scholarly journals Optimization of Local Anesthesia during Radical Maxillary Sinusotomy in Dental Patients

2021 ◽  
Vol 6 (5) ◽  
pp. 294-301
Author(s):  
O. Ya. Mokryk ◽  
◽  
Z. P. Putʹko ◽  
A. M. Hychka ◽  
A. M. Zaharkiv ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Local Anesthesia ◽  
Mucous Membrane ◽  
Comparison Group ◽  
Maxillary Sinusitis ◽  
Main Group ◽  
Nasal Passage ◽  
Dental Patients ◽  
Pterygopalatine Ganglion ◽  
Maxillary Sinuses

The purpose of the study was to give a clinical evaluation of the effectiveness of endonasal blockade of the nasopalatine nerve in different ways during radical maxillary sinusotomy in dental patients. Materials and methods. Clinical observations were performed in 50 patients diagnosed with chronic odontogenic maxillary sinusitis. Radical maxillary sinusotomy was performed under local potentiated anesthesia. All patients underwent anesthesia on the maxilla according to classical methods. Patients, depending on the methods of endonasal blockade of the nasopalatine nerve, were divided into two clinical groups: the main (24 people) and the comparison group (26 people). Patients of the main group underwent endonasal blockade of the nasopalatine nerve at the site of its branch from the pterygopalatine ganglion. In patients of the comparison group, the blockade of this nerve was performed before its entry into the incisal canal. The effectiveness of anesthesia was evaluated for clinical and autonomic manifestations of pain stress. Results and discussion. During the removal of polyps and pathological granulations from the mucous membrane of the maxillary sinus in patients of the main group there was no pain, no emotional-motor and autonomic manifestations of pain stress, which confirmed the effectiveness of the endonasal method of anesthesia of the nasopalatine nerve. In patients of the comparison group during similar surgical manipulations the full effect of local anesthesia was achieved in 50.0% of cases (χ2 – 8.065, р = 0.005). These were patients who had hypopneumatized or moderately pneumatized types of maxillary sinuses. The rest of the patients during the operation had emotional – motor and autonomic manifestations of pain stress during the removal of pathologically altered mucous membrane located on the medial wall of the maxillary sinus. Conclusion. Complete anesthesia of the mucous membrane, maxillary sinus, regardless of the degree of its pneumatization is achieved during the usage of endonasal blockade of the nasopalatine nerve at the site of its branch from the pterygopalatine ganglion during radical maxillary sinusotomy in dental patients. Anesthesia of the nasopalatine nerve in the lower nasal passage, before its entry into the incisal canal, allows painless surgery only in patients with hypopneumatized maxillary sinuses and in most patients with moderate pneumatization

scholarly journals Association between Odontogenic and Maxillary Sinus Conditions: A Retrospective Cone-Beam Computed Tomographic Study

2021 ◽  
Vol 10 (13) ◽  
pp. 2849
Author(s):  
Piotr Kuligowski ◽  
Aleksandra Jaroń ◽  
Olga Preuss ◽  
Ewa Gabrysz-Trybek ◽  
Joanna Bladowska ◽  
...  
Keyword(s):  
Bone Loss ◽  
Maxillary Sinus ◽  
Mucous Membrane ◽  
Maxillary Sinusitis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Odontogenic Infections ◽  
Computed Tomographic ◽  
Periodontal Bone Loss ◽  
Maxillary Sinuses

Odontogenic infections can directly trigger maxillary sinusitis. CBCT is an excellent choice for precise examination of maxillary sinuses and hard tissues within the oral cavity. The objective of this retrospective and the cross-sectional study was to analyze the influence of odontogenic conditions on the presence and intensity of maxillary sinus mucous membrane thickening using CBCT imaging. Moreover, periodontal bone loss and anatomic relationship between adjacent teeth and maxillary sinuses were assessed to evaluate its possible impact on creating maxillary thickening. The study sample consisted of 200 maxillary sinuses of 100 patients visible on CBCT examination with a field of view of 13 × 15 cm. The presented study revealed a significant influence of periapical lesions, inappropriate endodontic treatment, severe caries, and extracted teeth on the presence of increased thickening of maxillary sinus mucous membrane. In addition, an increase in the distance between root apices and maxillary sinus floor triggered a significant reduction of maxillary sinus mucous membrane thickening. The presence of periodontal bone loss significantly increases maxillary sinus mucous membrane thickening.

