scholarly journals Association between Maxillary Posterior Teeth Periapical Odontogenic Lesions and Maxillary Sinus Mucosal Thickening: A 3D Volumetric Computed Tomography Analysis

Sinusitis ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 8-20
Author(s):  
Regimantas Simuntis ◽  
Paulius Tušas ◽  
Ričardas Kubilius ◽  
Marijus Leketas ◽  
Nora Šiupšinskienė ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
3D Models ◽  
Apical Periodontitis ◽  
Average Volume ◽  
Posterior Teeth ◽  
Mean Diameter ◽  
Ct Analysis ◽  
Apical Lesions ◽  
Mucosal Thickening ◽  
Sinus Mucosa

Background: The detailed relationship between apical periodontitis and maxillary sinus mucosal thickening is still unknown. The aim of this study was to evaluate the association between maxillary posterior teeth periapical odontogenic lesions and maxillary sinus mucosal (MSM) thickening by using volumetric 3D CT analysis. Methods: A total of 83 subjects with apical periodontitis around maxillary posterior teeth and maxillary sinus mucosal thickening were selected. 3D models of maxillary sinus mucosa and apical lesions were reconstructed from CT, and their volume, mean diameter were calculated. Results: Mean MSM thickening was 8.81 ± 12.59 mm with an average volume of 5092.58 ± 7435.38 mm3. Men had higher MSM thickening than women. Mean diameter of apical lesion was 5.94 ± 2.68 mm; average volume was 200.5 ± 197.29 mm3. Mean distance between MSM and apical lesion was 1.83 ± 2.07 mm. Mucosal volume was the highest in the S1 and D1 configuration and the lowest in R3. Reducing the distance between apical lesion and MSM by each millimetre, the volume of MSM increases by 759.99 mm3. Conclusions: Volumetric CT analysis is a circumstantial method to evaluate the association between maxillary posterior teeth apical periodontitis and MSM thickening. This relationship is not related to the size of the apical lesion but depends on their anatomical position and the distance from the maxillary sinus mucosa.

The Maxillary Sinus: what the general dental team need to know part 3: maxillary sinus disease of endodontic origin

Dental Update ◽  
2020 ◽  
Vol 47 (6) ◽  
pp. 500-509
Author(s):  
James C Darcey ◽  
Garmon W Bell ◽  
Iain MacLeod ◽  
Colin Campbell
Keyword(s):  
Maxillary Sinus ◽  
Clinical Relevance ◽  
Close Relation ◽  
Apical Periodontitis ◽  
Endodontic Treatment ◽  
Radiographic Images ◽  
Sinus Disease ◽  
Mucosal Thickening ◽  
Apical Displacement

This paper, part 3 of the series, discusses the variation in maxillary sinus mucosal thickening when seen on radiographic images and the relation to disease. The role of apical periodontitis in disease of the maxillary sinus and its lining, the stages of endodontic treatment at which problems can arise and how these can be prevented, are considered. Complications involving extruded endodontic materials will also be discussed. CPD/Clinical Relevance: Apical periodontitis may very occasionally contribute to maxillary sinus infection, when the roots of teeth lie in close relation to the sinus. Apical displacement of infection, irrigants or materials during endodontic treatment may contribute to inflammation and infection and should be avoided.

scholarly journals Effect of ridge preservation at molar extraction sites with severe periodontitis on the Schneiderian membrane thickness changes: a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yiping Wei ◽  
Bo Zhang ◽  
Gang Yang ◽  
Tao Xu ◽  
Wenjie Hu ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Tooth Extraction ◽  
Test Group ◽  
Control Group ◽  
Ridge Preservation ◽  
Schneiderian Membrane ◽  
Severe Periodontitis ◽  
Mucosal Thickening ◽  
Sinus Mucosa ◽  
Molar Extraction

