FEATURES OF INTERDISCIPLINARY INTERACTION IN THE DIAGNOSIS AND TREATMENT OF ODONTOGENIC FORMS OF SINUSITIS AND PREPARATION FOR DENTAL IMPLANTATION

2019 ◽  
Vol 25 (3) ◽  
pp. 34-45
Author(s):  
R.A. Larin ◽  
◽  
D.D. Smirnova ◽  
S.V. Krasilnikova ◽  
A.A. Mhitaryan ◽  
...  
Keyword(s):  
Diagnostic Errors ◽  
Diagnosis And Treatment ◽  
Sinus Surgery ◽  
Surgical Interventions ◽  
Legal Documents ◽  
Dental Implantation ◽  
Number Of Patients ◽  
Sinus Lifting ◽  
Odontogenic Sinusitis ◽  
Interdisciplinary Interaction

In recent years, against the backdrop of actively developing technologies in therapeutic and surgical stomatology, as well as endoscopic technologies in ENT practice, there has been an increase in the number of patients with various, including previously unobserved forms of odontogenic sinusitis (OS). Аccording to various data, from 5 to 30% of all cases of chronic rhinosinusitis are some odontogenic forms. Their specific gravity in the structure of the pathology of ENT hospitals is also growing. Accordingly, the number of surgical interventions is also increasing, which, in turn, necessitates a unification of indications for surgical interventions for some form of odontogenic sinusitis and, especially, in preparation for dental implantation. In the latter case, situations are not uncommon when the patient is referred to the maxillary sinus surgery proactively, “just in case”, which is unacceptable. This leads to the appearance of neglected, chronic forms, what is called "difficult-to-treat rhinosinusitis." The odontogenic (phlogogenic) reasons may include: foreign bodies of the sinus, complicated periodontitis, the consequences of sinus lifting, implantation, etc. It is necessary to study and specify the leading ones in each patient, which is important for building a competent medical strategy. Not all issues of diagnosis and treatment of odontogenic sinusitis, preparation for dental implantation are regulated by legal documents (standards, clinical guidelines). In the most difficult situations, collegial decision-making with the participation of all interested specialists is necessary. The number of diagnostic errors is increasing, especially in preparation for dental implantation and differential diagnosis of odontogenic and rhinogenic forms of sinusitis. At the same time, the bulk of such errors are allowed when interpreting data from radiation studies, or when prescribing radiation studies in the wrong format (MRI, radiography). All this determines the relevance of this study

Evidence of an increase in the incidence of odontogenic sinusitis over the last decade in the UK

2011 ◽  
Vol 126 (1) ◽  
pp. 43-46 ◽  
Author(s):  
E Hoskison ◽  
M Daniel ◽  
J E Rowson ◽  
N S Jones
Keyword(s):  
Information Support ◽  
Sinus Surgery ◽  
Dental Disease ◽  
Oroantral Fistula ◽  
Dental Pathology ◽  
Number Of Patients ◽  
System Data ◽  
Odontogenic Sinusitis ◽  
The Uk ◽  
Age Range

AbstractBackground:Dental disease is a recognised cause of sinusitis. We perceived an increased incidence of sinusitis secondary to dental disease in recent years. This study reviews the incidence of odontogenic sinusitis, its clinical features and treatment.Methods:Medical records of patients with odontogenic sinusitis were identified using the senior author's clinical database and Hospital Information Support System data (January 2004 to December 2009).Results:Twenty-six patients were identified, nine females and 17 males (age range, 17–73 years). Rhinorrhoea and cacosmia were the commonest symptoms (81 and 73 per cent, respectively), with presence of pus the commonest examination finding (73 per cent). Causative dental pathology included periapical infection (73 per cent), oroantral fistula (23 per cent) and a retained root (4 per cent). In all 26 cases, treatment resulted in complete resolution of symptoms; 21 (81 per cent) required sinus surgery. The number of patients with odontogenic sinusitis undergoing surgery has steadily increased, from no cases in 2004 to 10 in 2009 (accounting for 8 per cent of all patients requiring sinus surgery). Reduced access to dental care may be responsible.Conclusion:The incidence of odontogenic sinusitis appears to be increasing. The importance of assessing the oral cavity and dentition in patients with rhinosinusitis is therefore emphasised.

scholarly journals A role of anesthesiologist in reducing surgical bleeding in endoscopic sinus surgery

Medicina ◽  
2010 ◽  
Vol 46 (11) ◽  
pp. 730 ◽  
Author(s):  
Darius Činčikas ◽  
Juozas Ivaškevičius ◽  
Jonas Martinkėnas ◽  
Svajūnas Balseris
Keyword(s):  
General Anesthesia ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Surgical Interventions ◽  
Number Of Patients ◽  
Surgical Bleeding ◽  
Surgical Field ◽  
The Impact

