Maxillary sinus for 2nd year BDS
-
Upload
jamil-kifayatullah -
Category
Health & Medicine
-
view
632 -
download
1
Transcript of Maxillary sinus for 2nd year BDS
![Page 1: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/1.jpg)
![Page 2: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/2.jpg)
![Page 3: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/3.jpg)
![Page 4: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/4.jpg)
![Page 5: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/5.jpg)
![Page 6: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/6.jpg)
![Page 7: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/7.jpg)
Paranasal sinuses
![Page 8: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/8.jpg)
Paranasal sinuses
![Page 9: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/9.jpg)
Paranasal sinuses
Paranasal Sinuses (PNS) are air containing bony spaces around the nasal cavity. Usually lined by respiratory mucous membrane of ciliated columnar epithelium 4 paired (bilateral) PNS are: Maxillary Frontal, Sphenoidal ,Ethmoidal
![Page 10: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/10.jpg)
Sinus
LATIN word meaning a Fold or Pocket.
![Page 11: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/11.jpg)
TYPES
named according to the bone in which they lie.
1) The Maxillary sinuses: largest of the paranasal sinuses ,are under the eyes in the maxillary bones.
![Page 12: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/12.jpg)
Maxillary Sinuses
Copyright © 2005, Mosby, Inc.
![Page 13: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/13.jpg)
Types of paranasal sinuses
2) The frontal sinuses: superior to eyes in the frontal bone which forms the hard part of the forehead.
![Page 14: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/14.jpg)
FRONTAL SINUSES
![Page 15: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/15.jpg)
Types of paranasal sinuses
3) the ethmoid sinuses: which are formed from several discrete air cells within the ethmoid bone between the nose and eyes.
![Page 16: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/16.jpg)
Ethmoid sinuses
![Page 17: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/17.jpg)
Sphenoid sinus
4) The sphenoid sinuses in the sphenoid bone at the centre of skull base under the pituitary gland.
![Page 18: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/18.jpg)
Lateral Sinus Anatomy
![Page 19: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/19.jpg)
Maxillary sinus
Maxillary sinus is the pneumatic space that is lodged inside the body of the maxilla and that communicates with the environment by way of the middle meatus and the nasal vestibule
![Page 20: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/20.jpg)
ANTRUM
Maxillary sinus is also called “ maxillary antrum” .ANTRUM IS A GREEK WORD MEANING “CAVE”.
ATTRIBUTED TO NATHIENEL HIGHMOORE ENGLISH PHYSICIAN 1600.
![Page 21: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/21.jpg)
Dr NATHANIEL HIGHMOORE
![Page 22: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/22.jpg)
Maxillary sinuses
![Page 23: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/23.jpg)
PARANASAL SINUSES
![Page 24: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/24.jpg)
STRUCTURE OF MAXILLARY SINUS
ANATOMY: FOUR SIDED PYRAMID BASE: medially towards nasal cavity
forming the lateral nasal wall. APEX: Extends laterally into the body of
zygomatic bone. ROOF( upper wall): Floor of the orbit. FLOOR: Alveolar process
![Page 25: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/25.jpg)
PYRAMID
![Page 26: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/26.jpg)
Boundaries
![Page 27: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/27.jpg)
Walls of maxillary sinus
![Page 28: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/28.jpg)
Occipitomental view
![Page 29: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/29.jpg)
Size
Adult maxillary sinus averages 34 mm in anteroposterior direction
Height= 33 mm Width= 23 mm. Volume of max sinus=15 to 20 ml.
![Page 30: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/30.jpg)
Radiological view
![Page 31: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/31.jpg)
Maxillary sinus
Osteum: at the base of sinus.Level: Middle nasal meatusAccessory ostia: 2 or more connect the sinus with middle nasal meatus.
![Page 32: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/32.jpg)
Osteum of max sinus
![Page 33: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/33.jpg)
![Page 34: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/34.jpg)
Pneumatization
Physiologic process that occurs in all paranasal sinus during the growth period causing them to increase in volume.
Pneumatization is the enlargement of the sinus by resorption of alveolar bone that formerly served to support a missing tooth or teeth and then occupies the edentulous space. A thin cortex remains over the alveolar ridge (arrow) to maintain a normal contour
Gradual pneumatization continuous process persisting throughout life.
![Page 35: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/35.jpg)
PNEUMATIZATION
EXPANSION OF MAXILLARY SINUS GREATER BASALLY IMPINGING MORE AND MORE ON ALVEOLAR PROCESS.
![Page 36: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/36.jpg)
pneumatization???
Pneumatization of alveolar process is believed to result from disuse atrophy initiated by tooth removal.