scholarly journals OPTIMIZATION OF LOCAL ANESTHESIA OF DENTAL PATIENTS DURING CYSTECTOMIES OF RADICULAR CYSTS THAT HAVE GROWN INTO THE MAXILLARY SINUS OR NASAL CAVITY

2021 ◽  
Vol 74 (4) ◽  
pp. 906-910
Author(s):  
Oleg Ya. Mokryk ◽  
Davyd S. Avetikov ◽  
Ivan S. Sorokivskyi ◽  
Solomiya T. Havryltsiv ◽  
Nataliia М. Sorokivska
Keyword(s):  
Nasal Cavity ◽  
Maxillary Sinus ◽  
Local Anesthesia ◽  
Main Group ◽  
Autonomic System ◽  
Control Group ◽  
Chi Square ◽  
Incisive Canal ◽  
Induced Stress ◽  
Pterygopalatine Ganglion

The aim: To provide clinical evaluation of the effectiveness of anesthesia for cystectomy of radicular cysts that have grown into the maxillary si-nus or nasal cavity using different techniques of endonasal block-ade of the nasopalatine nerve. Materials and methods: Clinical observations were conducted on 52 patients of different age and sex. These patients were diagnosed with large radicular cysts (more than 3.0 cm in diameter) that had grown into the maxillary sinus (33 cases) or into the nasal cavity (19 cases). The surgical excisions of cysts (oroantral cystectomies) were performed un-der local potentiated anesthesia. Patients were divided into two clinical groups, depending on the methods used for endonasal blockade of the nasopalatine nerve: the main and the control group. Patients in the main group underwent endonasal blockade of the nasopalatine nerve at the point of its emergence from the pterygopalatine ganglion. In the control group, the neural blockade was performed at the entry of this nerve into the incisive canal. Pain sensitivity and perception in patients were studied using subjective and objective methods. The data was analyzed by means of the Pearson’s chi – square tests. Results: During the enucleation of radicular cysts that grew into the inferior nasal meatus and maxillary sinus in patients of the main group there was no pain observed. There were no manifestations of pain-induced stress neither from the side of autonomic system, nor physical or emotional manifestations of pain, which confirmed the effectiveness of nasopalatine nerve anesthesia. In patients of the control group during similar operation the full effect of local anesthesia was achieved in 56.0% of cases (χ2 – 9,270, р = 0,003). The rest of the patients during cystectomies showed some signs of pain-induced stress from the side of autonomic system or in the form of physical or emotional manifestations. Conclusions: Endonasal blockade of the nasopalatine nerve at the point of its emergence from the pterygopalatine ganglion invariably provided a complete analgesia during enucleation of radicular cysts that have grown into the maxillary sinus or nasal cavity. Anesthesia of the nasopalatine nerve at its entry into the incisive canal allows pain-less cystectomy of radicular cysts that have spread to the front of the inferior nasal meatus from the front teeth.

