Management of upper odontogenic infections and the role of multidisciplinary treatment

Aim Odontogenic sinusitis is a group of infections related to dental conditions. It may involve the paranasal sinuses (upper odontogenic infections, UOs) and cervical-fascial spaces. Proper diagnosis and treatment of dental complications can be challenging due to  unspecific clinical presentation.

Materials and methods A retrospective study of 37 patients with acute UOs treated between January 2008 and December 2018 is presented. A clear etiological and chronological relationship between the odontogenic focus and sinonasal infection was required for inclusion in the study.

Results The causes of UOs were mainly dental implantation (29.8%) and tooth extraction (18.9%). In all cases, UOs were treated with transnasal endoscopic surgery, associated with transoral procedures in 24 out of 37 patients (64.9%). Empirical antibiotic therapy was used in all cases, whereas antibiogram-driven therapy was adopted secondarily in 22 out of 37 cases (59.4%). Surgical success was achieved in 97.3% of patients.

Conclusions Multidisciplinary agreement of an otorhinolaryngologist and dental surgeon is a crucial step in proper diagnosis and treatment of UOs. A correct surgical approach and antibiogram-driven therapy are key elements of correct resolution of infection.