![Page 37: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/37.jpg)
Periapical xray normal sinus
![Page 38: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/38.jpg)
Pneumatization
![Page 39: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/39.jpg)
Pneumatization of the sinus. Extension of the maxillary sinus into the tuberosity as a result of pneumatization
![Page 40: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/40.jpg)
RECESSES RECESSES: The maxillary sinus pneumatization may
extend into nearby bony elements as recesses - infero-medially into hard palate, laterally into zygomatic bone and posteriorly into ethmoids So, the expansions of maxillary sinus beyond the maxillary bone are known as recesses. Found in alveolar process(50 %), zygomatic process(41.5%),frontal process(40.5%),Palatine process (1.75%).
Some processes of maxilla get invaded by air spaces and these are called recesses
![Page 41: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/41.jpg)
Alveolar recess
![Page 42: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/42.jpg)
Recesses
![Page 43: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/43.jpg)
ZYGOMATIC RECESS= Superior alveolar nerves plus vessels in proximity with sinus.
Frontal Recess= invades and surrounds the contents of infraorbital canal.
Alveolopalatine recess; reduce the amount of bone between dental apices and sinus space.most often pneumatizes the floor of sinus adjacent to the roots of the first molar.
Fully developed alveolar recess= 3 depressions separated by 2 incomplete bony septa.
Anterior depression=premolar buds site Middle depression=molar buds, posterior depression= third
molar bud
![Page 44: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/44.jpg)
![Page 45: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/45.jpg)
Microscopic features 3 layers surround the space of the max sinus : 1) Epithelial Layer 2) Basal lamina 3) Subepithelial layer including the periosteum.
Most numerous cells in max sinus are – Columnar ciliated cells.
Additional cells:Basal cells, columnar non ciliated cells, mucus secreting goblet cells
![Page 46: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/46.jpg)
Histology of max sinus
![Page 47: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/47.jpg)
Epithelium
Ciliated Pseudostratified, columnar derived from olfactory epithelium of middle meatus
Most numerous cells in max sinus epithelium Columnar ciliated cells.
Additional cells:1)Basal cells 2)columnar non ciliated cells 3)mucus secreting goblet cells
![Page 48: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/48.jpg)
MICROSCPIC FEATURES
![Page 49: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/49.jpg)
MICROSCPIC FEATURES
![Page 50: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/50.jpg)
MICROSCPIC FEATURES
![Page 51: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/51.jpg)
MICROSCOPIC FEATURES
![Page 52: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/52.jpg)
Ciliated cells
Cilia is composed of typical 9+1 pairs of microtubules and provide mobile apparatus to the sinus epithelium
![Page 53: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/53.jpg)
Ciliated cells
![Page 54: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/54.jpg)
Scanning Electron microscopy of nasal/sinus cilia (orange in thisimage). The pink ball is a speck of pollen. The gray blobs are dust
particles
![Page 55: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/55.jpg)
Pathway of sinus drainage inside the maxillary sinus. Ciliated cells continually sweep mucous towards the
ostium.
![Page 56: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/56.jpg)
Ciliated cells
The ciliated cells enclose the nucleus & electron lucent cytoplasm with numerous mitochondria & enzyme containing organelles.
![Page 57: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/57.jpg)
Ciliated cells
The basal bodies serve as attachment of ciliary microtubules.
The cilia provide motile apparatus.
![Page 58: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/58.jpg)
Ciliated cells
By ciliary beating, the mucous blanket lining the epithelial surface moves from the interior of the sinus towards the nasal cavity
![Page 59: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/59.jpg)
Goblet cells
Basal segment contains nucleus Goblet cells contain RER & SER along
with the Golgi apparatus all of which are involved in the synthesis of secretory substances
This means that they contain all the characteristics of secretory cells.
![Page 60: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/60.jpg)
Goblet GLASS
![Page 61: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/61.jpg)
GOBLET CELLS
![Page 62: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/62.jpg)
Subepithelial layer
Contain subepithelial glands and reach the sinus lumen by way of excetory ducts.
The glands contain both serous and mucous acini i.e secrete serous as well as mucous secretion.
Myoepithelial cells surround the acini composed of either both secretory cells
or a pure population of cells of either secretory type.
![Page 63: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/63.jpg)
Subepithelial layer
The subepithelial layer also consists of collagen bundles,fibroblasts,vessels and nerves.
![Page 64: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/64.jpg)
Composition
serous secretion= water, neutral lipids, proteins, carbohydrates.
mucous secretion=compound glycoprotein's and mucopolysaccharides
![Page 65: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/65.jpg)
Subepithelial glands
AUTONOMIC NERVOUS SYSTEM(ANS)Control secretions from these glands.Supplied to max sinus from max nerve
complex.
