Odontogenic sinusitis (OS) is a highly prevalent, underappreciated and underdiagnosed disease that has been known for over 100 years. Apical periodontitis, periodontal disease and iatrogenic extrusion of foreign bodies into the sinus are the main causes of OS. Although the prevalence of sinus pathosis of dental origin is still controversial, otolaryngologists recognize that in the presence of recalcitrant sinusitis, a dental origin should be considered and properly treated. Currently, cone-beam computed tomography is the gold-standard imaging technique to assess the relationship between dental conditions, especially apical periodontitis and sinus diseases, and whenever this association is detected, patients should be seen by both a dentist and an otolaryngologist in order to achieve complete recovery. This article reviews the current concepts regarding the definitions, diagnosis and management of OS from a clinical point of view.

Campello AF, et al. Imaging Sci Dent. 2017 Mar;47(1):25-31. https://doi.org/10.5624/isd.2017.47.1.25

Oral manifestations of HIV infection can be an early sign of the disease and may indicate progression to AIDS. Although antiretroviral therapies, especially highly active antiretroviral therapy (HAART), have reduced the prevalence of HIV-related oral lesions, ongoing updates in diagnosis and treatment are essential due to the extended life expectancy of individuals living with HIV. Periodontal disease is a significant concern in these patients, influenced by altered immune responses and microbial dynamics, though the mechanisms are not fully understood. This exploratory study aimed to investigate the oral microbiota and periodontal disease prevalence in HIV-positive individuals by analyzing subgingival plaque samples from 24 patients. We identified 12 bacterial species using Polymerase Chain Reaction (PCR) and amplicon sequencing. Seven species were detected, with Filifactor alocis, Tannerella forsythia, and Porphyromonas endodontalis being the most common. Porphyromonas gingivalis was present in only 13.6% of samples, while T. forsythia was found in 58.3%. Genetic diversity was also observed in P. endodontalis and Selenomonas sputigena amplicons, with specific single nucleotide polymorphisms (SNPs) identified in both species. These results highlight the complex microbial interactions in the oral environments of people living with HIV, emphasizing the need for personalized diagnostic and therapeutic strategies for managing oral health in this population.

Apical periodontitis may be associated with odontogenic sinusitis in cases where the apex of the root is close to, or even within, the maxillary sinus. This study investigated the anatomical relationship between the cortical sinus floor and the root apices of maxillary molars in relation to age and gender. Two hundred cone-beam computed tomography exams (FOV 5 × 5 cm or 8 × 8 cm) were evaluated to determine the proximity of the roots of the molars to the maxillary sinus, according to age group and gender. The maxillary second molar is the tooth with the closest contact with the maxillary sinus, mainly the mesial–buccal root. In maxillary first molars, the palatal root is the nearest one and sometimes lies inside the sinus. Considering the age factor, in the elderly group, lower distances were found for all roots for the male group. In the elderly group, the only difference was found in the female distobuccal root of tooth 16, which was found to be shorter than the males (p < 0.05). In conclusion, the distance between the cortical bone of the maxillary sinus and the root apices varies considerably, and smaller distances were found in older females and for the upper second molar, especially the mesial–buccal root.

Odontogenic sinusitis is a highly prevalent yet frequently overlooked condition. Since anatomically, the roots of the upper molars and premolars may be in proximity to the maxillary sinus, apical periodontitis affecting these teeth may lead to the development of sinus membrane thickening suggestive of odontogenic sinusitis. The present cross-sectional study aimed to investigate the relationship between images suggestive of apical periodontitis and alterations in the maxillary sinus. One hundred and thirty Cone Beam Computed Tomographies (CBCTs) of the posterior maxilla were examined for the presence of apical radiolucent lesions and thickening of the sinus membrane. The relationship between the distance of the lesions from the sinus and the prevalence of sinus alterations was described and compared using a chi-squared test and logistic regression models. In the sample studied, 16.12% and 45.96% of the sinus images suggested mucositis and sinusitis, respectively. The mere presence of radiolucent apical lesions was not related to sinus alterations. However, lesions breaking through the cortical floor of the sinus were associated with a larger mucosal thickness, reaching statistical significance on the left side. Estimation of the magnitude showed that increasing the sample size would lead to a statistical difference on the right side as well. Thus, it can be concluded that, in cases where lesions suggesting apical periodontitis are closely related to the sinus floor, breaking though the cortical bone of the maxillary sinus floor, the prevalence of sinus mucosal thickening, indicating mucositis or sinusitis, is greater.