Signs of a sinus infection of odontogenic origin
Since the upper jaw teeth are located close to the maxillary sinus, the sinus infection may spread to the oral cavity or vice versa. This odontogenic maxillary sinusitis is ascribed to anaerobic organisms that dominate the oral cavity. The sinusitis could be acute and chronic. The management, microbiology and pathophysiology of odontogenic maxillary sinusitis, which is unilateral, are different from that of non-odontogenic maxillary sinusitis.
Causes of odontogenic sinusitisOdontogenic cysts
Alveolar or dental trauma
Perforations in the sinus while extracting the tooth
Secondary infection and irritation due to intra-antral foreign objects
Damage to the Schneiderian membrane owing to periodontal disease
Inadvertent displacement of bone graft materials, dental implants and other foreign bodies during dental surgeries and treatments
Microbiology of odontogenic sinusitis
Many similarities have been identified while analyzing microbiology of odontogenic sinusitis and a dentoalveolar abscess. Anaerobes, such as Fusobacterium, Prevotella, Porphyromonas and Peptostreptococcus, and viridians streptococci are commonly associated with both the conditions. The bacteria sitting in the nasophrynx and nasal cavity may also live in the odontogenic sinusitis' microflora. Thus, a wide range of organisms may trigger the odontogenic sinusitis.
The bacteriological analysis could not distinguish between chronic and acute odontogenic maxillary sinusitis. However, anaerobe, gram-negative bacilli- Fusobacterium sp. and Peptostreptococcus- are the primary organisms responsible for the infection. Two aerobes, S. aureus and ά-hemolytic streptococci, play major role in case of mixed infection.
Acute and chronic of odontogenic sinusitis
If the inflammation in the antral mucosa prolongs after acute odontogenic maxillary sinusitis, symptoms of chronic odontogenic sinusitis develop. The antral mucosa thickens due to fibers, leukocytes and edema during the chronic condition. In some cases, polyps may also develop.
Symptoms and signs of acute formMalaise
Pressure-like dull pain
Occasional eyebrow edema
Nasal obstruction or congestion
Erythema i.e. redness of the skin
Swelling of the anterior maxilla and cheeks
Fullness or pressure near the maxillary sinus
Smelly mucopurulent material draining into the nasophrynx and the nasal cavity
If a periapical abscess is the source of the infection, swelling may occur in the buccal vestibule and gingiva.
Symptoms and signs of chronic formMalodor
Constant pus from the oroantral fistula
Nasal discharge with / without postnasal drip
Tenderness in anterior maxillary area
Pain in tooth while chewing
However, signs of a sinus infection are subtle in chronic form.