Filling material in the maxillary sinus consequences

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Removing filling material from the maxillary sinus

Do you have a stuffy nose and a headache? Or did you take an x-ray for some reason and accidentally discovered filling material in your maxillary sinus?

Table of contents:

Is this possible and how could it even happen? It’s worth talking about the consequences of this phenomenon and treatment methods, if only because anyone can encounter this phenomenon.

Foreign body in the nasal sinus

How did the elements of the filling, which should close the hole in the tooth, get from the sinus? Naturally, after visiting the dentist’s office and dental treatment, or rather after:

In both cases, most often the walls of the sinuses are thin for some reason. And as a result of the procedure for installing a prosthesis or treating a tooth, they are injured.

It turns out that filling a tooth is not as easy as many people think due to incompetence in this matter. Sometimes the roots of the tooth are very close to the wall of the sinus, and when they are filled, the material ends up in the sinus itself.

Not only during the filling process can the dentist “introduce” material into the maxillary sinus. If the thickness of the bone tissue does not allow for normal installation of the implant, a specialist can “build up” it using artificial material.

The maxillary sinuses are anatomically located in the upper jaw, just above the teeth. Functionally, this is a very important formation. Thanks to the maxillary sinuses, during normal nasal breathing, the air is warmed to its optimum as it passes through the respiratory system. And already warmed it enters the bronchi and lungs. The lining of the nasal sinuses is represented by the mucous membrane, the role of which is to clean the air from microorganisms and dust.

The presence of various objects in the maxillary sinus is fraught with unpleasant and sometimes dangerous consequences. Therefore, if the question is whether to remove a foreign body or refrain from intervention, doctors give a clear answer - be sure to carefully remove it!

Treatment

Removal of a foreign body from the maxillary sinus is carried out promptly, that is, surgically. Then complex drug treatment is prescribed to eliminate inflammation in the intervention area. The operation is carried out in 2 ways:

The first method is more “ancient” and proven. But today it is rarely used, as it involves cutting the gums. The second is more popular and is carried out through the nasal passage by puncturing the paranasal sinus. This method takes about 15–30 minutes between the doctor and the patient. Performed under local anesthesia. Depending on the clinic, the patient is sent home on the same day or after 1–2 days. This operation is not classified as urgent (if there are no complications) or complex.

The first method, that is, laparoscopy, is usually used if endoscopic access is difficult for some reason. For example, you have a pronounced curvature of the nasal septum. This creates a purely mechanical obstacle to the penetration of the endoscope. Then you can remove the object and correct the curvature in “one session.”

If sinusitis is not all that ends the inflammatory process, but there is decomposition of the nerve of a nearby tooth, the formation of granulomas within the sinus, the doctor scrapes its mucous membrane.

Next, treatment is carried out using medications:

The affected paranasal sinus can be washed with a solution of antibacterial agents or a local antiseptic.

Before using antibiotics, it is advisable to carry out bacteriological seeding of biological material from the affected area in order to determine which microflora caused the inflammation. Most often this is an opportunistic coccal flora. But other microorganisms can also take part in the inflammatory process. Broad-spectrum antibiotics are prescribed until results are obtained.

If antibacterial therapy is aimed at combating “violently” leading conditionally pathogenic microflora and pathogenic microorganisms, then other drugs should spur the body’s own forces to fight inflammation and speedy recovery.

Consequences

In principle, surgery today is the only answer to a foreign “agent that has penetrated” into the maxillary sinus. But sometimes patients, especially those who have been “wearing a filling” in their sinus for years, if not decades, ask whether it is possible not to remove it, but to use physical therapy treatment.

The presence of filling material in the paranasal sinus is an absolutely surgical pathology! No amount of physiotherapy will help resolve such material. The presence of filling material in the maxillary sinus can have different consequences - from unpleasant to dangerous, although the material itself is inert.

The main complications from the penetration of foreign elements into the paranasal sinuses and damage to their mucous lining are:
  1. Sinusitis (bacterial, fungal).
  2. Encapsulation of material to form a cyst. A cyst is a benign formation. This is a capsule filled with serous contents. But the contents easily become purulent when coccal flora penetrates.
  3. Formation of granuloma with purulent contents.

Chronic sinusitis can be complicated by:

  • Meningitis.
  • Tonsillitis, otitis and other inflammatory diseases of the ENT organs.
  • Hypertrophy of the nasal mucosa and impaired nasal breathing.
  • Pathology of the cardiovascular system and mild brain hypoxia due to the lack of normal breathing through the nose.
  • Myocarditis due to damage to the heart muscle by coccal flora from a source of constant inflammation.
  • Bronchitis, pneumonia, complicated by obstruction with the risk of developing an asthmatic component.
  • Sepsis.
  • Osteoperiostitis (inflammation of the periosteum with the transition of the process to the bone) of the facial bones. Inflammation in the orbital area of ​​the eye can cause the patient's blindness and even death.

Of course, this entire set of complications is not always realized. But with hypothermia, ARVI, and even with ordinary fatigue, the risk of developing one or more of these consequences increases. Most often these are fungal or bacterial sinusitis. However, the risk of more serious complications always remains.

