maxillary
DESCRIPTION
MAXILLARY. SINUSITIS. MAXILLARY SINUSITIS. FROM. DENTAL ORIGIN. ANATOMY. Pyramid shape. Pseudostratified columnar Ciliated epithelium. Maxillary nerve. Maxillary arteries Facial arteries Infraorbital arteries Greater palatine arteries. Wall of maxillary sinus. Superior. - PowerPoint PPT PresentationTRANSCRIPT
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MAXILLARY
SINUSITIS
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ANATOMY
Pyramid shape
Pseudostratified columnar Ciliated epithelium
Maxillary arteries
Facial arteries
Infraorbital arteries
Greater palatine arteries
Maxillary nerve
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Superior Orbit , infraorbital nerve
Inferior Alveolar process of maxilla , root of molar + premolar [ 7,6,8,5,4,3 ]
Medial Nasal cavity , middle meatus
Anterior Canine fossa, Infraorbital foramen
Posterior Pterygopalatine fossa
Wall of maxillary sinus
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FUNCTION
ยั�งไม่�ทราบแน่�ชั�ด แต่�เชั��อว่�าม่�หน่�าท��ชั�ว่ยัให�เสี�ยังด�งกั�งว่าลใน่ขณะพู!ด ชั�ว่ยัให�กัระโหลกัศี�รษะเบาข%&น่ ชั�ว่ยัให�ลม่หายัใจชั(�ม่ชั�&น่ และชั�ว่ยัป้*องกั�น่คว่าม่ร�อน่ให�กั�บสีม่อง
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MAXILLARY SINUS
TOOTH
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MAXILLARY SINUSITIS
Infection or Inflammation of
the maxillary sinus
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CLINICAL SYMPTOMS
ACUTE SINUSITIS < 3 weeks
SUBACUTE SINUSITIS 3 weeks-3 months
CHRONIC SINUSITIS > 3 months
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SYMPTOMSBloked nose
Headache
Fever
Yellow or green-coloured mucus from the nose
Swelling of the face
Aching teeth in the upper jaw
Loss of the senses of smell and taste
Persistent cough
Generally feeling unwell
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ETIOLOGY
Allergic responses
chemical irritation
Infections mechanical obstruction
Infected maxillary tooth
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RISK FACTORSFrequent cold
Cigarette smoking
Regular use of nasal decongestant sprays
Untreated hay fever or other allergies
Structural abnormalities of the nose
Nasal polyps
Dental disease
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MAXILLARY SINUSITIS
FROM DENTAL ORIGIN
1.Periapical abscess
2.Periodontal diseases
3.Infected dental cyst
4.Dental material in antrum
5.Oroantral communication
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1.Periapical abscessAcute sinusitis
Anaerobic organisms
2.Periodontal diseases
Lane & O’Neal
Chronic sinusitis
5 years irrigation + antibiotics
examination communication with the maxillary
sinus via a periodontal pocket
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3.Infected dental cystPeriapical cyst
Most common of all cysts of the oral region
Epithelium rest of Malassez
The cyst enlarges in to the maxillary sinus
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4.Dental material in antrum
1.Displacement of root
extraction
third molar > second molar > canine
Pa or occlusal film loss of lamina dura
2.Implant
3.Root canal overfilling
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5.Oroantal communication
Cause
Extraction Trauma
Tumour Cyst
Examination
บ�บจม่!กัผู้!�ป้-ว่ยัให�สีน่.ท แล�ว่ให�สี��งน่/&าม่!กัแรงๆหากัทะล(จะม่�
ลม่ร��ว่ออกัม่าทางเบ�าฟั2น่ซี่��ท��ถอน่ หร�อใชั�เคร��องม่�อป้ลายัท!�ๆ
ลองแยังผู้�าน่เบ�าฟั2น่เข�าไป้
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SYMPTOMS
1.เม่��อบ�ว่น่ป้ากั จะม่�น่/&าเข�าจม่!กัข�างท��เกั.ดกัารทะล(
2.เล�อดออกัใน่จม่!กัข�างท��ทะล(
3.พู!ดเสี�ยังข%&น่จม่!กั
4.สี!บบ(หร��แล�ว่อม่คว่�น่ไว่�ไม่�อยั!�
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Treatment
1.กั/าจ�ดสีาเหต่(ของกัารต่.ดเชั�&อ
2. ให�ยัา
3.ท/าศี�ลยักัรรม่หร�อระบายัหน่อง
