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The maxillary sinus is an air-filled cavity lined with a mucous membrane and cilia whose mission is to reduce the weight of the skull and give resonance to the voice.It is located within the bones of the upper jaw, above the alveoli, which contain the roots of some of the upper jaw teeth, from the first premolar to the upper second molar.
This sinus bulges out in the nasal cavity through a narrow opening in the middle meatus of the nose, where the fluids and exudates formed inside it exit through this opening into the nose and out.
This sinus is bilateral and is shared between the maxillofacial surgeon and the ear, nose and throat specialist.
The majority of jaw injuries are of dental origin and are resolved by an oral and maxillofacial surgeon.
One of these injuries is the oral sinus fistula formed during voluntary extraction of the roots of one of the upper jaw teeth corresponding to and close to the bottom of the maxillary sinus, and sometimes one of the roots escapes into the maxillary sinus.
The solution in this case is to ensure that there is no root inside the sinus and perform a cosmetic closure.
The buds of a tooth may migrate and settle within the maxillary sinus, forming a cyst that includes the entire contents of the maxillary sinus. Here, the solution is to perform a procedure called Coldwell Lock.
The maxillary sinus is vulnerable to the occurrence of benign or malignant tumors. Any unilateral maxillary sinus injury must be suspected as to the cause and dental source.
Infections of the maxillary sinuses cause pain and headaches, and the pain increases with palpation and during prostration.
The panoramic image is a directed image, but it is not sufficient to prove the relationship between the bottom of the sinus and the corresponding apex of the teeth because it is scanned to a depth of only 25 mm, while the deepest point in the sinus reaches 45 mm.
The image from inside the mouth is more accurate, and sometimes there are other positions: back, front, nose, chin, nose and front, to show the contents of the maxillary sinuses.
In some cases, you may need axial tomography and resonator.
When dental implants occur, and if the thickness of the bone under the bottom of the sinus is small, we can add a bone graft inside the sinus while preserving the sinus lining from tearing.
Dr. Qasim Al-Haijani
Specialist in oral and maxillofacial surgery and dental implantology (Paris)