Root Canal & Sinusitis

Tarlowska W   A case of chronic inflammation of the right maxillary sinus caused by the introduction of cement into its lumen during root canal treatment of the 1st molar through the palatal root canal Czas Stomatol (1968 Jan) 21(1):25-8

Voss A   Radiographic studies of the correlation of the frequency of root  canal fillings and sinusitis  Dtsch Zahnarztl Z (1986 Aug) 41(8):795-7

Selden HS  The endo-antral syndrome: an endodontic complication. J Am Dent Assoc (1989 Sep) 119(3):397-8, 401-2

Infection of pulpally involved teeth near the maxillary sinus sometimes spreads into the sinus and causes serious complications. This pathological complex, involving both antral and periapical tissues, is referred to as the endo-antral syndrome (EAS). It includes diagnostic difficulties, treatment considerations, and occasionally persistent pathological antral alterations after nonsurgical endodontic therapy. Surgical measures are occasionally required to stimulate healing and preserve the teeth.

Dodd RB  Dodds RN  Hocomb JB  An endodontically induced maxillary sinusitis. J Endod (1984 Oct) 10(10):504-6

Sato K  Pathology of recent odontogenic maxillary sinusitis and the usefulness of endoscopic sinus surgery] Nippon Jibiinkoka Gakkai Kaiho (2001 Jul) 104(7):715-20

A Clinicopathological investigation of 34 patients with surgery- requiring odontogenic maxillary sinusitis was conducted. 1) Eighty- nine percent of the causative teeth leading to odontogenic maxillary sinusitis were teeth that had received a root canal treatment. The root canals of most of these teeth were incompletely filled with the filling material. 2) The pathological findings for the causative teeth showed pulpal necrosis and apical lesions after the root canal treatment. 3) Apical lesions in incorrectly treated teeth caused ostitis and odontogenic maxillary sinusitis. 4) The cause of odontogenic maxillary sinusitis should be questioned, even if a dental procedure has been performed. 5) All cases of sinusitis treated with endoscopic sinus surgery improved remarkably. Endoscopic sinus surgery is highly indicated for odontogenic maxillary sinusitis. 6) If the ventilation and drainage of the maxillary sinus is successful after surgery, most of the causative teeth (root canal- treated teeth with apical lesions) can be preserved only by treatment   with antibiotics.

Thevoz F  Arza A  Jaques B  Dental foreign body.  Schweiz Med Wochenschr (2000) Suppl 125:30S-34S

INTRODUCTION: Unilateral chronic maxillary sinusitis is frequently attributed to dental origin. The goal of this retrospective study is to determine the frequency of maxillary sinusitis due to a foreign body of dental origin and its characteristics. METHODS: Review of 197 sinusitis cases with maxillary sinus involvement operated in our department from 1991 to 1999. Selection of the 17 cases preoperatively suspect to be due to a foreign body of dental origin.
RESULTS: 9% of the 197 maxillary sinusitis were classified “odontogenic”. Intra-sinusal foreign bodies were identified in 5%: 2% of dental origin, 1% dental or radicular remnants, 2% of “pseudo” foreign bodies of mycotic origin. CONCLUSION: Chronic maxillary sinusitis attributable to a dental foreign body is rare and overestimated. There exists an important disproportion between the number of intra-sinusal dental foreign bodies and the number of patients who are symptomatic. Treatment is surgical by oral antrotomy and/or endonasal meatotomy. Only a prospective study could give a real estimation of the proportion of symptomatic cases and determine the predisposing factors.

Iikubo M  Sasano T  Shoji N  Sakamoto M  Nonsurgical treatment for odontogenic maxillary sinusitis using irrigation through the root canal: preliminary case report. Tohoku J Exp Med (2002 May) 197(1):47-53
As a new nonsurgical treatment for odontogenic maxillary sinusitis (OMS), irrigation of the maxillary sinus through the root canal of the causal tooth was carried out to the patient with OMS that had proved refractory to conservative treatments (i.e., root-canal treatment of the causal tooth and antibiotic therapy). Clinical signs, symptoms, and radiographs before and after the new treatment revealed evidence of good healing. The clinical signs and symptoms, such as oppressive pain in the cheek and retrorhinorrhoea, entirely disappeared immediately after the irrigation (which was done only once) without pain, and the obstructed ostiomeatal unit was aerated on the follow-up CT images. There was no side effect associated with saline irrigation, nor any recurrence of symptoms since the irrigation. We therefore propose the irrigation through the root canal of the causal tooth as a new treatment for periapical disease- induced maxillary sinusitis, a technique that should ensure proper ventilation and drainage by relieving obstruction of the ostiomeatal unit.

Multiple Sclerosis and Sinusitis

Callaghan TS  Multiple sclerosis and sinusitis.  Lancet (1986 Jul 19) 2(8499):160-1

Gay D  Dick G  Is multiple sclerosis caused by an oral spirochaete? Lancet (1986 Jul 12) 2(8498):75-7

Evidence of a direct link between chronic sinusitis and multiple
 sclerosis (MS) prompted examination of the old “spirochaetal
 hypothesis”. This hypothesis has not been shown to be erroneous and a
 spirochaetal infection of the central nervous system could explain
 the specific pathological, immunological, and epidemiological
 features of MS.

Gay D  Dick G  Upton G  Multiple sclerosis associated with sinusitis: case-controlled study in general practice.  Lancet (1986 Apr 12) 1(8485):815-9

In an analysis of general practice records the rate of chronic
 sinusitis was significantly greater in 92 patients with multiple
 sclerosis (MS) than in matched controls (p less than 0.0001). MS and
 chronic sinus infection were also significantly associated in the
 timing of attacks, in the age at which patients suffered their
 attacks, and in the seasonal pattern of attacks.

Jones RL  Crowe P  Chavda SV  Pahor AL  The incidence of sinusitis in patients with multiple sclerosis. Rhinology (1997 Sep) 35(3):118-9   

A retrospective study was performed to assess the incidence of sinus
 disease in patients with MS. The MRI scans of 108 patients referred
 to a regional Neurosciences Unit with a diagnosis of multiple
 sclerosis were examined. There were 71 females and 37 males with an
 age range of 22 to 67 years (mean: 39.7 years). The sagittal and
 axial images were reviewed and the degree of sinus disease noted.
 This was graded as absent, minimal, polypoid and pansinus. Fifty-
 seven patients (53%) had disease, the most common sinus involved was
 the maxillary followed by the ethmoid, frontal and sphenoid. Thirty-
 six patients had bilateral disease affecting the ethmoid sinuses most
 commonly. Three patients had fluid levels and four patients had
 retention cysts. The incidence of sinus disease is higher than in
 some other studies of normal populations.

Callaghan TS   Multiple sclerosis and sinusitis Lancet (1986 Jul 19) 2(8499):160-1

Symons AL  Bortolanza M  Godden S  Seymour G   A preliminary study into the dental health status of multiple   sclerosis patients. Spec Care Dentist (1993 May-Jun) 13(3):96-101

Khmel’nik VM    Combined intracranial complication in chronic odontogenic maxillary sinusitis Vestn Otorinolaringol (1981 May-Jun)(3):87-8 ISSN: 0042-4668 

Craelius W   Comparative epidemiology of multiple sclerosis and dental caries. J Epidemiol Community Health (1978 Sep) 32(3):155-65