Saturday, October 27, 2018

Understanding Sinusitis with an Endodontic Origin

Based in Portland, Oregon, Terry L. Isom, DMD, directs Isom Endodontics and provides treatments that are effective in preserving teeth in danger of being lost. A particular focus of Dr. Terry Isom and his team is in leading edge root canal therapies that reflect the patient’s overall health needs. 

A recent article in the American Association of Endodontists’ Communique brought focus to endodontic infections that do not display the usual symptoms such as dental pain, sinus tracts and swelling, and ligament widening identifiable through radiographic tests. 

A type of infection that often has an unclear endodontic source is that which occurs in the maxillary posterior teeth. Spreading throughout the maxillary sinuses, the end result is maxillary sinusitis of endodontic origin (MSEO). This has sinonasal symptoms that may include facial pain, congestion, runny nose, and an unpleasant odor. Thermal pain does not occur because the tooth's endodontic therapy is failing, and percussion tenderness is absent because the sinus acts as a drain for infection pressure.

Unfortunately, sinonasal symptoms often lead to primary physician misdiagnosis, rather than proper endodontic care. For the dentist to discover endodontic reasons for sinusitis, existing teeth need to be carefully examined for pulpal necrosis and past endodontic treatments should be evaluated. The endodontic component must be identified in order to perform comprehensive treatment, rather than simple removal of the diseased sinus tissue.