Abstract Background Information regarding the reaction of bone augmentation in terms to sinus mucosa thickness of periodontally compromised molar extraction sites is limited. This retrospective study aimed to analyze the effect of ridge preservation procedures following the extraction of molars with severe periodontitis on the healing pattern of adjacent maxillary sinus mucosal membranes. Methods Thirty-one periodontally compromised maxillary molar teeth either receiving ridge preservation (test group, n = 20) or undergoing spontaneous healing (control group, n = 11) were investigated. Cone-beam computed tomography (CBCT) scanning was performed before the extraction procedure and repeated 6 months later. The mucosa thickness (MT) of the adjacent periodontally compromised molar tooth was measured from CBCT images before tooth extraction and after 6 months of healing at nine assigned measurement points. The data were analyzed at α = 0.05. Results The prevalence of pre-extraction maxillary sinus mucosal thickening was 60.0% and 63.6% in the test and control groups, respectively. The average MT of the thickened sinus mucosa before tooth extraction was 3.78 ± 2.36 mm in the test group and 4.63 ± 3.20 mm in the control group (P = 0.063). The mean mucosal thickening reductions in the thickened MT subjects after 6 months of healing were 2.20 ± 2.05 mm (test group) and 2.64 ± 2.70 mm (control group), P = 0.289. The differences of MT between the time prior to extraction and after 6 months of healing were statistically significant within both groups (P < 0.05). Conclusions Following extraction of molars with severe periodontitis, a reduction in swelling of the Schneiderian membrane has been observed regardless of the addition of a DBBM socket graft. However, a mucosal thickness > 2 mm was still frequently observed.

scholarly journals Endo-antral syndrome in aspergillosis

2017 ◽  
Vol 63 (4) ◽  
pp. 169-173
Author(s):  
Alexandru Andrei Iliescu ◽  
◽  
Paula Perlea ◽  
Sînziana Adina Scărlătescu ◽  
Irina Maria Gheorghiu ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Filamentous Fungi ◽  
Root Canal ◽  
Apical Periodontitis ◽  
Root Canals ◽  
Genotype Analysis ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Apical Lesions ◽  
Aspergillosis Of Maxillary Sinus

While initiating an endo-antral syndrome, inside the endodontic system and the chronic apical lesions of upper teeth anatomicaly related to the maxillary sinus floor, may be found both endopathogenic bacteria and filamentous fungi. Similarly the improper root canal treatments may facilitate an emerging aspergillosis of maxillary sinus. By phenotype and genotype analysis in 10% of chronic apical periodontitis were disclosed filamentous fungi of Aspergillus genus (A. fumigatus, A. versicolor and A. niger). Accordingly might be also taken into consideration the hypothesis of mutual pathogenical relationship between pulpal and sinusal pathology, since at its turn the aspergillosis of maxillarx sinus can also promote the contamination of already filled or still untreated necrotic root canals with filamentous fungi.

Persistent Apical Periodontitis: Bacterial Taxonomic Analysis and Treatment Through Intentional Replantation

2020 ◽  
Author(s):  
Fernando Eduardo Coria-Valdiosera
Keyword(s):  
Antibiotic Therapy ◽  
Root Canal ◽  
Resistance Mechanisms ◽  
Apical Periodontitis ◽  
Infectious Process ◽  
Identification Of Bacteria ◽  
The Right ◽  
Apical Lesions ◽  
Endodontic Retreatment

Introduction: The microorganisms own different resistance mechanisms that allow them to resist the chemo-mechanical cleanliness of root canal and antibiotic therapies causing the persistence of apical lesions. Methods: This clinical case describes a male patient diagnosed with pulp necrosis in the right lower central incisor due to trauma, which developed apical periodontitis manifesting itself extra orally. Root canal treatment along with antibiotic therapy was performed, but because the infectious process persisted, endodontic retreatment and a new antibiotic therapy were carried out, however, the clinical evolution was not favorable. For this reason, the intentional replantation was chosen as the outright treatment, performing apicectomy and curettage of the periapical lesion, from which the isolation and taxonomic study of microorganisms were carried out, with the respective antibiogram. Results: In the 10-day clinical follow-up, the extraoral infectious process disappeared almost completely and 6 months later, a complete repair of the bone tissue was observed on the tomography. Conclusion: A better understanding of the persistence of apical periodontitis was achieved by taxonomic identification of bacteria and the intentional replantation allowed to remove the apical biofilm gaining an excellent wound healing.

scholarly journals Influence of the Periapical Status of the Posterior Maxillary Teeth on the Width of the Schneiderian Membrane of the Maxillary Sinus Mucosa

