Journal Reading

Odontogenic maxillary sinusitis: A

review

Guided by:
dr. Shelly Tjahyadewi, Sp.THT-KL

Anindya Koniek Oktaviarum

01.210.6080
 Maxillary sinusitis of
odontogenic origin

A well-known condition in The Schneiderian membrane is

both the dental and violated by conditions arising
otolaryngology communities from dentoalveolar unit
 pathophysiology
Maxillary sinusitis of
odontogenic origin
microbiology

diagnostics

management

failure to accurately identify a lead to persistent symptomatology and

dental cause failure of medical and surgical therapies
 Data bases

Cochrane Library PubMed Science Direct

resulted in 35 articles
 INTRODUCTION

10-12% of maxillary sinusitis (MS) cases 30-40% of chronic maxillary sinusitis

have been attributed to odontogenic cases contributes to dental cause
infections
 infections of the Promotes the development of
maxillary pos terior periapical or periodontal
teeth odontogenic infection into MS

Sinus membrane
(violated by)
pathologic lesions of
the jaws and teeth

maxillary (dental)
trauma
dental and implant
surgery complications
iatrogenic causes

maxillofacial surgery
procedures
 Etiologi Odontogenic Sinusitis Maxillaris
(Arias-Irima)

Iatrogenia Periodontitis Odontogenic

(55,97%) (40,38%) cysts (6.66%)
 Tooth engagement

molar region premolar region

(47,68%) (5.96%) Canine (0.66%)

M1
(22.51%) P2(1.98%)

M3
(17.21%)

M2 (3.97%)
 Clinical Features

sinonasal symptoms headaches Dental symptoms

unilateral unilateral anterior

nasal maxillary tenderness pain
obstruction

postnasal drip dental

rhinorrhea
hypersensitivity

Foul odor
and taste
 DIAGNOSTIK

The panoramic
The Water’s view CT scan
radiograph

Gold standard
evaluating the relationship
of the maxillary dentition to identifying MS
the sinus, pneumatization, due to its high
and pseudocysts resolution and ability
to discern bone and
soft tissue
 PENATALAKSANAAN
resolution of the infection removal of an
prevent recurrence and external dental
complications root from the
sinus cavity,
extraction

classical Caldwell-
Luc The functional
endoscopic sinus
surgery (FESS)
 classical Caldwell-
Luc

Mucocilliary lining is detrimental to

antral lining is completely
replaced by sinus physiology
removed
nonfunctional mucosa

has a high rate intraoperative bleeding, infraorbital

nerve damage

facial swelling, cheek discomfort,

immediate postoperative pain, signifi cant hemorrhage and
temperature elevation

facial asymmetry, facial and teeth numbness or

paresthesia, oroantral fi stulas, gingivolabial
long term wound dehiscences, dacryocystitis, facial pain,
teeth devitalization, recurrent sinusitis, recurrent
polyposis, antral wall sclerosis) complications
 The functional
endoscopic sinus
surgery (FESS)

entails middle antrostomy and removal of only irreversibly diseased tissue,

polyps, and foreign bodies through the middle antrostomy window thus preserving
sinus mucosa and function
 Oroantral communication (OAC)
rela tively common
complication of dental
surgery
Once a sinus communication has
been diagnosed following dental
surgery such as extraction, the size
of the defect must be assessed.
Successful management depends largely on
primary closure of the defect and adequate
medical management
Defect of 5 mm or less generally close
spontaneously in compliant patients.
resorbable barrier, such as absorbable gelatin
sponge (Gelfoam, Ferrosan Inc., Soeborg,
Denmark) and suturing
Defect is greater than 5 mm, primary closure
is indicated and can generally be
accomplished with standard surgical
techniques such as buccal advancement
fl aps, palatal island fl aps, full- or split-
thickness palatal pedicle fl aps, gold foils, or
buccal fat pad pedicle fl aps
 oroantral fistula

an unnatural communication between the mouth and the max illary sinus which
is covered with epithelia and can be fi lled with granulation tissue or polyposis of
the sinal mucous membrane

occurs as a result of extraction of upper lateral teeth, which do not heal by means of a
blood clot but inside which granulation tissue forms, and on the edges narrowing of its
vestibule occurs by migration of the epithelia cells of the gin gival proprie, which cover the
edges of the vestibule and partially grow into the canal

enables the passage of microfl ora from the oral cavity into the maxillary sinus the infl
ammation occurs with all possible consequences
 The symptoms during the occurrence of an oro antral fi stula are similar to the
symptoms of oroan tral communication

purulent discharge may When the nostrils are closed with the fi ngers and
drip through the fi stula the patient is asked to blow through the nose, air
may hisse from the fi stula into the mouth

when the patient drinks he feels as

the test with a blunt probe will
though part of the liquid enters the nose from
confirm the existence of a fi
that side of the jaw and occasionally runs out
stular canal
of the nostril on the same side

Caldwell Luc
must be procedure endoscopic
quickly closed surgery
CRITICAL APPRAISAL
 IDENTITAS JURNAL
• Judul asli:

• Penulis:
Regimantas Simuntis, Ričardas Kubilius, Saulius Vaitkus
• Diambil dari:
SCIENTIFIC ARTICLES Stomatologija, Baltic Dental and
Maxillofacial Journal, 16:39-43, 2014
 Pembahasan Judul dan Pengarang
+ • Jumlah kata dalam judul < 12 kata
(10 kata)

Menggambarkan isi utama • Deskripsi Judul

penelitian, menarik, dan tanpa
singkatan

• Tempat & waktu penelitian dalam

-
judul

Kurang lengkap dalam penulisan • Daftar penulis sesuai aturan jurnal

gelar

• Korespondensi penulis
+
 Pembahasan Abstrak
•+
Abstrak satu paragraf

Mencakup komponen •+
IMRC

Informatif •+

Tanpa singkatan selain •+

yang baku
•+
Kurang dari 250 kata (220)
 Ringkasan metode
No. Kriteria Ya (+) atau Tidak (-)

1 Jenis dan rancangan penelitian +

2 Waktu & tempat penelitian -
3 Populasi sumber -
4 Teknik sampling -
5 Kriteria inklusi -
6 Kriteria ekslusi Tidak disebutkan
7 Perkiraan dan perhitungan besar Tidak disebutkan
sampel
8 Perincian Cara penelitian -
9 Blind Tidak disebutkan
10 Uji statistik -
11 Program komputer Tidak disebutkan
12 Persetujuan subjek (IC) Tidak disebutkan
Ringkasan pembahasan, kesimpulan, daftar
pustaka
No. Kriteria Ya (+) atau Tidak (-)

1 Pembahasan dan kesimpulan +

didapatkan teprisah
2 Pembahasan dan kesimpulan +
didapatkan dengan jelas
3 Pembahasan mengacu pada -
penelitan sebelumnya
4 Pembahasan sesuai landasan teori +
5 Saran penelitian -
6 Penulisan daftar pustaka sesuai +
aturan
7 Tahun daftar pustaka 1996-2012
 PENGUJIAN VALIDITAS EKSTERNA
• Apakah hasil dapat diterapkan pada sampel
terpilih?
Tidak ada subjek drop out.
• Apakah hasil dapat diterapkan pada populasi
terjangkau?
Melalui random sampling, sehingga dianggap
mewakili populasi terjangkau.
• Apakah hasil dapat diterapkan pada populasi
target? Dapat.