Radiologic Evaluation of Odontogenic Sinusitis and Its Etiologic Factors: Lessons Learned from a Retrospective Study...

Area of Science:

• Dentistry
• Radiology
• Otolaryngology

Background:

• Odontogenic sinusitis (ODS) is a common but often overlooked cause of maxillary sinus inflammation.
• Dental, periodontal, endodontic, and iatrogenic factors frequently contribute to ODS.
• Accurate identification of the odontogenic source is crucial for effective treatment planning.

Purpose of the Study:

• To evaluate the utility of cone-beam computed tomography (CBCT) in identifying odontogenic etiologies of maxillary sinusitis.
• To develop a CBCT-based classification system for odontogenic sinusitis.
• To propose an imaging-guided management algorithm for ODS.

Main Methods:

• Retrospective observational study of 85 patients with CBCT-confirmed ODS.
• Analysis of CBCT scans to identify tooth-related and treatment-related etiologic factors.
• Development of a CBCT-based classification of odontogenic etiologies.

Main Results:

• CBCT revealed diverse odontogenic factors including endodontic/periapical pathology, periodontal disease, post-extraction changes, cysts, fistulas, retained roots, displaced materials, and implant complications.
• A classification system with 16 radiologic categories was established.
• The classification correlated radiologic findings with appropriate dental, surgical, and otolaryngologic treatment.

Conclusions:

• CBCT is superior to conventional radiography for diagnosing ODS, offering detailed visualization of the maxillary sinus and dental structures.
• A structured CBCT evaluation enhances etiologic diagnosis and supports multidisciplinary decision-making.
• CBCT-guided management leads to individualized treatment strategies for ODS patients.