The maxillary sinus is an air-filled space within the maxilla bone that communicates with the nasal cavity. It is one of the four paired paranasal sinuses. Maxillary sinusitis is inflammation of the maxillary sinus that can be acute, sub-acute, or chronic. It can occur due to infection or allergies spreading from dental sources like periapical or periodontal lesions, overextended dental materials into the sinus, or iatrogenic sinus perforation during dental surgery. Symptoms of maxillary sinusitis include toothache, facial pain, and tenderness over the sinus that is worsened by lowering the head. An oro-antral communication is an abnormal connection between the oral cavity and

1. Maxillary sinus:
It’s the pneumatic space that is lodged inside the body of maxilla and
that communicate with the environment by the way of middle meatus
and the nasal vestibule.
Introduction:
Paranasal sinuses (PNS) are air containing bony spaces around nasal
cavity.
Usually lined by respiratory mucous membrane of ciliated columnar
epithelium.
4 paired (bilateral) PNS are:
-Maxillary
-Frontal
-sphenoid.
- Ethmoidal.

3. • Maxillary Sinus Infection:
• When inflammation develops in the sinus
either due to infection or allergy, it is defined
"sinusitis" and it's the most common disease of
the sinus.
• Maxillary sinusitis could be broadly divided
into:
• • Acute
• • Sub-acute
• • Chronic

4. Dental Implication of Maxillary
Sinus
• Maxillary Sinusitis of Dental Origin:
• Spread of infection from peri-apical or
periodontal lesions.
• Over extension of sealers , cements , GP or
silver cones.
• Periapical surgery of maxillary posterior teeth.
• Iatrogenic: sinus perforation or instrument
breakage

6. • Toothache of Maxillary Sinus Origin:
• In sinusitis a feeling of constant dull aching
pressure or discomfort could be felt on the
posterior maxillary teeth.
• Etiology:
• Part of the nerve supply of the sinus is
posterior superior alveolar nerve that supply
the posterior teeth at the same time.

7. • Clinical Characteristics of Sinus Toothache:
• Dull, constant, non-pulsating aching pain in maxillary
posterior teeth and sometimes all the teeth in the affected
side.
• Infra-orbital redness.
• Toothache is increased with lowering or bending forward the
head.
• Pain on palpation of the affected sinus.
• Pt. may complain of feeling of teeth elongation.
• Teeth are sensitive to percussion or chewing and to cold
drinks and food.

8. Oro-Antral Communication & Fistula
• Oro-Antral Communication: (OAC)
• Is an abnormal connection between the oral
cavity and antral cavity (maxillary sinus) as a
result of loss of the soft and hard tissues
that normally separate both compartments.

9. • Oro-Antral Fistula: (OAF)
• Is a pathological fistular canal lined with
epithelium (stratified squamous epithelium)
which may or may not be filled with
granulation tissue or polyposis of the sinus
mucous membrane.

10. • Oro-Antral Fistula: (OAF)
• Is a pathological fistular canal lined with
epithelium (stratified squamous epithelium)
which may or may not be filled with
granulation tissue or polyposis of the sinus
mucous membrane.