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Patients with odontogenic sinusitis may present with symptoms similar to those of other forms of sinusitis, such as nasal congestion, purulent nasal discharge, facial pain or pressure, and a reduced sense of smell. However, the presence of dental pain, foul smell, or a history of recent dental procedure might suggest an odontogenic source.
An oroantral fistula (OAF) is an epithelialized oroantral communication (OAC), which refers to an abnormal connection between the oral cavity and the antrum. [1] The creation of an OAC is most commonly due to the extraction of a maxillary tooth (typically a maxillary first molar) which is closely related to the antral floor.
Symptoms may include: Dull, aching, throbbing pain in the area of the socket, which is moderate to severe and may radiate to other parts of the head such as the ear, eye, temple and neck. [2] [5] [7] [8] The pain normally starts on the second to fourth day after the extraction, [5] [8] and may last 10–40 days. [1]
There is a bony floor of the sinus, dividing the tooth socket from the sinus itself. This bone can range from thick to thin, from tooth to tooth, from patient to patient. In some cases it is absent and the root is, in fact, in the sinus. At other times, this bone may be removed with the tooth, or may be perforated during surgical extraction.
Periapical is defined as "the tissues surrounding the apex of the root of a tooth" and a cyst is "a pathological cavity lined by epithelium, having fluid or gaseous content that is not created by the accumulation of pus."
Mouth infections are usually diagnosed on history and physical exam in the dental office or at a clinic visit with an otolaryngologist. [1] Swelling within the oral cavity or cheeks, along with a history of progressively worsening tooth pain and fevers, is usually enough evidence to support the diagnosis of a mouth infection.
Other symptoms may include hypoesthesia, paresthesia, and discomfort. [3] In rare instances, patients may experience associated facial swelling with the presence or absence of pain due to concurrent infection. [4] Patients experiencing symptoms also tend to be older and have the periapical form of cemento-osseous dysplasia. [3]
The tooth will no longer be sensitive to hot or cold but can be very tender to pressure. Dental caries can also cause bad breath and foul tastes. [16] In highly progressed cases, an infection can spread from the tooth to the surrounding soft tissues. Complications such as cavernous sinus thrombosis and Ludwig angina can be life-threatening. [17 ...
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