John R Craig1, Roderick W Tataryn2, Bruce Y Cha3, Pallavi Bhargava4, Al Pokorny5, Stacey T Gray6, Jose L Mattos7, David M Poetker8. 1. Henry Ford Health System, Department of Otolaryngology- Head and Neck Surgery, Detroit, MI, United States of America. Electronic address: jcraig1@hfhs.org. 2. Tataryn Endodontics, Spokane, WA, United States of America; Loma Linda University, Department of Endodontics, School of Dentistry, Loma Linda, CA, United States of America. 3. University of Connecticut, Division of Endodontology, School of Dental Medicine, Farmington, CT, United States of America. 4. Henry Ford Health System, Department of Internal Medicine, Division of Infectious Disease, Detroit, MI, United States of America. 5. Spokane ENT Clinic, Spokane, WA, United States of America; University of Washington, Department of Otolaryngology- Head and Neck Surgery, Seattle, WA, United States of America. 6. Harvard Medical School, Department of Otolaryngology- Head and Neck Surgery, Boston, MA, United States of America. 7. University of Virginia, Department of Otolaryngology- Head and Neck Surgery, Charlottesville, VA, United States of America. 8. Medical College of Wisconsin, Department of Otolaryngology- Head and Neck Surgery, Milwaukee, WI, United States of America; Zablocki VAMC, Division of Surgery, Milwaukee, WI, United States of America.
Abstract
PURPOSE: Endodontic disease is one of the most common causes of bacterial odontogenic sinusitis (ODS). Diagnosing ODS of endodontic origin involves otolaryngologists confirming sinusitis, and dental specialists confirming endodontic sources. The purpose of this study was to conduct a multidisciplinary literature review to highlight clinical and microbiological features of ODS, and the most optimal diagnostic modalities to confirm endodontic disease. METHODS: An extensive review of both medical and dental literature was performed by rhinologists, endodontists, and an infectious disease specialist. Frequencies of various clinical and microbiological features from ODS studies were collected, and averages were calculated. Different endodontic testing and imaging modalities were also evaluated on their abilities to confirm endodontic disease. RESULTS: ODS patients most often present with unilateral sinonasal symptoms for over 3 months, purulence on nasal endoscopy, and overt dental pathology on computed tomography (CT). Subjective foul smell, and maxillary sinus cultures demonstrating anaerobes and α-streptococci (viridans group) may be more specific to ODS. For endodontic evaluations, cold pulp testing and cone-beam CT imaging are most optimal for confirming pulpal and periapical disease. CONCLUSION: Diagnosing ODS requires collaboration between otolaryngologists and dental specialists. Clinicians should suspect ODS when patients present with unilateral sinonasal symptoms, especially foul smell. Patients will generally have purulent drainage on nasal endoscopy, and both sinus opacification and overt dental pathology on CT. However, some patients will have subtle or absent dental pathology on CT. For suspected endodontic disease, endodontists should be consulted for at least cold pulp testing, and ideally cone-beam CT.
PURPOSE: Endodontic disease is one of the most common causes of bacterial odontogenic sinusitis (ODS). Diagnosing ODS of endodontic origin involves otolaryngologists confirming sinusitis, and dental specialists confirming endodontic sources. The purpose of this study was to conduct a multidisciplinary literature review to highlight clinical and microbiological features of ODS, and the most optimal diagnostic modalities to confirm endodontic disease. METHODS: An extensive review of both medical and dental literature was performed by rhinologists, endodontists, and an infectious disease specialist. Frequencies of various clinical and microbiological features from ODS studies were collected, and averages were calculated. Different endodontic testing and imaging modalities were also evaluated on their abilities to confirm endodontic disease. RESULTS: ODS patients most often present with unilateral sinonasal symptoms for over 3 months, purulence on nasal endoscopy, and overt dental pathology on computed tomography (CT). Subjective foul smell, and maxillary sinus cultures demonstrating anaerobes and α-streptococci (viridans group) may be more specific to ODS. For endodontic evaluations, cold pulp testing and cone-beam CT imaging are most optimal for confirming pulpal and periapical disease. CONCLUSION: Diagnosing ODS requires collaboration between otolaryngologists and dental specialists. Clinicians should suspect ODS when patients present with unilateral sinonasal symptoms, especially foul smell. Patients will generally have purulent drainage on nasal endoscopy, and both sinus opacification and overt dental pathology on CT. However, some patients will have subtle or absent dental pathology on CT. For suspected endodontic disease, endodontists should be consulted for at least cold pulp testing, and ideally cone-beam CT.
Authors: María Helena Rey-Martínez; Pedro Luis Ruiz-Sáenz; Natalia Martínez-Rodríguez; Cristina Barona-Dorado; Cristina Meniz-García; Jorge Cortés-Bretón Brinkmann; Juan Antonio Suárez-Quintanilla; José María Martínez-González Journal: Biology (Basel) Date: 2022-01-20