![Page 66: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/66.jpg)
![Page 67: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/67.jpg)
Functions Of Maxillary Sinus
Warming/Humidification of air. Contribution to immune response i.e bactericidal
lysozyme . Lightening the skull Resonance to voice Assistance in regulation of intracranial pressure Enhance Facio-cranial resistance to shock
![Page 68: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/68.jpg)
Nerve Supply
Nerve Supply: MAXILLARY DIVISION OF V NERVE i.e V2
1) Anterior, middle and posterior superior alveolar nerves,
2) Infra orbital nerves 3) greater palatine
nerve
![Page 69: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/69.jpg)
Maxillary nerve
![Page 70: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/70.jpg)
GREATER PALATINE NERVE
![Page 71: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/71.jpg)
INNERVATION
The innervation of the sinus is important from a diagnostic standpoint. Post wall of the sinus receives its supply from Posterior and Middle Superior Alveolar nerves while anterior wall is by Anterior Superior Alveolar Nerve. These nerves travel enclosed in the wall of the sinus innervating the related teeth (Wallace 1996). Thus it is commonly seen that pain of the sinus is mimicked as toothache and vice versa and is difficult to distinguish
![Page 72: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/72.jpg)
Arterial supply Major blood supply from branches of maxillary
artery 1) infraorbital artery 2) posterior superior dental artery 3) anterior superior dental artery 4) greater palatine 5) sphenopalatineSmaller contribution from facial artery both branches of external carotid artery.
![Page 73: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/73.jpg)
EXTERNAL CAROTID
![Page 74: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/74.jpg)
FACIAL ARTERY
![Page 75: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/75.jpg)
SPHENOPALATINE ARTERY
![Page 76: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/76.jpg)
Venous Drainage
Venous Drainage: Via the Facial vein, Sphenopalatine vein anteriorly and the Pterygoid venous plexus posteriorly Anterior, middle and superior dental veins drain into the infra-orbital vein Pterygoid plexus communicates with the cavernous sinus by emissary veins
![Page 77: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/77.jpg)
Venous Drainage
![Page 78: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/78.jpg)
VENOUS DRAINAGE
![Page 79: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/79.jpg)
CLINICAL IMPORTANCE
The significance of the vascular drainage of the sinus lies in the fact that apart from the joining typical pathways in the maxilla to the jugular veins, it can also drain upward into the ethmoidal and frontal sinuses and eventually reach the cavernous sinus in the floor of the brain. Spread of infections via this route is a serious complication of maxillary sinus infections
![Page 80: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/80.jpg)
Lymph Drainage
PREAURICULAR NODES Submandibular lymph node PAROTID node Facial node
![Page 81: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/81.jpg)
![Page 82: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/82.jpg)
CLINICAL CONSIDERATIONS
![Page 83: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/83.jpg)
CLINICAL CONSIDERATIONS
Developmental anomalies Agenesis( complete absence of max sinus) Aplasia( altered development) Hypoplasia(underdevelopment) Supernumerary sinus(occurrence of 2
completely separated sinuses on the same side)
![Page 84: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/84.jpg)
CLINICAL CONSIDERATIONS
Pituitary gigantism: sinuses larger than normal Some congenital infections: sinuses smaller than
normal e.g congenital syphilis Pathologically generated- functional and
systemic association Transfer of pathologic condition is through
Mechanical blood or lymphatic system.
![Page 85: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/85.jpg)
Hypoplasia Maxillary sinus hypoplasia presence of three of following four
criteria: 1. oval-shaped sinus 2. absence of pneumatization of the sinus below the level of the nasal floor 3. presence of medial wall of the sinus laterally to a vertical line drawn tangentially to the medial orbital border 4. lateral extension of the sinus medial to a vertical line drawn through the middle of the orbit at the level of the infundibulum, in the coronal plane
![Page 86: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/86.jpg)
HYPOPLASIA
![Page 87: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/87.jpg)
HYPOPLASIA OF MAXILLARY SINUS
![Page 88: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/88.jpg)
MAXILLARY SINUS HYPOPLASIA
![Page 89: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/89.jpg)
HYPOPLASIA OF MAXILLARY SINUS
![Page 90: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/90.jpg)
Clinical considerations Chronic infections of mucoperiosteal layer cause
neuralgia becoz of superior al n invovolvement. Neuralgia of maxillary nerve “tic doulorex” may mimic sinus pain Non specific bacterial sinusistis Infections caused by
streptococci,staphylococci,pnemococci,virus of common cold.