Therefore, if you have one or more signs of damage to the paranasal sinuses (which we will discuss below), you should go to the doctor and “ask” for a hardware examination. The same needs to be done if you have been treated for a long time, persistently and to no avail with antibiotics and the Arthur Proetz method (“cuckoo”/punctures).

Signs

A foreign body in the maxillary sinus can remain completely asymptomatic for a long time, if inflammation does not begin at the site of insertion of the foreign object. Or it can signal that it is in a branch of the respiratory tract:

  • Pain when tapping on the bone near the nose and under the sockets of the eyes.
  • Feeling of heaviness in the head, headache.
  • Persistent runny nose, refractory to drug treatment.
  • Aching pain in the upper jaw, radiating to the teeth and aggravated by chewing.

If the inflammatory process occurs acutely with suppuration in the area where foreign elements are located, it is possible:

  • Increased body temperature up to febrile levels.
  • Copious nasal discharge.

The discharge is usually purulent in nature. This is a thick yellow-green mucus with an unpleasant putrefactive odor. This is how sinusitis develops.

A little about diagnostics

Almost 100% results are guaranteed by CT scanning of the maxillary sinuses. In the picture you can clearly see the filling itself. And in the case of a fungal infection, the body of the fungus is also affected. According to ENT surgeons, the following are less informative in this regard:

It cannot be done without interviewing the patient and rhinoscopy. An experienced doctor may suspect the penetration of a foreign element even before a hardware examination. But it will be possible to begin eliminating the “blockage” only after a computed tomography scan.

Source: http://elaxsir.ru/zabolevaniya/drugie-zabolevaniya/plombirovochnyj-material-v-gajmorovoj-pazuxe-posledstviya.html

Presence of filling material in the maxillary sinus

  • Clinical picture
  • How can a foreign body enter the maxillary sinus?
  • How is a foreign body in the sinuses diagnosed?
  • The procedure for removing a foreign body from the maxillary sinuses
  • Consequences of a foreign body entering the maxillary cavity

In some cases, filling material in the maxillary sinus remains after treatment of the oral cavity, which leads to the development of chronic complications. The maxillary sinus is located above the upper jaw, in the infraorbital region, and is covered with mucous membrane. This system plays an important role in human life: air circulation in the nasal cavity and voice resonance occur.

Clinical picture

The presence of a foreign body can be confirmed if there are the following signs that signal the development of an inflammatory process:

  1. Nagging pain in the area of ​​the maxillary sinuses. They are especially strong in those moments when a person bends his head down. Most often, the patient complains of a feeling as if the facial bones of the skull are being squeezed out under internal pressure during bending.
  2. An inexplicable feeling of a heavy head even after a night's rest. Many patients note that these unpleasant sensations interfere with sleep.
  3. When a foreign body is found in the maxillary sinus, the patient notes difficulties in the process of chewing, often painful sensations from its localization.
  4. Purulent mucous discharge. When you blow your nose, purulent secretion comes out in large quantities, and the level of pain decreases for a while. The discharge that is blown out smells unpleasant and has a putrid odor characteristic of the inflammatory process. With exacerbation of inflammation, a slight increase in body temperature to 37-38° C is observed.
  5. The patient experiences increased fatigue and weakness, the condition is characterized by a general loss of strength.
  6. Some experience partial loss of appetite or complete loss of appetite. The patient may experience nausea due to purulent discharge.

But all these symptoms do not indicate the presence of a foreign body in the sinuses. They can accompany sinusitis or other diseases that develop as independent diseases.

How can a foreign body enter the maxillary sinus?

The most common foreign object lodged in the maxillary sinuses is dental filling material. When filling, material enters the cavity. The wall of the sinus turns out to be pathologically thin, and the root of the tooth in the maxillary sinus is located too close due to individual characteristics. This leads to its damage as a result of treatment of dental pathologies.

If the sinus wall is thin, it is sometimes impossible to install implants. In this case, the wall is built up using dental materials to increase its thickness. Only if the thickness corresponds to the norm, implantation occurs according to all the rules, that is, no trouble will occur with the implanted tooth.

But there are other common reasons for the appearance of a foreign body: fragments of matches, pieces of medical instruments used to examine the maxillary sinuses, small parts of construction sets, toys, fruit seeds.

The presence of a foreign object in the maxillary sinuses leads to the development of an inflammatory process, accompanied by purulent accumulations and pain.

How is a foreign body in the sinuses diagnosed?

The doctor identifies the presence of a foreign body as follows:

  1. Complaints of pain corresponding to the development of inflammation are heard. Based on the results of the oral interview, one can only assume the presence of a foreign object. It is confirmed only after research has been carried out.
  2. Information is collected about the onset and course of the disease state. The fact of treatment and filling of teeth is separately noted.
  3. The maxillary sinuses are examined. This is done using a nasal speculum. Procedures for rhinoscopic examination and endoscopic examination with a soft or rigid tube are performed.
  4. Examination on a computed tomograph. It allows you not only to confirm the presence of a foreign object in the sinus, but also to determine the amount of purulent contents.

If painful sensations begin after treatment of purulent diseases in the tooth, its cavity or on its roots, an examination and consultation with a dentist is required.