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1.กำ��จั�ดส�เหตุ�กำ�รตุ ดเชื้��อ
Periapical abscess OCD Extraction
Periodontal diseases Extraction + periodontal surgery
Periapical cyst enucleation cyst + RCT
extraction
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Dental material in antrum
1.กำ��จั�ดส�เหตุ�กำ�รตุ ดเชื้��อ
ว่�สีด(ท��ม่�ขน่าดใหญ่�หร�อม่�กัารต่.ดเชั�&อ ผู้�าต่�ด Caldwell – luc operation
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ถ�าร!ท��ทะล(ม่�ขน่าดเล6กัม่ากั ไม่�ต่�องท/ากัารร�กัษา แน่ะน่/าให�ผู้!�ป้-ว่ยังดกัารสี��งน่/&าม่!กัแรงๆ 7-10 ว่�น่ blood clot ท��อยั!�ใน่เบ�าฟั2น่จะ heal และป้7ดร!ทะล(ได�
ถ�าร!ทะล(ม่�ขน่าดใหญ่� (> 5 ม่.ม่.)ให�ท/า flap ป้7ด
1.Immediate repair
2.Delayed
1.กำ��จั�ดส�เหตุ�กำ�รตุ ดเชื้��อOroantral communication
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1.Buccal flapกัารผู้�าต่�ดป้7ด OAC
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2.Palatal flapกัารผู้�าต่�ดป้7ด OAC
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Use of third molar transplantation for closure of the oroantral communication after tooth extraction [ Kitagawa et al , ORAL SURGERY
ORAL MEDICIEN ORAL
PATHOLOGY,2003,vol 95,409-415 ] Methods
1. ถอน่ฟั2น่ท��ม่�พูยัาธิ.สีภาพูออกั 5.น่/าthird molarม่าใสี�ยั�งsocketท��เต่ร�ยัม่ไว่�
2.ต่รว่จว่�าเกั.ดOAC 6 .ใชั�น่.&ว่กัดและใชั�ค�อน่ขน่าดเล6กัเคาะเบาๆ
3 .เต่ร�ยัม่socket 7 .ยั%ดฟั2น่ด�ว่ยั suture splint ,adhesive resin
4 .ถอน่third molar 8.ร�กัษารากัฟั2น่1( เด�อน่หล�ง transplantation )
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CASE REPORTS
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CASE REPORTS
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conclusions
Tooth transplantation of a mature third molar for closure of the OAC is a simple and excellent method because the transplanted tooth not only closes the communication to the maxillary sinus, but it also satisfactorily functions at the recipient site during mastication,even in adult patients.
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2. ให�ย� 1.antibiotics penicillins , ampicillin amoxicilin
500 ม่กั. ว่�น่ละ 3-4 คร�&ง
2.
2.nasal decongestantsTopical agents phenylephrine HCl 0.5%
oxymetazoline HCl 0.05%
Oral systemic agents phenyl propanolamine
pseudoephedrine
หลอดเล�อดหดต่�ว่ ลดกัารบว่ม่ของเน่�&อเยั��อ ระบายัหน่องได�ด�
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3.ชื้�วยทำ��ให�ผู้��ป่�วยสบ�ยขึ้��น
2. ให�ย�
ยัาลดไข�
ยัาลดป้ว่ด
ยัาละลายัเสีม่หะ
ยัาลดอากัารไอ
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3.ทำ��ศั�ลยกำรรมหร�อระบ�ยหนอง
1. Antral puncture and sinus irrigation
2. Intranasal antrostomy or Nasoantral Window
3. Caldwell – luc operation
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1.Antral puncture and sinus irrigation
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2.Intranasal antrostomy or Nasoantral Window
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3.Caldwell – luc operation
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3.Caldwell – luc operation
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conclusions
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References
1. David A. Mcgowan, Prudence W. Baxter, Jacqueline Jame :The maxillary sinus and its dental implication , British library cataloguing in publication data 1993
2. Yoshimasa Kitagawa, Use of third molartransplantation for closure of the oroantral communication after tooth extraction , ORAL SURGERY ORAL MEDICIEN ORAL PATHOLOGY 2003,95,409-414
3. www.dentalgentlecare.com/sinus_headaches_and_dental_health.htm
4 . เชั�&อโชัต่. ห�งสีสี!ต่:ศี�ลยัศีาสีต่ร:ชั�องป้ากัและแม่6กัชั.โลเฟัเชั�ยัล,หน่�า260-274
5. จ.รพู�น่ธิ: พู�น่ธิ:ว่(ฒิ.กัร :กัารว่.น่.จฉั�ยัและกัารบ/าบ�ดกัารต่.ดเชั�&อสีาเหต่(จากัฟั2น่,2542,391-408
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