치성 상악동염의 임상적 연구

Clinical study of odontogenic maxillary sinusitis

The author has studied retrospectively the odontogenic maxillary sinusitis with the purpose of obtaining some useful data for diagnosis and treatment plan of that relatively common disease in dentistry. The used study material was 70 patients with odontogenic maxillary sinusitis who diagnosed and treated at the Department of Dentistry in Hanyang Medical College Hospital and the Department of Dentistry in National Medical Center from Mar. 1987 to Dec. 1990. The author analyzed the distribution and incidence of sex, age, and side, clinical signs and symptoms, etiologic factors, radiologic findings, etiologic teeth, treatment methods of sinusitis, etiologic teeth and oroantral fistula, and also studied the influence of methods of presurgical managements upon the result of closure of oroantral fistula. The conclusions were as follows. 1. The odontogenic maxillary sinusitis was most frequently occurred during the third decades (31.4%). 2. The developmental incidences by sex was superior in male by the ratio of 1.9 : 1. 3. There were equal incidences by site in odontogenic maxillary sinusitis. 4. Main etiologic factors were periapical infection(48.6%), odontogenic cysts(22.9%), and accidental perforation of maxillary sinus and involvement of foreign body(20%). 5. Clinical signs and symptoms of odontogenic maxillary sinusitis showed characteristics of dental origin also with that of sinusitis of nasal origin. 6. Main etiologic teeth were maxillary first molar(36.5%), second premolar(15.9%) and second molar(15.9%). 7. Caldwell-Luc operation was effective for irreversible odontogenic maxillary sinusitis, but conservative managements should be sufficiently considered in the case of reversible one. 8. As a method of presurgical management, maxillary sinus irrigation contributes an important role to the prevention of recurrence of oroantral fistula of odontogenic maxillary sinusitis.