Only an X-ray examination can accurately confirm the presence of a foreign body in the maxillary sinus. The image shows compactions in the sinuses, purulent contents are marked by accumulation in the lower part of the maxillary cavity.

You will need to consult a surgeon who will describe the procedure for removing filling material from the sinus. This event is necessary, since the removal of a foreign body occurs through surgery.

The procedure for removing a foreign body from the maxillary sinuses

Treatment includes many measures: surgery with antibacterial therapy and prevention of possible sinusitis.

Removal of a foreign body is carried out in two ways: through the nasal cavity or by opening the gums through a hole in the damaged wall of the sinus. In some cases, the cause of the tumor is the active decomposition of the nerve in the dental cavity or the formation of a purulent sac over the tooth. In this case, the surgical method is curettage of the mucous membrane of the sinus cavity.

After surgery to remove a foreign body, antibacterial therapy is mandatory. Using a laboratory test, the type of pathogenic microorganisms that led to inflammation of the mucous membrane is determined. Based on the data obtained, antibiotics are prescribed to stop the process. The development of sinusitis can be caused by streptococci, staphylococci, gram-positive and gram-negative microorganisms or their colonies activated under the influence of external factors. The use of anti-inflammatory drugs relieves the exacerbation of the disease and leads to its complete cessation.

Immunomodulators and vitamin complexes are prescribed as preventive measures. Against the background of the ongoing inflammatory process, the body's resistance to external infections rapidly decreases.

Consequences of a foreign body entering the maxillary cavity

A foreign body entering the sinus can cause various complications. When filling material enters the maxillary cavity, it inevitably leads to the activation of inflammation in the maxillary cavity, that is, sinusitis. Sinusitis is an inflammatory disease of the mucous membrane, which can take several forms. Often the cause of sinusitis is an untreated tooth or its roots. Moreover, many treat it without suspecting the true cause of the disease. In this case, the disease may be treated unsuccessfully for several years unless surgery is performed.

There is another pathology that develops when a foreign body enters the sinus. This is a cyst of the maxillary sinus. A cyst is a benign neoplasm in the sinus, which is a cavity filled with purulent fluid.

In addition, mycetoma may develop. Mycetoma is a form of sinusitis that develops when a foreign object in the sinus cavity is ignored for a long time.

Prolonged inflammation in the sinuses can provoke the development of diseases such as meningitis and inflammation of the tonsils.

In addition, the consequence of an untreated disorder is osteoperiostitis. In this case, an active process of inflammation of the facial bones of the skull occurs. Depending on the severity of the disease, the treatment process can be not only extremely lengthy, but also painful. In the most severe cases, it comes down to removing the affected bone and replacing it with an implant.

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What to do if there is a foreign body in the maxillary sinus - filling material?

Filling material in the maxillary sinus is accompanied by unpleasant symptoms, if they occur, you should immediately seek medical help. Lack of treatment can lead to serious complications due to inflammatory processes, although the composition of the filling does not pose a health hazard. The symptoms are similar to those of a runny nose, which cannot be cured using conventional therapeutic methods; after diagnosis, surgical treatment is performed.

We recommend reading this article to anyone who has been suffering from a runny nose for a long time and cannot cure it with medications; an examination by a doctor will help identify the cause of the pathology.

Actions to take if filling material gets into the maxillary sinus

Diseases of the ENT organs are considered one of the most common; they are often accompanied by a runny nose, sore throat and are infectious in nature. One of the complications of rhinitis is also considered to be sinusitis, which can develop due to the penetration of foreign objects into the maxillary sinuses, most often this is associated with dental procedures. During dental treatment, filling material can penetrate through the thin bone septum into the maxillary sinus, which is accompanied by unpleasant symptoms.

Inflammatory processes lead to the development of sinusitis, which, if untreated, transforms into a chronic form, threatening the development of serious complications. When the first signs appear, you should undergo a diagnosis; based on the data obtained, the doctor prescribes surgery.

Diagnostic methods

If filling material gets into the maxillary sinus, professional diagnostics are carried out; it plays a leading role in this case.

Diagnostic procedure:

  1. Questioning the patient - an experienced doctor will be able to identify the inflammatory process based on complaints of pain.
  2. Collecting anamnesis, in parallel, the fact of visiting the dentist is recorded.
  3. Inspection of the paranasal sinuses using special instruments for the presence of foreign elements, endoscopy and rhinoscopy are used.
  4. CT scan – provides the most accurate diagnosis, allows you to identify the presence of a foreign body and other inflammatory processes, the extent of damage to the nasal mucosa and the amount of pus.
  5. X-ray of the maxillary sinuses - the images clearly show all the seals, purulent formations and other defects. In this case, you will also need diagnostics and consultation with a surgeon; a comprehensive examination will help identify the problem and prescribe treatment.

Symptoms and signs

The symptoms of a foreign body entering the maxillary sinus may vary, much depends on the size, degree of contamination, and characteristics of the body. In some cases, the object is surrounded by a mucous membrane and the pathology does not manifest itself in any way. But, most often in such cases, the body rejects the foreign body, as a result of which the inflammatory process of the mucous membrane starts.

