treatment plan and seminar 2
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8/13/2019 Treatment Plan and Seminar 2
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Treatment plan and seminar
Done By :
Haider Maad 200911769Abdullah yasar yousef 200810468
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Case
39 year old man presented with swollen cheek
with discomfort and dull ache. O/E: diffuse
hard swelling on LHS cheek, mesial caries on
UL6 which is not ttp . Exam also revealed
spontaneous tearing from L eye and nasal
obstruction along with disturbed sensation of
LHS cheek
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Differential Diagnosis
A. Dental abscess
B. Sialadenitis
C. Sinusitis
Final Diagnosis : Sinusitis
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sinusitis
Acute sinusitis is a bacterial
infection in one or more
sinuses, which include the
maxillary, ethmoid, andfrontal sinuses
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Classifications
• Acute cases, which last for four weeks or less
• Sub acute cases, which last four to twelve
weeks
• Chronic cases, which last more than twelve
weeks and can continue for months or even
years
• Recurrent cases, which involve several acute
attacks within a year
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Etiology
• Viral infection : Most cases of acute sinusitis arecaused by the common cold.
• Bacterial infection : When an upper respiratory tract
infection persists longer than seven to 10 days, it'smore likely to be caused by a bacterial infection thanby a viral infection.
• Fungal infection. increased risk of a fungal infection
if patient have sinus abnormalities or a weakenedimmune system
• Tooth infection
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Etiology
• Usually the first maxillary molar is involved
because of its location.6 If this is the case, the
radiograph may reveal an obvious periapical
radiolucency, a widened periodontal ligament
space at the apex of a tooth, or a tooth with
extensive restorations and/or caries
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Symptoms of acute sinusitis
• Nasal obstruction or congestion, causing
difficulty breathing through the nose
• Pain, tenderness, swelling and pressure
around your eyes, cheeks, nose or forehead
• Foul odor
•
Fever• Tearing in one eye
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Complications • Chronic sinusitis. Acute sinusitis may be a flare-
up of a long-term problem known as chronicsinusitis. Chronic sinusitis is sinusitis that lastslonger than eight weeks.
• Meningitis. This occurs when infection spreads tothe lining of the brain.
• Vision problems. If infection spreads to your eyesocket, it can cause reduced vision or even
blindness• Ear infection. Acute sinusitis may occur with an
ear infection.
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Risk factors • fever or another allergic condition that
affects your sinuses
• A nasal passage abnormality, such as a
deviated nasal septum, nasal polyps or tumors
• A medical condition such as cystic fibrosis, or
an immune system disorder
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Diagnosis
• The most important factors in differentiating
viral from bacterial sinusitis are the overall
symptom. Symptoms of viral infection tend to
peak early and gradually resolve , Thus
symptoms present for less than 10 days point
to a viral infection, whereas symptoms
present for more than 10 days without animprovement suggest a bacterial infection.
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Diagnosis
• Imaging studies. Images taken using
computerized tomography (CT) or magnetic
resonance imaging (MRI) can show details of
your sinuses and nasal area. While notrecommended for uncomplicated acute
sinusitis, imaging studies may help identify
abnormalities or suspected complications.
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Diagnosis
Waters (occipitomental) view
Caldwell (occipitofrontal) view
Lateral view
Modified basilar view (a submental vertex view)
Ultrasonography
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Management
• Nasal Irrigation - this is also known as sinus
irrigation, sinus rinse. It is a home procedure
that involves a salt water rinse to clear the
nasal passages.
Warm compress - if you apply a warm
compress gently to the affected areas of yourface you may have some relief of symptoms.
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Management
• Decongestant tablets these may reduceswelling and allow the sinuses to drain
Antibiotics : can provide small improvements insinusitis cases, most patients recover withoutthe drugs within two weeks. However, in
patients with severe symptoms, like high fever,severe pain in cheeks and swelling of face,antibiotic treatment maybe required
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Management
antibiotics may be prescribed in some cases
• If symptoms are severe or if the patient very
unwell.
• If patient have another illness such as cystic
fibrosis, heart problems or a weakened
immune system.
• If symptoms are not settling within 7 days, or
are worsening.
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Management
• Surgery is normally only considered if medical
treatment fails , most sinus operations are
performed without an external incision.
• Endoscopic surgery
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Thank You Questions