DOI:

10.37988/1811-153X_2023_3_52

Prevention and treatment of chronic odontogenic sinusitis by autotransplantation of the third molar in retention (clinical cases)

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Authors

  • I.R. Ganzha 1, PhD in Medical sciences, associate professor of Department of Pediatric Dentistry and Orthodontics
    ORCID ID: 0000-0002-0563-717X
  • M.A. Postnikov 1, PhD in Medical Sciences, full professor of the Therapeutic dentistry Department
    ORCID ID: 0000-0002-2232-8870
  • I.S. Ganzha 2, 4th year student
    ORCID ID: 0009-0008-5118-4598
  • 1 Samara State Medical University, 443001, Samara, Russia
  • 2 Medical University “REAVIZ”, 443099, Samara, Russian Federation

Abstract

Odontogenic maxillary sinusitis and sinonasal complications of dental treatment are a common problem that leads patients to dentists and/or otorhinolaryngologists. Elimination of the source of odontogenic infection is associated with the removal of the causal tooth and the formation of a junction with the maxillary sinus — perforation of the Schneider membrane. Autotransplantation of a tooth is a procedure that involves the removal of erupted or retinated tooth and its relocation to another place in the oral cavity of the same person. The aim of the study was to develop and introduce into clinical practice a method for the treatment of odontogenic perforated sinusitis by autotransplantation of the third molar, which is in a retinated state.
Materials and methods.
From 2020 to 2023, the treatment of sinonasal complications and/or odontogenic perforated sinusitis was carried out by autotransplantation of the retinated molar of the 3rd molar. The data of 22 clinical cases were processed and analyzed. The effectiveness of the treatment was evaluated. The results of a survey of patients on the severity of symptoms of odontogenic sinusitis were compared.
Results.
The result of this work was the creation of a “Method of plastic perforation of the maxillary sinus using autotransplantation of the third molar”, the implementation of which leads to a complete cure of maxillary odontogenic sinusitis and the closure of the oroantral message. The viability of the neurovascular bundle of an autotransplanted molar was demonstrated and evaluated in 20 clinical cases. The effectiveness of treatment is demonstrated by the results of comparing the survey of patients on the severity of symptoms of odontogenic sinusitis before treatment and 2 months after autotransplantation and demonstrates the elimination of symptoms of maxillary sinusitis, as well as improving the quality of life of patients. The data of dynamic clinical and X-ray diagnostic observation of patients 1.5, 6, 12 and 24 months after the interventions show the effectiveness of the developed method of treatment of sinonasal complications. The statistical significance of the decrease in symptoms was confirmed by the Wilcoxon test at p<0.005, p<0.001 and p<0.0001.
Conclusions.
Carrying out the “Method of plastic perforation of the maxillary sinus using autotransplantation of the third molar” treatment ensures the elimination of sinonasal complications of dental treatment, allow you to restore the continuity of the dentition and chewing efficiency. It is possible to avoid the use of allogeneic, xenogenic, synthetic and other foreign grafts to restore the integrity of the maxillary sinus. It is possible to avoid expensive restorative treatment using dental implants and large-scale bone and plastic manipulations. To successfully reproduce the method of treatment of chronic odontogenic sinusitis by autotransplantation of the third molar in retention, all the risks and benefits of the proposed method should be evaluated. It is recommended to use a personalized approach to the patient, taking into account the state of his somatic health and comorbidity data, as well as the patient’s attitude to this method of treatment.

Key words:

odontogenic sinusitis, sinonasal complications, autotransplantation, tooth retention, third molar, wisdom tooth, perforation, treatment of sinusitis

For Citation

[1]
Ganzha I.R., Postnikov M.A., Ganzha I.S. Prevention and treatment of chronic odontogenic sinusitis by autotransplantation of the third molar in retention (clinical cases). Clinical Dentistry (Russia).  2023; 26 (3): 52—59. DOI: 10.37988/1811-153X_2023_3_52

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Received

April 26, 2023

Accepted

August 27, 2023

Published on

September 24, 2023