Relationship between infected tooth extraction and improvement of odontogenic maxillary sinusitis

Odontogenic maxillary sinusitis (OMS) is a well-recognized disease in otolaryngology and oral and maxillofacial surgery. It is diagnosed comprehensively based on the presence of dental disease and radiographic evaluation. Although the disease involves a combination of dental and otorhinolaryngological features, appropriate criteria have not been well established for prioritizing dental procedures in the initial treatment of OMS. We investigated whether computed tomography (CT) score, including the Lund-Mackay score, can help prioritize tooth extraction as the initial treatment for OMS.

We also investigated the radiographic features of 32 patients with OMS treated by tooth extraction alone. Both pre-and post-extraction CT images of OMS cases were evaluated.

Lund-Mackay scores before tooth extraction were significantly lower in postoperatively healed patients than in non-healed patients. Furthermore, CT scores of the anterior and posterior ethmoid sinuses and frontal sinuses, obtained before tooth extraction, were significantly lower in postoperatively healed patients than in non-healed patients.

Collectively, low Lund-Mackay and CT scores of the ethmoid and frontal sinuses are significantly associated with healing of OMS treated by tooth extraction alone. The sinus CT score can help identify a treatment strategy for OMS.