Visibility in the surgical field reduced by bleeding is one of the most important problems of endoscopic sinus surgery. It causes the risk of serious complications and reduces intervention quality. Recently, an increasing number of patients undergo surgical interventions under general anesthesia. Since general anesthesia may influence surgical bleeding in physiological and pharmacological pathways, the role of an anesthesiologist is extremely important in reducing bleeding. The impact of different anesthesia methods on quality of the surgical field is being investigated, and the most effective medicines are being sought.

scholarly journals THE PROBLEM OF DEVELOPMENT OF MAXILLARY SINUSITIS AFTER SINUS-LIFTING SURGERY

2020 ◽  
Vol 16 (3) ◽  
pp. 5-10
Author(s):  
Ekaterina Remizova ◽  
Malkan Amkhadova ◽  
Tamara Gergieva ◽  
Islam Amkhadov
Keyword(s):  
Clinical Practice ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Systematic Analysis ◽  
Bone Material ◽  
Dental Implantation ◽  
Sinus Cavity ◽  
Sinus Lifting ◽  
Odontogenic Sinusitis ◽  
Optimal Visualization

Subject. In some clinical cases maxillary sinus lift is a nessesary surgery preparing for dental implantation in the distal parts of the upper jaw. However, despite the widespread using of this type of surgery in clinical practice, the percentage of postoperative complications leading to the development of odontogenic maxillary sinusitis after sinus-lifting surgery does not decrease from year to year. Among the complications of sinus lifting, the following main ones are distinguished: perforation of the maxillary sinus mucosa and nasal cavity; rejection of a previously installed dental implant; migration of the implant and/or bone material to the maxillary sinus; bleeding; acute maxillary sinusitis. The aim is to conduct a systematic analysis of domestic and foreign literature sources to determine the main factors of development of postoperative odontogenic sinusitis, as well as features of diagnosis and prevention of this complication. Methodology. The review of research allows us to consider the etiology of odontogenic maxillary sinusitis after sinus-lifting surgery and the pathogenesis of the disease, to draw conclusions about possible ways to prevent its development. Results. Odontogenic sinusitis that developed after the sinus-lifting operation is very common in clinical practice, despite the widespread use of this type of bone augmentation and proven methods of surgical intervention. The reason for this can be both anatomical prerequisites and iatrogenic factors, as well as insufficient diagnosis of pathologies of the paranasal sinuses in the preoperative period. Conclusions. The development of postoperative sinusitis can be avoided with careful planning of the operation, necessarily with computer tomography (preferably, cone-beam (dental) computed tomography, which is characterized by a relatively low load for optimal visualization of the maxillofacial tissues). Pathological changes in the sinus cavity and paranasal structures should be eliminated as planned before the sinus-lifting operation.

scholarly journals DENTAL IMPLANTATION AS A METHOD OF OPTIMIZING TREATMENT OF PATIENTS WITH COMPLETE DENTAL TEETH

2019 ◽  
pp. 33-40
Author(s):  
O.V. Dobrovolskaya
Keyword(s):  
Dental Implants ◽  
New Technologies ◽  
System Level ◽  
Cochrane Library ◽  
Comprehensive Treatment ◽  
Surgical Interventions ◽  
Dental Implantation ◽  
Number Of Patients ◽  
Orthopedic Rehabilitation

The development of dentistry at the present stage opens up new possibilities in the treatment of adentia by intraosseous implantation of artificial supports for dentures, which opened up new opportunities for improving the quality of comprehensive rehabilitation of dental patients. The development of new methods of surgical interventions and prosthetics, the creation of new implant systems help us to increase the life of dentures on implants and to improve the quality of life of patients. Aim of the study. Literary sources analysis with the study of possible complications and their causes at various stages of patient rehabilitation with dental implants in patients with complete absence of teeth. Materials and methods. The review and analysis of scientific-medical literature of 2013-2019 years was conducted, according to the databases Scopus, Web of Science, Med Line, The Cochrane Library, EMBASE, Global Health, CyberLeninka, RINC. Attention is focused on the main causes of patient rehabilitation with dental implants in patients with complete absence of teeth. Results of the studies and their discussion. The method of dental implantation is increasingly used in practical dentistry in the replacement of various defects in the dentition. Dental implants dramatically increased the quality of orthopedic rehabilitation of patients due to the possibility of using fixed dentures in the replacement of dentition defects in both partial and complete adentia. It is worth noting that along with the positive results of implantation, complications are also observed. Removable prostheses on implants can be divided into two groups: fixed on separate implants with spherical abutment or on the beam connecting the implants. The increased interest in this method of treatment is due to a variety of clinical situations, characteristics of the prosthetic bed, the development of new technologies for the construction of prostheses; an increase in the number of patients satisfied with stabilization and retention of prostheses due to implants. The most important stage ensures the further success of the proposed comprehensive treatment of patients, a thorough examination, diagnosis, determination and compliance with indications and contraindications for dental implantation in conditions that are far from optimal. Inadequate consideration of the characteristics of the somatic and dental anamnesis, complaints, motivation and expectations of the patient from the upcoming treatment, examination data, clinical examination, assessment of the functional state of the patient’s dentofacial system, level of oral hygiene, can lead to unjustified expectations of the patient, local and general complications. Conclusions. Advances in dental science, the emergence of the latest technologies in our time allow us to approach the problem of rehabilitation of patients with a complete absence of teeth in the lower jaw using removable and fixed prostheses based on dental implants.

