Maxillary sinusitis is a common reason for consultation among people who visit a primary care physician. This is mainly due to the fact that the most common cause of this pathology is the common cold, which is, in turn, the most common of all existing diseases.
Given its prevalence among the population, in this article we will clarify what maxillary sinusitis is, what its symptoms are and how it is cured. In addition, we will explain its origin, as it may also be related to dental implants.
What is maxillary sinusitis?
Maxillary sinusitis is the inflammation -and obstruction- of the paranasal sinuses, which are a set of cavities connected to the nasal cavities. Although we have already mentioned that the most frequent cause of such inflammation is the classic cold caused by a virus, the origin can also occur due to other reasons.
Among them, the presence of bacteria, a fungus or an allergy, but also after a sinus lift to place dental implants. In any case, what happens to a person suffering from maxillary sinusitis is that air does not pass normally through the sinuses, as the cavities become blocked. This causes discomfort and prevents proper breathing.
Maxillary sinusitis can be cured by antibiotics or, if these do not work, even by surgery.
What are sinuses?
The paranasal sinuses are cavities located in the face. They are eight in total and are located four on each side of the nose. These sinuses are, in turn, formed by the frontal sinus, the ethmoidal sinus, the maxillary sinus and the sphenoidal sinus. These cavities are of great importance in our organism since they are essential for breathing, speaking and smelling.
Paranasal sinuses in the face
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PARANASAL SINUSES
What are the symptoms of maxillary sinusitis?
The most common symptoms of maxillary sinusitis are easily identifiable. These vary, in turn, depending on how advanced the pathology is, with fever being one of the most alarming signs.
Nasal discharge and obstruction
Facial pain
Cough
General malaise
Fatigue
Headache
Decreased sense of smell
Fever
Do not ignore the symptoms
Especially if you have problems for several weeks, see your doctor to treat maxillary sinusitis as soon as possible.
How is the diagnosis made?
Although the signs of maxillary sinusitis are quite clear, it is true that in order to confirm the diagnosis – and follow an appropriate treatment – it is necessary to visit our doctor. This visit should be made if we observe the following:
The symptoms described last for more than a week or worsen as the days go by.
You have a fever or a severe headache
When we go to the doctor’s office, the professional will perform a clinical examination that includes, among others, a study of the sinuses and radiographic tests.
Woman with sinusitis
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SYMPTOMS OF MAXILLARY SINUSITIS
Once the pathology has been diagnosed, maxillary sinusitis can be classified into two types according to its duration:
Acute
Symptoms may last up to four weeks. After this time, normality is restored and the person does not show symptoms again.
Chronic
Contrary to the previous case, the symptoms persist over time and last more than three months. Moreover, in chronic maxillary sinusitis, episodes are repeated periodically.
Chronic maxillary sinusitis of dental origin
As mentioned above, this disease can occur as a side effect after dental implants have been placed. Occasionally, a patient does not have sufficient bone in the posterior maxillary area to ensure the correct grip of the screw.
To solve this problem, an operation known as sinus lift can be performed. Although it is an operation that does not usually generate long-term problems for the patient, sometimes a complication occurs in the postoperative period: sinusitis.
The truth is that this is a rare problem, which does not necessarily occur if the surgeon who performs the operation is sufficiently experienced.
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Sinusitis caused by sinus elevation
There are several factors that can lead to the appearance of maxillary sinusitis, and one of them is directly related to sinus elevation.
A large part of the population has had some dental loss and therefore the placement of implants is a technique in great demand. Although it is an intervention that is frequently performed, sometimes the person presents certain complications that prevent the placement of implants. One of them is an insufficient height and volume of bone mass in the upper jaw that prevents the correct fastening of the dental implant.
In such cases, the dental professional must perform a surgical technique called sinus lift, a procedure that vertically increases the amount of bone available in the upper anterior maxilla.
The postoperative period following sinus lift surgery does not usually present serious complications for the patient. It is true that, in the days following the operation, the person will notice a noticeable swelling in the face, which will gradually subside after 7 to 10 days.
However, one of the major complications of the surgical technique is infection of the area, the symptoms of which will begin to appear from the fourth day after the intervention.
