Cone Beam Computed Tomographic Evaluation of Maxillary Sinus Lesions of Dental Origin

Abstract

The maxillary sinus belonging to the nasal and oral cavity is the most susceptible of the all sinus to the invasion by pathogenic bacteria, either through their communication with the nasal cavity, or the product of odontogenic infection (Brock, 2006). The adult maxillary sinus is an air-fill cavity within the body of the maxilla. It is bounded by dento-alveolar portion of maxilla, orbital floor, lateral nasal walls, and lateral wall of the maxilla. In dentate individuals, continued pneumatization and expansion can occur such that only sinus mucoperiosteum (Schneidarian membrane) is left. In edentulous individuals, continued expansion may leave only alveolar bone between sinus and oral cavity (as a result,patients may need an alveolar ridge augmentation prior to dental implant.The roots of the second molars are closest to maxillary sinus,followed by first and third molars,second and first premolars, and canine. Attachment of the labial levator and orbicularis oculi muscles on the lateral wall of the maxilla can direct the spread of infection. Weak lateral wall is more easily penetrated than sinus floor. As a result, odontogenic infections commonly present with soft tissue vestibular/fascial infections, and rarely sinusitis (Legert et al 2004).

Diagnosis of dental ongm of the disease is mainly based on dental examination, clinical findings and medical history. The review includes the inspection of the oral tissues, looking for inflammation and erythema, despite the fact that this finding is rarely seen m association with maxillary sinus. Inflammation of the soft tissue 1s rarely caused by maxillary sinusitis due to the absence of veins anastomosed and connecting to the subcutaneous tissue, but chronic