Tema9:

1) Overview of chronic sinus inflammation 2) Classification of chronic sinusitis: -Partially diffuse purulent hyperplastic with oral communication jaw, acute 3) Causative factors in favor and maxillary sinusitis 4) Etiopathogeny 5) Anatomic Phatology 6) symptoms 7) diagnosis: - clinical examination - Point sinusografia with contrast - radiography - Diafanoscopia - rino - and sinusoscopia 8) Differential diagnosis is made with: - rinogena chronic sinusitis, intrasinusal mucous cyst, cystic tumors dental specific sinusitis 9) Treatment: radical surgery after Caldwell-Luc. after Dencher

2) Classification of chronic sinusitis: -Partially diffuse purulent hyperplastic with oral communication jaw, acute

Odontogenic origin chronic sinus: 1.After extension: a) Partial and b) Broadcast 2. After clinical forms: a) purulent b) hyperplastic c) communication oro-maxillary c) Re worse.

3) Causative factors in favor and maxillary sinusitis 4) Etiopathogeny

ETIOLOGY 1. Main causes: a) lower body resistance b) chronic inflammation of the lining of the nasal-sinus c) ostia obstruction of the middle meatus d) Sinus polyps e) deviations of the septum

Determining factors:?

a) apical periodontitis or chronic granulomatous spurt b) osteitis alveolar process c) radicular cysts and follicular d) deep periodontal pockets e) latent root infections f) traumatic endodontic treatments g) dental extraction of teeth sinus h) endosseous implants

5) Anatomic Phatology

pathological Anatomy Mucosa shows an infiltrated limfoplasmocitar Processes occurring fibrosis and numerous polyps In advanced stages polyps can obstruct the ostium and cavity bucosinusala This sinus empyema and rebound effect of the inflammatory process.

6) symptoms

Symptoms Subjective January. Pain especially in the morning February. Cacosmia Three. Moderate feeling of tension geniosuborbitara

Objective January. Elimination of unilateral mucopurulent secretion February. Mucosa hyperemia, bold covered with scabs Three. The ostium sinus polyps proliferative Examination dental arches January. causal periodontal dental injuries February. oro-antral fistula Three. if oral-sinus communication, the sign is positive Valsava and liquids can network through the nose April. overall usually not affected but may indicate pharyngitis, laryngitis which creates a general malaise

7) diagnosis:
Diagnosis Physical examination January. Visual inspection of the alveolar arches emphasizes dental periodontal lesions, oro-sinus fistula, or polyps empty socket. February. Percussion - affected sinus wall is more sensitive compared to the healthy. Three. Sinus puncture - practiced inferior meatus or the anterior wall of the maxillary sinus pus highlights. April. Previous rhinoscopy - unilateral purulent mucus, sinus polyps. Laboratory examination Radiography - Sinus value less intense and less homogeneous, thickened mucosa that may present adenoids Diafanoscopia highlight the following signs: a) sign of Hering-lack of transparency of the sinus b) sign-Davidson's lack of lighting on the affected nerve head c) the sign of Garel-sufferer does not charge light on the affected side.

8) Differential diagnosis is made with:

Differential Diagnosis January. rinogena which is bilateral maxillary sinus and causes lacks dentoparodontale February. intrasinusal cyst (mucocel) Three. Dental cystic tumors April. epithelioma of mesostructured-over and nasal secretions are accompanied by small hemorrhages, cacosmie, abnormal sensitivity of the affected nerve.

9) Treatment: radical surgery after Caldwell-Luc. after Dencher

The goal of treatment Removing etiological factor Action on microbial agent. Processing of the maxillary sinus drug. Limiting the expansion of infectious process. Body immunity. Rehabilitation of disturbed functions.

Drug treatment - With aliens tooth causes: Antibioticogramei the antibiotics. General and local antibiotic treatment by introducing into the maxillary sinus. Analgesics. Hiposensibilizante (Dimitrol, suprastin). Vasoconstrictorii (glazolin, naftezin). Antipyretics.

Detoxified

surgery -Caldwell-Luc operation -The process Denker

Caldwell-Luc operation 1. Loco-regional anesthesia 2. Buccal gingival incision above the gum adhesive portion of the upper lip frenulum until 2nd premolar. 3. Anterior wall of the sinus trepanation canine fossa. 4. Removal of sinus secretions 5. Providing naso-sinus drainage by opening the inferior meatus 6. Introduction in sinus antibiotic powder 7. Vestibular incision suture. Denker procedure

January. Loco-regional anesthesia. February. Taking off pyriform crest and inferior meatus of canines fossa Three. Opening and removing sinus mucosa affected April. Suture the mucosa.