Some of the signs that may alert the patient of a possible infection are:
Bad taste in the mouth
Pain
Inflammation does not subside
Suppuration
This infection is the one that can cause maxillary sinusitis, that is, inflammation and obstruction of the paranasal sinuses.
Maxillary sinusitis and dental implants
One of the worst effects of sinusitis in patients who, after undergoing sinus lift surgery, have had an implant placed, is that it can lead to treatment failure. Therefore, there is a direct relationship between, firstly, the sinus lift technique and the appearance of sinusitis and, secondly, between this pathology and the loss of implants.
A report carried out by researchers at the Medical University of Lublin, Poland, followed the evolution of 59 patients with implants for 12 years. The results showed that 11.4% of them developed chronic sinusitis.
In many cases, this disease is caused by a rupture in the Schneider’s membrane, as pointed out in a meta-analysis carried out by various academic and scientific institutions in Korea.
Such a rupture is one of the risks involved in sinus lift and, if it were to occur, it would be necessary to postpone the operation for two months. This is the time it takes for the membrane to regenerate itself again.
A study was conducted at Kyushu University in Japan to determine the causes of postoperative infection and implant loss after sinus lift. The evaluation of 109 patients with 252 dental implants was followed.
Of the total, prosthesis placement was unsuccessful in 6.6% due to postoperative infection, mainly because the patients had chronic sinusitis before undergoing the procedure.
Therefore, the report concludes that preoperative chronic sinusitis could be an important cause of postoperative infection and implant loss when sinus lift is used.
What is the treatment of maxillary sinusitis?
As we have already indicated, the most advisable thing to do is to go to our doctor’s office.
It is necessary not only to receive a clear diagnosis through X-rays and other tests, but also to address the disease properly.
At this point, it is important to note that there are no natural treatments or home remedies for maxillary sinusitis.
This is because it is necessary to take antibiotics – prescribed by a physician, in this case – for a few days to cure the infection and prevent complications.
However, if after taking the antibiotic the sinusitis has not disappeared, it will be necessary to remove the pus and clean the area by surgery.
Treatment for maxillary sinusitis
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SURGERY FOR SINUSITIS
How can this condition be prevented?
Although it is not in our power to completely prevent the appearance of maxillary sinusitis, we can offer you some tips to reduce the chances of suffering from it:
Drink plenty of fluids (mainly water).
Use a humidifier at night
Avoid tobacco smoke or spaces with a lot of pollution.
If you suffer from a respiratory tract infection, administer decongestant medication.
If you have allergies, take medication as soon as you notice the first symptoms.
If you have dental implants, go to your check-ups and follow a thorough hygiene routine.
Of course, the ideal is to prevent sinusitis so that it does not even appear.
However, if this is not possible, it is essential to tackle it before it presents greater complications so that the prognosis is more favorable.
Therefore, if you are several days with the symptoms described, do not think about it and go to your doctor as soon as possible.
This way you will not only get a more favorable diagnosis, but you will also be able to solve the problem quickly, avoiding the discomfort it entails.
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Bibliographic references
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Aleksandrowicz P, Kusa-Podkańska M, Grabowska K, Kotuła L, Szkatuła-Łupina A, Wysokińska-Miszczuk J., (2018). Extra-Sinus Zygomatic Implants to Avoid Chronic Sinusitis and Prosthetic Arch Malposition: 12 Years of Experience. J Oral Implantol. 2019 Feb;45(1):73-78. (https://www.ncbi.nlm.nih.gov/pubmed/30074849)
Kim JS, Choi SM, Yoon JH, Lee EJ, Yoon J, Kwon SH, Yeo CD, Ryu JS, Lee JH, You YS, Kim SG, Lee MH, Han BH, (2019). What affects postoperative sinusitis and implant failure after dental implant: A Meta-analysis. Otolaryngol Head Neck Surg. 2019 Jun;160(6):974-984 (https://www.ncbi.nlm.nih.gov/pubmed/30776960).
Kozuma A, Sasaki M, Seki K, Toyoshima T, Nakano H, Mori Y., (2017). Preoperative chronic sinusitis as a significant cause of postoperative infection and implant loss after sinus augmentation from a lateral approach. Oral Maxillofac Surg. 2017 Jun;21(2):193-200.(https://www.ncbi.nlm.nih.gov/pubmed/28332067)