2021 ◽  
Vol 11 (9) ◽  
pp. 3908
Author(s):  
Igor Tsesis ◽  
Eyal Rosen ◽  
Ilan Beitlitum ◽  
Einat Dicker-Levy ◽  
Shlomo Matalon
Keyword(s):  
Maxillary Sinus ◽  
Third Molar ◽  
Root Tips ◽  
Schneiderian Membrane ◽  
Second Molar ◽  
Periapical Lesions ◽  
Posterior Maxilla ◽  
Mucosal Thickness ◽  
Tooth Type ◽  
Mucosal Thickening

Background: Various parameters are known to affect the amount and type of mucosal thickening. The aim of this retrospective study was to investigate these effects through a survey of cone-beam computed tomography (CBCT) images. CBCT scans of 150 patients, which included the area of the MS and maxillary teeth (canine, first premolar, second premolar, first molar, second molar, and third molar), were evaluated retrospectively for the presence of sinus mucosal thickening. The parameters evaluated as possible causes of mucosal thickening were age, sex, tooth type, proximity to the maxillary sinus, endodontic treatment, and periapical lesion. Descriptive statistics and multiple logistic regression were used to analyze the data. A total of 28% of the teeth presented with mucosal thickening, which was associated with periapical lesions in 57.1% of 77 cases. The size of the lesion was the only parameter that was found to be significantly connected to the presence of mucosal thickness. More than 50% of teeth with periapical lesions in the posterior maxilla exhibited mucosal thickening. Other parameters such as age, sex, and the position of the root tips in relation to the MS floor did not influence the probability of developing mucosal thickening.

scholarly journals Systemic and Extraradicular Bacterial Translocation in Apical Periodontitis

2021 ◽  
Vol 11 ◽  
Author(s):  
María José Bordagaray ◽  
Alejandra Fernández ◽  
Mauricio Garrido ◽  
Jessica Astorga ◽  
Anilei Hoare ◽  
...  
Keyword(s):  
Porphyromonas Gingivalis ◽  
Peripheral Blood Mononuclear Cells ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Apical Periodontitis ◽  
Healthy Individuals ◽  
Peripheral Blood Mononuclear ◽  
Blood Mononuclear Cells ◽  
Apical Lesions ◽  
Total Bacteria

Apical periodontitis is an inflammatory disease of microbial etiology. It has been suggested that endodontic bacterial DNA might translocate to distant organs via blood vessels, but no studies have been conducted. We aimed first to explore overall extraradicular infection, as well as specifically by Porphyromonas spp; and their potential to translocate from infected root canals to blood through peripheral blood mononuclear cells. In this cross-sectional study, healthy individuals with and without a diagnosis of apical periodontitis with an associated apical lesion of endodontic origin (both, symptomatic and asymptomatic) were included. Apical lesions (N=64) were collected from volunteers with an indication of tooth extraction. Intracanal samples (N=39) and respective peripheral blood mononuclear cells from apical periodontitis (n=14) individuals with an indication of endodontic treatment, as well as from healthy individuals (n=14) were collected. The detection frequencies and loads (DNA copies/mg or DNA copies/μL) of total bacteria, Porphyromonas endodontalis and Porphyromonas gingivalis were measured by qPCR. In apical lesions, the detection frequencies (%) and median bacterial loads (DNA copies/mg) respectively were 70.8% and 4521.6 for total bacteria; 21.5% and 1789.7 for Porphyromonas endodontalis; and 18.4% and 1493.9 for Porphyromonas gingivalis. In intracanal exudates, the detection frequencies and median bacterial loads respectively were 100% and 21089.2 (DNA copies/μL) for total bacteria, 41% and 8263.9 for Porphyromonas endodontalis; and 20.5%, median 12538.9 for Porphyromonas gingivalis. Finally, bacteria were detected in all samples of peripheral blood mononuclear cells including apical periodontitis and healthy groups, though total bacterial loads (median DNA copies/μL) were significantly higher in apical periodontitis (953.6) compared to controls (300.7), p&lt;0.05. Porphyromonas endodontalis was equally detected in both groups (50%), but its bacterial load tended to be higher in apical periodontitis (262.3) than controls (158.8), p&gt;0.05; Porphyromonas gingivalis was not detected. Bacteria and specifically Porphyromonas spp. were frequently detected in endodontic canals and apical lesions. Also, total bacteria and Porphyromonas endodontalis DNA were detected in peripheral blood mononuclear cells, supporting their plausible role in bacterial systemic translocation.

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