The presence of a foreign object can be recognized by the following signs:

  1. Heaviness in the nose.
  2. Pain when chewing, which can radiate to the upper jaw.
  3. Loss of appetite, pain when swallowing.
  4. Fever.
  5. Persistent runny nose that cannot be treated.
  6. Discharge from the nasal cavity - often with an unpleasant odor.
  7. General intoxication of the body.

How can a foreign object end up in the maxillary sinus?

The upper wall of the oral cavity is very thin, the filling material easily penetrates into the sinuses. When a hole appears, surgery is most often performed.

A foreign body may end up in the maxillary sinus due to large tooth roots; it can be not only a filling, but also any other small object that the dentist can use during an external examination. In medical practice, there have been cases of matches and toothpicks being found in the paranasal sinuses, but the patient was not always aware of this. In any case, surgical intervention is required; this is the only way to prevent a process that can lead to various complications.

What will happen if left untreated?

The main method of treatment is surgical intervention, and there is always a part of patients who carry a foreign body in their sinus for years, avoid surgery and require drug therapy. Despite the inertness of the filling material, physiotherapeutic procedures are useless in this case; the only way out is surgery.

The consequences of finding a foreign object in the sinus can be quite mild:

  • sinusitis of fungal or bacterial origin;
  • encapsulation of material, accompanied by the formation of a cyst, the contents of which often become purulent;
  • formation of purulent granuloma.

In medical practice, many cases have been recorded where the pathology was accompanied by sinusitis; in the absence of treatment, the disease transformed into a chronic form.

Complications of chronic sinusitis:

  • inflammatory diseases of other ENT organs;
  • meningitis;
  • hypertrophy of the mucous membranes of this area, difficulty in nasal breathing;
  • heart disease and mild brain hypoxia due to impaired normal breathing;
  • myocarditis – occurs as a result of damage to the heart by harmful microorganisms from the source of inflammation;
  • pathologies of the lower respiratory tract with an increased risk of an asthmatic component;
  • osteoperiostitis of the head bones;
  • sepsis.

All these complications do not always develop; the risk of their occurrence increases against the background of exacerbations, acute infections, overwork, hypothermia, and weakened immunity. At the first signs of damage to the walls of the maxillary sinus, you should consult a doctor.

Methods of treatment, removal of a foreign object

The main method of treatment is to remove the filling material from the maxillary sinus; this should be done immediately after diagnosing the pathology. In this case, there is no need for long trips to hospitals; the intervention of doctors does not take much time. The operation is performed in public and private clinics, the cost depends on the pricing policy and region of residence. It is very important to follow your doctor’s recommendations, monitor your health, and avoid infectious diseases.

There are two main ways to remove a filling:

  1. The endoscopic method is scraping of the mucous membrane through the nasal cavity.
  2. Laparoscoria - foreign material is removed through an incision in the gum.

Both methods have been used with great success for several decades and the procedure does not take much time. Both are performed under local anesthesia.

After surgery, being under the supervision of a doctor in an inpatient setting is indicated.

Before discharge, conservative therapy is prescribed:

  • taking antibiotics, the action of which is aimed at destroying microorganisms that provoke sinusitis;
  • filling and sanitation of dental canals;
  • flushing the sinuses with medications to remove purulent fluid;
  • introduction of vasodilators into the nasal cavity;
  • taking painkillers;
  • taking immunomodulatory drugs, multivitamins.

Recommendations after treatment

After surgery, you should be attentive to your own health, avoid hypothermia, which will prevent relapses of sinusitis.

The patient should adhere to the following recommendations:

  1. Observation by a dentist will help reduce the risk of caries and other diseases that develop against the background of dental diseases.
  2. Regular dental and oral care is required.
  3. Any injuries to the head, throat and nose area are contraindicated.
  4. Taking multivitamins will help strengthen the body's immune status.
  5. In order to prevent complications of sinusitis, it is recommended to avoid hypothermia, and timely treatment of the runny nose and other inflammatory diseases of the ENT organs is mandatory.

Conclusion

A foreign body in the maxillary sinus is quite rare; many patients cannot even imagine it. Most often, filling material is found in the maxillary sinus, penetrating through the thin wall of the upper jaw into the maxillary sinuses after visiting the dentist. The symptoms are very similar to infectious sinusitis, only conventional treatment in this case is ineffective, since the inflammatory processes will not disappear as long as a foreign body is present in the sinus. The main method of treatment is surgery, after which the patient must take medications for a certain time; its absence can lead to serious complications, including meningitis.

Source: http://gaimorit.guru/info/v-gajmorovoj-pazuhe-inorodnoe-telo

What happens if filling material gets into the maxillary sinus?

Today, an increasingly pressing issue is the entry of a foreign body into the maxillary sinus. More and more cases have been recorded in which a filling is found in the maxillary sinus. In this case, the person experiences a constant runny nose, pain in the head and lack of smell.

Most often, a foreign object remains after dental treatment and it must be removed urgently, since ignoring this issue can lead to a dangerous outcome.

About the proximity of teeth and sinuses

The consequences of filling material in the maxillary sinus are unpredictable: they can lead to surgical intervention or the development of dangerous and even chronic complications.

The proximity of the maxillary sinus and the upper row of teeth is dangerous for human health due to the individual structure of the tooth roots. They can have different lengths and sizes. Therefore, in the case of wisdom teeth treatment, the dentist must monitor his actions especially carefully.

