Root cause analysis: An examination of odontogenic origins of acute maxillary sinusitis in both immunocompetent & immunocompromised patients

Jennifer L. McCarty, Ryan M. David, Shelly Y. Lensing, Rohan S. Samant, Manoj Kumar, Rudy L. Van Hemert, Edgardo J.C. Angtuaco, Ryan T. Fitzgerald

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background and Purpose: Dental and periodontal diseases represent important but often overlooked causes of acute sinusitis. Our goal was to examine the prevalence of potential odontogenic sources of acutemaxillary sinusitis according to immune status and their associations with sinusitis. Materials and Methods: A retrospective review of maxillofacial computed tomography studies from 2013 to 2014 was performed. Each maxillary sinus and its ipsilateral dentition were evaluated for findings of acute sinusitis and dental/periodontal disease. Results: Eighty-four patients (24 immunocompetent, 60 immunocompromised) had 171 maxillary sinuses that met inclusion criteria for acute maxillary sinusitis. Inspection of dentition revealed oroantral fistula in 1%, periapical lucencies in 16%, and projecting tooth root(s) in 71% of cases. Immunocompromised patients were more likely to have bilateral sinusitis than immunocompetent patients (67%vs 33%, P = 0.005).Apaired case-control analysis in a subset of patients with unilateral maxillary sinusitis (n = 39) showed a higher prevalence of periapical lucency in association with sinuses that had an air fluid level29% of sinuses with a fluid level had periapical lucency compared with 12%without sinus fluid (P = 0.033). Conclusions: Potential odontogenic sources of acute maxillary sinusitis are highly prevalent in both immunocompetent and immunocompromised patients, although the 2 patient populations demonstrate no difference in the prevalence of these potential odontogenic sources. Periapical lucencies were found to be associated with an ipsilateral sinus fluid level. Increased awareness of the importance of dental and periodontal diseases as key components of maxillofacial computed tomography interpretation would facilitate a more appropriate and timely treatment.

Original languageEnglish (US)
Pages (from-to)484-488
Number of pages5
JournalJournal of Computer Assisted Tomography
Issue number3
StatePublished - 2017
Externally publishedYes


  • Dental disease
  • Maxillary sinusitis
  • Odontogenic sinusitis
  • Sinusitis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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