![Page 91: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/91.jpg)
Clinical considerations/importance/implications
1) Oroantral communication accidental opening in the floor of the
antrum caused during extraction of maxillary first molar which has a thin bone separating the roots from the antrum.
a tract b/w oral cavity and max antrum not lined by epithelium.
![Page 92: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/92.jpg)
Fates of oro antral communication
Either close spontaneouly Become epithelialized and persist as true
fistulae
![Page 93: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/93.jpg)
OROANTRAL COMMUNICATION
![Page 94: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/94.jpg)
Oroantral commmunication/fistula
CAUSES Surgical extraction of first molar Extraction of tooth showing
hypercementosis Radicular cyst Granuloma AbscessTherefore surgical intervention necessary
![Page 95: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/95.jpg)
EXTRACTION OF FIRST MOLAR
![Page 96: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/96.jpg)
![Page 97: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/97.jpg)
PERIAPICAL LESION OR GRANULOMA CAUSING OAF
![Page 98: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/98.jpg)
Pituitary gigantism
![Page 99: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/99.jpg)
Tic doulourox( trigeminal neuralgia)
![Page 100: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/100.jpg)
Malignant lesions
Malignant lesions adenocarcinoma squamous cell carcinoma osteosarcoma fibrosarcoma lymphosarcoma
![Page 101: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/101.jpg)
Malignant lesions
Primary manifestation in max teeth 1) pain 2) loosening 3) Supraeruption 4) bleeding in gingival tissue
![Page 102: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/102.jpg)
MALIGNANT LESION
![Page 103: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/103.jpg)
AXIAL VIEW CT SCAN
![Page 104: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/104.jpg)
CORONAL VIEW CT SCAN
![Page 105: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/105.jpg)
CT SCAN REPORT
![Page 106: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/106.jpg)
CLINICAL CONSIDERATIONS/IMPLICATIONS Infections introduced into the antrum
through periapical infections.
![Page 107: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/107.jpg)
Infections introduced into the antrum through periapical infections.
![Page 108: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/108.jpg)
Maxillary sinusitis
![Page 109: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/109.jpg)
Maxillary sinusitis
![Page 110: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/110.jpg)
Signs symptoms When you begin to experience maxillary sinusitis you will
notice the following symptoms: • Nasal congestion
• Facial pain• Differentiated facial sensations• Night-time coughing• Jawbone pain• Teeth pain• Runny nose• Sinus pressure• Chronic tooth aches
![Page 111: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/111.jpg)
Axial CT showing a displaced tooth root into the right maxillary sinus causing sinusitis
![Page 112: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/112.jpg)
Maxillary Sinusitis of Dental Origin : Maxillary Sinusitis of Dental Origin Spread of infection from
Periapical or Pdl. Abscess Due to overextension of Sealers, Cements, GP, Silver cones As a result Of Periapical Surgery of posterior maxillary teeth Due to iatrogenic Causes like Perforation of Sinus membrane Or breakage of Instrument
Maxillary Sinusitis of Dental Origin Spread of infection to the
sinus from a dental abscess: Commonest cause of direct spread of oral infection to the sinus is a “Periapical abscess” Odontogenic sinusitis is seldom associated with acute abscess. It is always secondary to chronic suppuration from a granuloma or a periodontal abscess
![Page 113: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/113.jpg)
Maxillary Sinusitis of Dental Origin : Some common causes of maxillary sinusitis related to dentistry are the
iatrogenic displacement of a maxillary tooth root tip into the sinus during extraction, perforation of the sinus membrane during exodontia, andextrusion of materials used in root canal therapy into the sinus. When teethadjacent to a lone-standing molar have been removed, alveolar bone isresorbed over time mesial and distal to the remaining tooth. This resorptionresults in thinner alveolar bone separating the oral cavity and sinus. If ata later time the lone-standing molar requires extraction, the risk of alveolarbone or maxillary tuberosity fracture with concomitant oroantral commu-nication is high. Other oral and maxillofacial surgery or dental procedures,such as maxillary orthognathic surgery, preprosthetic surgery, sinusmembrane lifts and sinus grafting, and dental implant placement, haveoccasionally been cited as causing sinusitis. The incidence of sinusitis withthese procedures, when properly performed is almost nonexistent, howev
![Page 114: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/114.jpg)
Displacement of root into maxillary sinus during extraction of a tooth.
![Page 115: Maxillary sinus for 2nd year BDS](https://reader036.fdocuments.us/reader036/viewer/2022062503/58e950511a28ab262c8b5b45/html5/thumbnails/115.jpg)