Desafios no diagnóstico e intervenção odontológica em casos de sinusite maxilar odontogênica: relato de caso

Abstract

Maxillary odontogenic sinusitis (MOS) is a pathology that accounts for approximately 10 to 12% of maxillary sinusitis cases. The etiology of OMS stems from periapical, periodontal, or iatrogenic disease and is primarily associated with anaerobic bacteria. Clinically, it is mainly characterized by a foul odor, facial pain, and purulent nasal configuration and orientation, which interferes with the individual's well-being. Accurate diagnosis of the dental origin is of paramount importance in cases of this type of sinusitis, as classic treatments for chronic rhinosinusitis are generally ineffective for maxillary odontogenic sinusitis. Currently, research shows underreporting of OMS, an underestimated diagnosis, and the need for clear clinical protocols to avoid unnecessary drug or surgical treatments. Thus, the objective of this work is to report the management of a case of odontogenic maxillary sinusitis associated with endodontically treated tooth 27 in a female patient, based on current scientific evidence, as well as to systematize and critically analyze studies on this topic. Clinical examination revealed painful symptoms, and imaging showed the second mesiobuccal canal without endodontic treatment, with rupture of the maxillary sinus floor due to a periapical lesion and opacification of the maxillary sinus. Five months after the end of treatment, complete closure of the periapical lesion, absence of signs of communication with the maxillary sinus, and intact antral mucosa were observed. This approach shows that accurate diagnosis and dental treatment are essential for preventing chronicity and resolving cases of odontogenic maxillary sinusitis.