Radiography and Ultrasonography in Paranasal Sinusitis

1987 ◽  
Vol 28 (1) ◽  
pp. 31-34 ◽  
Author(s):  
C. Jensen ◽  
C. von Sydow
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Screening Method ◽  
Clinical Signs ◽  
Paranasal Sinusitis ◽  
Reasonable Degree ◽  
Degree Of Confidence ◽  
Sinus Radiography ◽  
Maxillary Sinuses

In order to analyze whether ultrasonography with a reasonable degree of confidence can replace radiography in the diagnosis of sinusitis, 138 patients with clinical signs of sinusitis were examined with both methods. It was found that maxillary sinus fluid was recognized ultrasonographically with a confidence that increased with the amount of fluid, judged from radiographic examinations. In a sub-group of 45 cases, fluid confirmed by maxillary sinus puncture was detected by ultrasonography in 35/45 sinuses (78%) and by radiology in 38/45 sinuses (84%). In patients with radiographically normal maxillary sinuses, the correlation to ultrasound was good. However, mucosal swelling and polyps or cysts observed at radiography were poorly demonstrated by ultrasonography. In addition, the ultrasound method was not reliable for frontal sinus diagnosis. It was concluded that ultrasonography can be recommended in maxillary sinusitis for follow-up of treatment and as a screening method before sinus radiography.

scholarly journals Removal of firearm projectile from the maxillary sinus: a case report

2020 ◽  
Vol 68 ◽  
Author(s):  
Cristóvão Marcondes de Castro RODRIGUES ◽  
Izabella SOL ◽  
Daniela MENESES-SANTOS ◽  
Larissa Gonçalves Cunha RIOS ◽  
Jonas Dantas BATISTA ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Maxillary Sinus ◽  
Local Anesthesia ◽  
Paranasal Sinuses ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Hard Tissues ◽  
The Face ◽  
Maxillary Sinuses

ABSTRACT Foreign bodies in the paranasal sinuses after critical accidents are rare occurrences that have sporadically been reported worldwide. Firearm projectiles, daggers, knives, glass fragments, stones, teeth, and wood can get lodged in the soft and hard tissues of the face. The management and prognosis in these cases depend on the composition and location of the foreign body as well as on the presence or absence of infection. Although there are reports involving the soft tissues of the face, the ethmoid, sphenoid, frontal, and maxillary sinuses are the most frequently involved sites. The main manifestation of this condition is sinusitis arising from infection and/or inflammation caused by the foreign body, which is a contaminated object. We report a case of removal of a firearm projectile located in the maxillary sinus of a 34-year-old patient under local anesthesia.

scholarly journals Modified Caldwell-Luc Technique to retrieval of tooth fragment displaced into the maxillary sinus: A case report

2021 ◽  
Vol 10 (2) ◽  
pp. e26210212353
Author(s):  
José Wittor de Macêdo Santos ◽  
Emily Ricelly da Silva Oliveira ◽  
Humberto Pereira Chaves Neto ◽  
Fernanda Soares Ramos ◽  
Braz da Fonseca Neto ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Foreign Bodies ◽  
Early Stage ◽  
Maxillary Sinusitis ◽  
Third Molar ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Maxillary Molars ◽  
Upper Third ◽  
Maxillary Sinuses

During the surgical removal of maxillary molars, tooth or fragment displacement into the maxillary sinus may occur. The presence of foreign bodies inside these cavities leads to complications such as mucoceles, cellulitis, oroantral fistulae and maxillary sinusitis, to prevent the arise and worsening of complications, these events must be addressed in an early stage. This article aims to report the removal of a tooth root from the maxillary sinus, through the modified Caldwell-Luc (CLM) approach and describe the current indications for the Caldwell Luc technique. It reports an upper third molar surgery in which a patient had the distal root of the left superior third molar displaced into the maxillary sinus, later showing signs of sinus opacification and loss of patency of the maxillary ostium obstructed by the root. After antibiotic treatment, the root was recovered through the CLM technique by local anesthesia, without complications. Foreign bodies in the maxillary sinuses must be urgently addressed, avoiding the development of infectious conditions, the CLM approach is the choice approach to manage these complications by a simple and safe way.