Let us recall that the maxillary sinus is located above the human upper jaw. It occupies about ten centimeters in the nose area, and the bottom of the sinus is in contact with the wisdom teeth.

The sinus is covered with a mucous membrane, which is susceptible to various inflammatory infections and more serious diseases, such as sinusitis.

This area performs several important functions. The maxillary sinus is responsible for air circulation and the resonance of your own voice.

Therefore, any infection or even a filling getting into the maxillary sinus is a serious and dangerous situation. Let's consider several reasons for foreign bodies getting into this cavity:

  1. First of all, a foreign object can end up in the dentist’s office.
  2. Negligent attitude towards health and ignoring processes in the oral cavity.
  3. In special, but extremely rare cases, there is a lack of hygiene.

Inflammatory disease of the maxillary sinus usually appears on only one side, but in some situations there is immediate bilateral inflammation.

This disease affecting the upper teeth is called odontogenic sinusitis.

Signs of foreign body entry

To confirm the presence of a foreign object in the maxillary sinus area, it is enough to know a few signs. They are usually symbolized by inflammatory processes in this area:

  1. When tilting the head down, a person experiences pain in the sinus area. The patient feels as if the facial bone is being squeezed out under pressure.
  2. After sleep, a person may experience a feeling of a heavy head. This feeling can also cause lack of sleep.
  3. Loss of appetite associated with problems chewing foods. Patients often experience pain when swallowing food.
  4. In special cases, a person develops purulent or watery discharge. They have an unpleasant odor.
  5. Increased body temperature, up to 39 degrees Celsius.
  6. Severe swelling of the cheeks.
  7. Increased fatigue, general weakness.
  8. Nausea and vomiting.

The listed symptoms are symptoms of a disease such as sinusitis. In any case, the patient needs to listen to the body’s signals and consult a qualified doctor for diagnosis and treatment.

Unfortunately, the entry of a foreign object into the maxillary sinus is always unexpected. The size of the impact of a filling or even a whole tooth depends on the individual characteristics of the person’s structure.

To determine the location of an object, it is necessary to take a photograph using X-rays. In addition, be examined using computed tomography and other elements that help determine the location.

If you do not start freeing the sinus from the extra object at the very first symptoms, a person may experience incredible headaches and loss of sleep. In more severe cases, memory loss is noted.

How a foreign object can get into the maxillary area

According to statistics, more than forty percent of foreign objects entering the maxillary sinus area are associated with unprofessional dental treatment. Since the upper row of teeth is in close proximity to the maxillary sinus, when filling teeth, perforation of the upper jaw may occur.

In this case, the filling material easily falls into the described area. Due to the naturally thin wall of the upper mouth, a foreign object can easily pass into the walls of the maxillary sinus.

The appearance of a hole between the teeth and the maxillary sinus is dangerous to human health. Therefore, in this case, urgent surgery is necessary.

Other reasons for the appearance of holes include large tooth roots. Remember that not only a filling can get into the maxillary area, but also small objects that could be used to conduct an external examination of the tooth.

But getting foreign objects is not always associated with a visit to the dentist. There are cases of exacerbation due to endodontic treatment.

In all cases, it is necessary to perform an operation to remove the foreign object. If an experienced specialist works, this problem can be noticed already in the dentist’s chair.

Foreign body in the maxillary sinus - surgery

Please pay attention to the following factors when visiting your dentist. If you have profuse bleeding from the mouth and you cannot puff out your cheeks, this is a clear sign that a foreign object has entered the maxillary area. In addition, the following symptoms are noted:

  1. When you exhale through the nose, blood appears.
  2. A person feels air currents in his mouth.
  3. Voice change.

All these factors indicate a problem that needs to be addressed urgently. In this case, the patient is prescribed a computed tomography and x-ray.

It is important to determine the exact number of foreign objects! If a large amount of excess objects gets in, you should seek immediate medical attention.

Treatment involves drug and antibacterial therapy, as well as surgery.

There are two ways to extract a foreign object:

  1. Operation through the nasal area.
  2. If there is a large amount of excess objects, the gums are opened.

The operation is performed under local anesthesia and takes thirty minutes.

After successful surgical intervention, antibacterial therapy is prescribed. This is necessary to prevent the occurrence of sinusitis and other inflammatory processes.

In addition, the patient is prescribed preventive measures and a course of vitamins. The patient also needs to monitor his diet and prevent repeated perforations.

Remember that any surgical intervention negatively affects the patient's immune condition. Therefore, be sure to take as many vitamins as possible, as well as vegetables and fruits.

Conclusion

Remember that a foreign body in the body can cause serious inflammation. At the first symptoms of a foreign object in the maxillary area, you should urgently consult a specialist. The consequences of a foreign body entering the maxillary cavity can be very disastrous.

This inflammation provokes an inflammatory disease of the mucous membrane, which can have several forms or the formation of a cyst.

Directory of main ENT diseases and their treatment

All information on the site is for informational purposes only and does not claim to be absolutely accurate from a medical point of view. Treatment must be carried out by a qualified doctor. By self-medicating you can harm yourself!

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What to do if there is a foreign body in the maxillary sinus - filling material?