Inflammatory disease of the womans reproductive system: modern trends in diagnosis and therapy (literature review)

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 35-41
Author(s):  
T Yu Pestrikova ◽  
I V Yurasov ◽  
E A Yurasova
Keyword(s):  
Genital Tract ◽  
Inflammatory Diseases ◽  
Diagnosis And Treatment ◽  
Long Term Results ◽  
Modern Approach ◽  
Pelvic Organs ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Diagnostic Approaches

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.

Quality of life after anti-reflux surgical interventions: possible solutions to the problem

2020 ◽  
pp. 3-25
Author(s):  
D. Lukanin ◽  
G. Rodoman ◽  
M. Klimenko ◽  
A. Sokolov ◽  
A. Sokolov
Keyword(s):  
Quality Of Life ◽  
Hiatal Hernia ◽  
Antireflux Surgery ◽  
Nissen Fundoplication ◽  
Laparoscopic Nissen Fundoplication ◽  
Partial Fundoplication ◽  
Surgical Interventions ◽  
Number Of Patients ◽  
Laparoscopic Nissen

The article presents the results of a prospective controlled parallel clinical study of a new modification of laparoscopic antireflux surgery in the treatment of gastroesophageal reflux disease in combination with a hiatal hernia compared with laparoscopic Nissen fundoplication in terms of assessing quality of life after surgery. Clinical and instrumental examination of patients was carried out a year after surgical interventions. In accordance with the results of instrumental examination after surgery, the proposed modification of laparoscopic partial fundoplication is not inferior to laparoscopic Nissen fundoplication both, in terms of relief of reflux esophagitis symptoms and in relation to the recurrence of hiatal hernia. Clinical monitoring indicates a significantly higher quality of life for patients after the modified antireflux surgery, which is associated with a number of factors. The implementation of this fundoplication led to a decrease in the number of patients with complaints of dysphagia, the development of which is directly related to the surgery performance, as well as to a statistically significant reduction of bloating in the upper abdomen. Another advantage of the modified surgery is a significantly smaller number of cases of gas-bloat syndrome. In addition, the disorders developing in the framework of the gas bloat syndrome after laparoscopic Nissen fundoplication are more severe.

scholarly journals Role of Endoscopic Sinus Surgery and Dental Treatment in the Management of Odontogenic Sinusitis Due to Endodontic Disease and Oroantral Fistula

2021 ◽  
Vol 10 (12) ◽  
pp. 2712
Author(s):  
Anda Gâta ◽  
Corneliu Toader ◽  
Dan Valean ◽  
Veronica Elena Trombitaș ◽  
Silviu Albu
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Dental Treatment ◽  
Treatment Success ◽  
Sinus Surgery ◽  
Rank Test ◽  
Oroantral Fistula ◽  
Surgical Closure ◽  
Communication Time ◽  
Odontogenic Sinusitis ◽  
Mean Time

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.

scholarly journals Aromatic L-amino Acid Decarboxylase (AADC) deficiency: results from an Italian modified Delphi consensus

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Carlo Fusco ◽  
◽  
Vincenzo Leuzzi ◽  
Pasquale Striano ◽  
Roberta Battini ◽  
...  
Keyword(s):  
Amino Acid ◽  
Diagnostic Delay ◽  
Steering Committee ◽  
Outcome Data ◽  
Diagnosis And Treatment ◽  
Acid Decarboxylase ◽  
Delphi Consensus ◽  
Amino Acid Decarboxylase ◽  
Modified Delphi ◽  
Number Of Patients

Abstract Background Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare and underdiagnosed neurometabolic disorder resulting in a complex neurological and non-neurological phenotype, posing diagnostic challenges resulting in diagnostic delay. Due to the low number of patients, gathering high-quality scientific evidence on diagnosis and treatment is difficult. Additionally, based on the estimated prevalence, the number of undiagnosed patients is likely to be high. Methods Italian experts in AADC deficiency formed a steering committee to engage clinicians in a modified Delphi consensus to promote discussion, and support research, dissemination and awareness on this disorder. Five experts in the field elaborated six main topics, each subdivided into 4 statements and invited 13 clinicians to give their anonymous feedback. Results 100% of the statements were answered and a consensus was reached at the first round. This enabled the steering committee to acknowledge high rates of agreement between experts on clinical presentation, phenotypes, diagnostic work-up and treatment strategies. A research gap was identified in the lack of standardized cognitive and motor outcome data. The need for setting up an Italian working group and a patients’ association, together with the dissemination of knowledge inside and outside scientific societies in multiple medical disciplines were recognized as critical lines of intervention. Conclusions The panel expressed consensus with high rates of agreement on a series of statements paving the way to disseminate clear messages concerning disease presentation, diagnosis and treatment and strategic interventions to disseminate knowledge at different levels. Future lines of research were also identified.

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