scholarly journals CLINICAL CASE OF ODONTOGENIC MAXILLARY SINUSITIS

2018 ◽  
Vol 3 (1) ◽  
pp. 44-46
Author(s):  
N S Hrappo ◽  
E Yu Mironova ◽  
A A Kotyakov ◽  
L V Solovjeva
Keyword(s):  
Maxillary Sinus ◽  
Inflammatory Process ◽  
Clinical Observation ◽  
Surgical Intervention ◽  
Maxillary Sinusitis ◽  
Subsequent Development ◽  
Medial Wall ◽  
Nasal Passage ◽  
Nasal Concha ◽  
Inferior Nasal Concha

Aim - to show the clinical observation of the development of odontogenic maxillary sinusitis in case of entering the sinus of the root of the tooth. Materials and methods. The results of the study - video endoscopy of the nasal cavity and CT of the paranasal sinuses - were evaluated. The obtained data pointed to the foreign body that caused not only an inflammatory process with subsequent development of the mycetoma, but also destruction of the medial wall of the maxillary sinus, the inferior nasal concha. Access to the maxillary sinus was discussed, and surgical intervention was performed. Conclusions. The root of the tooth was extracted through the developed defect of the medial wall of the maxillary sinus communicating with the lower nasal passage.

Correlation of Middle Meatal and Maxillary Sinus Cultures in Acute Maxillary Sinusitis

1997 ◽  
Vol 11 (2) ◽  
pp. 139-144 ◽  
Author(s):  
Abhay M. Vaidya ◽  
James M. Chow ◽  
James A. Stankiewicz ◽  
M. Rita I. Young ◽  
Herbert L. Mathews
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Bacterial Flora ◽  
Acute Sinusitis ◽  
Middle Meatus ◽  
The Past ◽  
Colony Forming Units ◽  
Sinus Ostium ◽  
Convincing Data ◽  
Maxillary Sinuses

Cultures obtained from the middle meatus have been used frequently in the past to direct therapy in patients with acute maxillary sinusitis. However, no convincing data have been published to indicate that middle meatal cultures accurately represent the bacterial flora within the maxillary sinus. The hypothesis of this experiment is that bacteria obtained by directed middle meatal cultures qualitatively and quantitatively correlate with cultures taken by maxillary sinus puncture. Acute sinusitis was induced by injecting 108 colony-forming units of bacteria directly into the maxillary sinuses of rabbits in which the ostia were occluded with cotton packs. Eight animals were injected with Staphylococcus aureus, eight with Haemophilus influenzae, and eight with Streptococcus pneumoniae. The packs were removed after 3 days, and specimens were obtained from the middle meatus in the region of the maxillary sinus ostium, and from the maxillary sinus, 1 day later. The contralateral maxillary sinuses of six of the animals were injected with normal saline and served as controls. There was a 100% correlation rate between cultures of specimens obtained from the maxillary sinus and from the middle meatus in all 24 animals. In addition, the quantitative counts from the middle meatus and the maxillary sinus correlated. Control animals showed no bacterial growth from either the middle meatus or the maxillary sinus. These results show that, in an animal model of acute sinusitis, cultures of specimens from the middle meatus reflect the contents of the maxillary sinus.

scholarly journals Performance of deep learning object detection technology in the detection and diagnosis of maxillary sinus lesions on panoramic radiographs

2020 ◽  
pp. 20200171 ◽  
Author(s):  
Ryosuke Kuwana ◽  
Yoshiko Ariji ◽  
Motoki Fukuda ◽  
Yoshitaka Kise ◽  
Michihito Nozawa ◽  
...  
Keyword(s):  
Deep Learning ◽  
Object Detection ◽  
Maxillary Sinus ◽  
False Positive ◽  
Maxillary Sinusitis ◽  
Learning Object ◽  
Data Sets ◽  
Panoramic Radiographs ◽  
Class 1 ◽  
Maxillary Sinuses