Often, pathological processes that occur in the maxillary sinuses are a consequence of the penetration of foreign bodies and harmful bacteria into their cavity, which contributes to the development of sinusitis.

The sinuses play a very important role in the body - with their help, air circulates in the nasal cavity, and important organs are protected from hypothermia when inhaling.

Moreover, the maxillary sinuses are also resonators for the human voice. Thus, any penetration of foreign material into the cavity can provoke an inflammatory process and lead to complications in the form of sinusitis.

Causes and clinical picture

The main reason for the penetration of foreign objects into the maxillary cavity is, no matter how strange it may sound, the usual filling material that is used in dentistry for dental treatment. During dental surgery, when a tooth is filled, some of the material may penetrate into the sinuses. This usually happens as a result of unprofessional actions of the dentist.

The fact is that the sinus septum is extremely thin and fragile, and the tooth root in this cavity is located extremely close to the wall due to the anatomical features of the human body. If you do not calculate the force, then during dental intervention, the maxillary wall located in the upper jaw area can simply break or puncture, and a piece of filling material will penetrate into the cavity.

Therefore, the main reasons for the penetration of filling material into the sinuses are:

  • penetration of a foreign object during filling of teeth located in the upper part of the jaw;
  • when a tooth is removed and the wall of the sinus is damaged, and dental material penetrates into the cavity during the procedure;
  • when it is impossible to install an implant, it is customary to “build up” the sinus wall using a special material to slightly increase its thickness. This is done so that implantation becomes possible and nothing happens to the tooth in the future. However, during this process, damage to the septum may occur with the introduction of artificial material into its cavity.

If a foreign object penetrates the maxillary sinus, an inflammatory process begins to develop, which may be accompanied by an infection with signs of sinusitis.

If this happens, and the filling material ends up in the maxillary sinus during dental intervention, then the onset of the inflammatory process can be determined by certain signs:

  • a person begins to constantly experience aching pain in the maxillary sinuses, which can radiate to the infraorbital or buccal area of ​​the face. The pain may intensify when moving the head, especially when bending forward;
  • severe malaise and weakness manifests itself;
  • the temperature begins to rise to 38 degrees;
  • possible discharge in the form of pus from the nasal passage with a characteristic unpleasant odor;
  • it seems as if the tooth is constantly hurting at the site of inflammation, and the pain can radiate throughout the entire jaw, especially when chewing food;
  • there is a loss of appetite;
  • there is a constant feeling of heaviness in the head;
  • due to the fact that purulent discharge from the nasal passage is constantly occurring, vomiting and even nausea are possible;
  • constant discomfort in the upper jaw;
  • an unreasonable runny nose appears.

These symptoms may not appear immediately. Sometimes the problem is discovered during an X-ray of the head. However, if these signs occur and do not go away for a long time, this is a reason to promptly consult a doctor.

Diagnostics

The presence of dental material in the maxillary sinuses can be determined with maximum accuracy only by conducting a complete examination of the patient, namely:

  1. First, the doctor will listen to all the patient’s complaints and determine the signs of the disease. After a preliminary examination of the maxillary sinuses using a special mirror, the doctor will refer the patient for examination.
  2. A visit to the dentist will be required for a preliminary consultation and examination of the oral cavity for the presence of an inflammatory process.
  3. In some cases, you may need to visit a surgeon for consultation. This is necessary in order to determine which surgical method will be used to remove the foreign body.
  4. The most effective diagnostic method is to examine the sinuses using x-rays.
  5. A CT scan may also be required, which will not only identify a foreign object in the nasal sinus, but also see the volume of purulent contents and the condition of the mucous membrane.

Once an accurate diagnosis is established and the presence of a foreign object in the sinuses is confirmed, the doctor will be able to prescribe adequate treatment for the pathology.

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How is a foreign object removed from the sinus?

As for the method of treating this disease, it comes down to removing material from the sinus through surgery. This approach is due to the fact that any foreign object in the human body always requires immediate removal.

Removal can be done in two ways:

  • directly through the nasal cavity by scraping the mucous membrane (endoscopic method);
  • or through the gum by cutting it and removing foreign material through an opening in the injured sinus wall (laparoscopy).

The operation itself is short-lived, lasting between fifteen and twenty minutes. Before removal begins, the patient is given a local anesthetic. After the operation, the patient must remain in the hospital for several days under the supervision of his doctor.

Before discharging the patient, the doctor will definitely prescribe medication and, if necessary, conservative therapy:

  • antibiotics that can completely kill the infection that caused sinusitis;
  • filling and sanitation of carious canal cavities;
  • flushing the maxillary sinuses with a special medicinal substance to remove residual pus and infection;
  • vasodilators into the nose to further remove sinus contents;
  • painkillers;
  • it is possible to puncture the sinus to remove pus;
  • To increase the protective functions of the body, vitamin complexes and immunomodulators are prescribed.

In any case, the most effective method today is surgical removal of the foreign body from the maxillary sinuses. However, in order to prevent the spread of infection after removal, complex therapy is required, including drug treatment.

