  
José Leopoldo Ferreira Antunes ◽  
Antonio Carlos Frias ◽  
Maria da Luz Rosário de Souza ◽  
Karen Glazer Peres ◽  
...  

This study assessed oral health outcomes (perceived dental treatment need, untreated dental caries, gingival bleeding, periodontal pockets, and pain in teeth and gums), in relation to color/race inequalities among adolescents in each Brazilian region. The database included dental examination and interview of 16,833 15-19-year-old adolescents, surveyed by the Brazilian health authority, from May 2002 to October 2003, in accordance with international diagnostic criteria standardized by the World Health Organization. Prevalence ratios estimated by Poisson regression, and controlled by socioeconomic status and access to fluoridated piped water, assessed oral health differentials among color/race groups and country's regions. Except for periodontal pockets, prevalence figures were higher in the North and Northeast: perceived dental treatment needs, untreated dental caries, gingival bleeding at probing and pain in teeth and gums varied between 80-83%, 75-76%, 38-43%, and 17-18%, respectively, in these regions. Adolescents living in the Southeast - the richest Brazilian region - presented a better general profile of oral health than their counterparts living in the remaining regions; they had a lower prevalence of untreated dental caries (54%) and unfavorable gingival status (29%). However, the Southeast presented color/race inequalities in all oral health outcomes, with a poorer profile systematically affecting browns or blacks, depending on the oral health condition under consideration. These results reinforce the need for expanding the amplitude of health initiatives aimed at adolescent oral health. Socially appropriate health programs should concurrently aim at the reduction of levels of oral disease and its inequalities.


2011 ◽  
Vol 35 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Abhinav Singh ◽  
MP Bharathi ◽  
Peter Sequeira ◽  
Shashidhar Acharya ◽  
Meghashyam Bhat

Objectives: To assess oral health status and practices of 5- and 12-year-old Tribal school children.Methods: A total of 418, 5-year-old children and 327, 12-year-old children were enrolled. Information on demographic characteristics of participants along with oral health behavior was collected. Clinical data were collected on dental fluorosis, periodontal status, dental caries and treatment needs. Dean's index criterion was used to assess dental fluorosis. Community Periodontal Index (CPI) for periodontal conditions and Dentition status and treatment needs for dental caries were recorded. Results: Between meal sugar consumption was high (100%). None of the children in both the age groups had visited trained health personnel for dental treatment. Dental fluorosis prevalence in 5- and 12-year olds was 11.9% and 22.9% respectively. Bleeding on probing and calculus was common between both the age groups. A low mean number of healthy sextants were found and this decreased with age. Mean dmft/DMFT values for 5- and 12-year olds were 4.13 ± 3.90 and 1.15 ± 1.62. Significant caries index (SIC) scores for 5- and 12-year olds were 7.17 ±4.30 and 3.78 ± 3.21 respectively. Conclusion: The present study reveals high sugar consumption, dental fluorosis, poor oral hygiene, and untreated dental disease of tribal children. Under these circumstances, the implementation of preventive programs including restriction of sweets in school premises for the tribal children is the key to good oral health.


2017 ◽  
Author(s):  
D. J. Caplan ◽  
Y. Li ◽  
W. Wang ◽  
S. Kang ◽  
L. Marchini ◽  
...  

AbstractThis study aimed to describe the survival trajectory of dental restorations placed in an outpatient population of geriatric and adult special needs patients over a 15-year span, with particular interest in longevity of subsequent restorations in teeth that received multiple restorations over time. Dental restorations of different types and sizes in patients age ≥65 years treated between 2000-14 at the University of Iowa, College of Dentistry were followed until they incurred an event (i.e., restoration replacement, extraction of the tooth, or endodontic treatment of the tooth). Survival analysis and extended Cox regression models were used to generate hazards ratios for selected predictor variables. A total of 9184 restorations were followed in 1551 unique patients. During the follow-up period, 28.7% of these restorations incurred an event; and overall the restorations had a median lifespan of 6.25 years. In multivariable regression models, after controlling for gender and age, composite restorations and greater number of restoration surfaces were associated with higher risks of failure; and the initial restoration recorded in the database for each subject tended to have lower risk of failure than restorations placed later that included any of those same surfaces. This information potentially could be helpful to elderly patients considering various restorative treatment options during the dental treatment planning and informed consent process.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0253517
Author(s):  
Laura Gray ◽  
Lisa McNeill ◽  
Weiming Yi ◽  
Anastasia Zvonereva ◽  
Paul Brunton ◽  
...  

The dimensions of patient-centred care include not only clinical effectiveness and patient safety, but, importantly, the preferences of patients as consumers of healthcare services. A total of 249 participants were included in the study, with a balanced population proportional representation by age, gender, ethnicity and geographic region of New Zealand. An online questionnaire was used to identify participants’ decision-making process, and what factors and barriers for participants to seek dental treatment. Cross-tabulations, Spearman correlation analysis and Pearson Chi-Square analysis were used for the statistical analyses. Three most common reasons for visit were check-up (77%), clean (57%) and relief of pain 36%). A desire to treat a perceived problem was the most common encouraging factor to seek dental care. Cost was the most common barrier to seeking dental services. The majority of participants attended a private practice (84%), with convenience of location and referral from professionals the most likely to influence their choice. Participants felt the most important trait a dental practitioner could demonstrate was to discuss treatment options with them before any treatment. Dental check-up, teeth cleaning and relief of pain were the most common reasons for patients to choose dental services. Cost and ethnicity of the consumers had a significant impact on how dental services were perceived and sought. Dental practitioners may need to reorientate how they express value of oral health practice, not just in regard to communication with patients, but also with government funding agencies.


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