Objective: The first aim of this study was to determine the performance of a deep learning object detection technique in the detection of maxillary sinuses on panoramic radiographs. The second aim was to clarify the performance in the classification of maxillary sinus lesions compared with healthy maxillary sinuses. Methods: The imaging data for healthy maxillary sinuses (587 sinuses, Class 0), inflamed maxillary sinuses (416 sinuses, Class 1), cysts of maxillary sinus regions (171 sinuses, Class 2) were assigned to training, testing 1, and testing 2 data sets. A learning process of 1000 epochs with the training images and labels was performed using DetectNet, and a learning model was created. The testing 1 and testing 2 images were applied to the model, and the detection sensitivities and the false-positive rates per image were calculated. The accuracies, sensitivities and specificities were determined for distinguishing the inflammation group (Class 1) and cyst group (Class 2) with respect to the healthy group (Class 0). Results: Detection sensitivities of healthy (Class 0) and inflamed (Class 1) maxillary sinuses were 100% for both testing 1 and testing 2 data sets, whereas they were 98 and 89% for cysts of the maxillary sinus regions (Class 2). False-positive rates per image were nearly 0.00. Accuracies, sensitivities and specificities for diagnosis maxillary sinusitis were 90–91%, 88–85%, and 91–96%, respectively; for cysts of the maxillary sinus regions, these values were 97–100%, 80–100%, and 100–100%, respectively. Conclusion: Deep learning could reliably detect the maxillary sinuses and identify maxillary sinusitis and cysts of the maxillary sinus regions. Advances in knowledge: This study using a deep leaning object detection technique indicated that the detection sensitivities of maxillary sinuses were high and the performance of maxillary sinus lesion identification was ≧80%. In particular, performance of sinusitis identification was ≧90%.

scholarly journals Does the quality of residual alveolar bone apical to a periodontal lesion beneath the maxillary sinus play a vital role in preventing the extension of periodontal disease to maxillary sinus? A CBCT-assisted retrospective study

2021 ◽  
pp. 1-10
Author(s):  
Vijay Apparaju ◽  
Sunil Kumar Vaddamanu ◽  
Bhupesh Kiran Mandali ◽  
Rajesh Vyas ◽  
Vishwanath Gurumurthy ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Mucous Membrane ◽  
Alveolar Bone ◽  
Maxillary Sinusitis ◽  
Inverse Correlation ◽  
Vital Role ◽  
Cone Beam ◽  
Significant Difference ◽  
One Way Anova

BACKGROUND: The mucous membrane of the maxillary sinus is sensitivis susceptible to infection or inflammation adjacent to it, which may contribute to mucous membrane thickening (MMT). Residual alveolar bone quality (RABQ) is considered a quality of the remaining bone apical to periodontal defect adjoining to the floor of the maxillary sinus. OBJECTIVE: The current study aimed to analyze the minimum RABQ to prevent the extension of periodontal pathology from reaching maxillary sinus using cone-beam computed tomography (CBCT). METHODS: In this retrospective observational study, 240 sinus exposure CBCT records of 146 patients were evaluated. Patients with at least one sinus exposure were included. RABQ and MMT were calculated using CBCT inbuilt tools. RABQ was divided into four groups based on gray scale values (GSV). Statistical analysis was performed using one way ANOVA and independent sample t-tests. Correlation was completed applying Pearson’s correlation coefficient. RESULTS: A significant difference (p< 0.05) was observed between the MMT values of the four RABQ groups. Inverse correlation was observed between mean MMT and GSV values. Mean MMT was higher than pathological MMT range (> 2 mm), with significant differences in groups A and B, where mean GSV values are less than 500. Mean GSV greater than 500 in groups C and D show non-pathological MMT. Prevalence of MMT is 91.4% if GSV is < 500 and 7.5% if GSV is > 500. CONCLUSIONS: Our study suggests that MMT is present if RABQ has GSV values < 500. Maxillary sinusitis and its etiology from periodontal pathology can be excluded based on RABQ adjoining periodontal lesion. Early detection and prompt treatment along with appropriate regenerative protocols can be performed to increase the RABQ. Further microbiological investigation is required to support the present results.

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