Consequences, possible complications and methods of prevention

The material used by dentists for filling, if it gets into the sinuses, will inevitably provoke the occurrence of an inflammatory process, which, if not treated in a timely manner, can lead to complications such as:

  • the most common form of complications is sinusitis, which provokes inflammation of the maxillary sinus;
  • an incorrectly removed or sealed tooth with penetration of a foreign body into the sinuses can provoke not only sinusitis, but also mycetoma - a fungal disease of the sinuses;
  • against the background of sinusitis caused by the penetration of a foreign object into the sinuses, other severe infectious diseases may occur: meningitis, inflammation of the facial bone, etc.;
  • another pathology that can develop is a cyst (qualitative neoplasm) in the sinus cavity;
  • changes in the tonsils of the palate.

Thus, if you suspect a pathology caused by the penetration of a foreign object during dental procedures, you should immediately consult a doctor.

After removing the foreign body, you should carefully monitor your health to exclude the possibility of relapse of sinusitis.

The following recommendations must be followed:

  1. In order to avoid unpleasant consequences, you should see a dentist in order to minimize the likelihood of caries and other problems associated with disease of the teeth and gums.
  2. Maintain oral hygiene.
  3. All injuries and mechanical damage to the head, face and nose should be avoided.
  4. Periodically take vitamin complexes and minerals.
  5. In order not to encounter consequences in the form of sinusitis, in particular, even if there is a foreign object in the sinuses, you should promptly treat a runny nose and avoid hypothermia.
  6. Treat inflammatory processes occurring in the ENT system in a timely manner.

Despite the fact that penetration of foreign objects into the sinuses during dental treatment is an extremely rare occurrence, if this does happen, you should not delay treatment. After all, any inflammatory process caused by this pathology can lead to sinusitis.

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Filling material in the maxillary sinus

Inside the upper jaw there is a space filled with air, first described by the doctor Nathaniel Highmore. Air enters it from the nasal cavity through an opening on the inner surface of the bone. The space belongs to the paranasal sinuses and is called the maxillary sinus. An X-ray examination sometimes reveals filling material in the maxillary sinus, which requires consultation with an otolaryngologist or maxillofacial surgeon.

Types of foreign bodies penetrating the maxillary sinuses

Foreign objects are classified according to the method of entry into the body - through natural openings or due to damage; according to the anatomical location; by origin - organic or inorganic nature; depending on the radiopacity - visible on an x-ray or not.

A foreign object cannot penetrate the sinus of the maxillary bone through the only natural opening connecting it with the nasal cavity. A foreign body enters the maxillary cavity when:

  • damage or injury;
  • dental manipulations.

In the latter case, the “culprit” is the lower wall, as it is the thinnest and located in close proximity to the teeth.

The foreign body is often a tooth root or a dental filling in the maxillary sinus. Filling material enters the maxillary sinus during endodontic (intradental) treatment. Filling material that gets into the maxillary sinus does not manifest itself for a long time, because the composition of the material is practically harmless, and the mucous membrane inside the cavity has a very small number of nerve endings and blood vessels.

Let’s try to understand in more detail what are the consequences of filling material getting into the maxillary sinus, how filling material is removed from the maxillary sinus, and how necessary it is to remove filling material from the maxillary sinus.

Symptoms and signs

After the filling material enters the maxillary sinus, the patient has no symptoms for several years. But the composition of the filling is very “attractive” to fungal microflora. Fungi are classified as opportunistic bacteria. Under normal conditions, they live on the mucous membranes, without showing themselves in any way and without causing any unpleasant sensations.

Gradually, the fungal mycelium grows around the filling material, filling the space of the nasal sinus. A mycetoma forms, which over time leads to the development of fungal sinusitis. One of the complications and consequences of finding a filling material in the maxillary sinus and the proliferation of fungal microflora is blockage of the natural opening, impaired ventilation, and accumulation of exudate inside the maxillary sinus.

  • a feeling of fullness and discomfort in the area of ​​the maxillary bone;
  • pain in teeth when chewing;
  • painful sensations that increase when tilting the head;
  • impaired sense of smell and breathing through the nose;
  • thick, curd-like discharge from the nose with an unpleasant odor.

A person has two upper jaws, therefore, two maxillary sinuses. Usually the symptoms are one-sided. Signs of general intoxication are added - increased body temperature, fatigue and weakness, sleep and appetite disturbances.

How to diagnose

Sometimes the presence of filling material is discovered by chance on an x-ray of the paranasal sinuses, if the patient was referred with suspicion of another pathology. The presence of complaints and a history of dental procedures will allow the doctor to suspect a foreign body. The otolaryngologist will examine the nasal and oral cavity, teeth, recommend a laboratory blood test, bacteriological culture of the nose, and refer you for a consultation with a dentist.

It is possible to conduct an examination using an endoscope. This will make it possible to conduct a visual assessment of the mucous membrane of the maxillary sinus and take a sample for bacteriological analysis directly from the source of the process.

To confirm the diagnosis of a foreign body, magnetic resonance imaging and radiography of the sinuses are possible, but computed tomography is considered the most informative diagnostic procedure. The method is a layer-by-layer x-ray examination of the maxillary sinuses. Thanks to modern equipment, the negative impact of X-rays on the body is minimal. The examination is painless. The patient may experience discomfort and anxiety from having to lie in a forced position and alone in a confined space. It is important to reassure the patient that the doctor sees and hears him during the procedure.

Consequences of a foreign body entering the maxillary cavity

Mycetoma and fungal sinusitis are the most common consequences of filling agents getting into the maxillary sinus. We should not forget about other adverse consequences.

  • cysts of the upper jaw;
  • periodontal disease;
  • osteoperiostitis;
  • fistula formation;
  • inflammatory processes of the palatine tonsils;
  • lesions of the middle and inner ear;
  • spread of infection into the nasolacrimal duct;
  • inflammation of the membranes of the brain.

You will be interested in the article - Features of the procedure for removing a maxillary sinus cyst.

Removing a foreign body from the maxillary sinus will help avoid complications. Therefore, it is important to remove the filling material even when nothing bothers the person.

Treatment methods for removing a foreign object

The patient has the right to detailed information about the state of his health. The attending physician will talk about possible methods for removing filling material from the maxillary sinus, the advantages and disadvantages of the chosen method, and the choice of pain relief method.

A foreign object from the maxillary sinus can be removed:

  • by the method of classical radical maxillary sinusotomy;
  • by performing endoscopic maxillary sinusotomy;
  • using microsinusrotomy;
  • carrying out other operations.

"Tomia" translated from Greek means cutting or dissection. Maxillary sinus - opening of the maxillary sinus. The choice of surgical treatment method is influenced by the patient’s age, severity of the lesion, the presence of diseases of other organs and systems, immune status, allergy history, and anatomical features of the structure of the maxillary sinuses.

The specialist will make a several centimeter long incision between the upper lip and gum. Then it will penetrate directly into the bone cavity and remove the filling material. After cleansing the maxillary sinus, it will create a connection with the nasal cavity - an antrostomy.

The operation is considered radical and is often performed under general anesthesia. Allows the doctor to gain good access and thoroughly clean the maxillary sinus. Unfortunately, the patient will have a scar, and the postoperative period will require a stay in a medical facility and will be overshadowed by unpleasant memories of swelling of the mucous membrane, pain, impaired sense of smell and possible loss of facial sensitivity. Opponents of classical maxillary sinusotomy call the negative point the risk of complications, the most unpleasant of which is damage to the trigeminal nerve.

Endoscopic maxillary sinusotomy

An endoscope is a medical device that is a soft tube that a specialist inserts into an organ. Thanks to the fiber optics of the device, the doctor will see what is hidden inside, and will also take material for examination and cleanse the sinus.

Endoscopic maxillary sinusotomy is performed by introducing an endoscope:

  • through the natural opening connecting the maxillary sinus with the nasal cavity;
  • in the presence of a fistula between the oral cavity and the maxillary sinus directly through the fistula;
  • after puncture of the anterior wall of the upper jaw.

The choice of puncture site depends on the location of the filling material and the characteristics of the inflammatory process. It may be necessary to have two accesses at once to fully carry out the intervention.

The use of modern endoscopes allows you to avoid anesthesia and carry out the procedure under local anesthesia. Endoscopic maxillary sinusotomy is classified as minimally invasive surgery. It can be carried out on an outpatient basis.

Some clinics offer to perform microsinusrotomy. What distinguishes it from conventional endoscopic surgery is that the puncture size is only a few millimeters in diameter. However, it is not always possible to remove filling material through a small hole.

Pneumatization of the maxillary sinuses

Pneumatization is the airiness of the bone. In the absence of adverse changes inside the maxillary sinus, pneumatization is normal. The sinus functions normally, the circulation of air masses is not impaired.

Why is the degree of sinus airiness important in diagnosis? The mucous membrane is not visible on the x-ray. When inflamed, the mucous membrane becomes swollen, communication with the nasal cavity becomes difficult, and the inside of the sinus fills with pus. The volume of air decreases. Thus, a decrease in pneumatization is indirect evidence of the development of sinusitis.

On an x-ray image, the pneumatization of the maxillary sinuses is assessed by comparison with the orbits. Normally, the background intensity is the same. If pneumatization is impaired, the x-ray picture looks “the other way around.” If there is more air, the background of the x-ray image is darker; if there is less air, it is lighter.

A physiological decrease in pneumatization is observed in childhood, when the sinuses are not yet developed. Increased pneumatization is possible when the walls of the sinus become thinner and its size increases.

Recommendations after treatment

Treatment is not limited to surgery. After a maxillary sinusotomy, the patient requires medical supervision. In the case of radical surgery, the tampons are removed from the nasal cavity on the third day, and the sutures are removed a few days later. Irrigation of the nasal cavity with antiseptics is prescribed, nasal drops are vasoconstrictors, with glucocorticoids, in the form of saline solutions.

In order to combat the infection, the issue of prescribing antibacterial drugs is being decided. In the case of mycetoma - antifungal antibiotics. Swelling is being fought. During the healing period, physiotherapeutic procedures are indicated. The patient is prohibited from overheating and hypothermia, eating spicy, salty, too hot or cold food.

Getting filling material into the maxillary sinus is an unpleasant thing, but modern medicine can successfully cope with it. Timely adequate treatment will help a person forget about the problem forever.

Source: http://stopillness.ru/plombirovochnyj-material-v-gajmorovoj-pazuhe/