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ORAL SURGERY: Tables

May 1, 2001
by Oral Health


Table 1: Signs and Symptoms associated with Maxillary Sinusitis

MajorMinor
Facial painDental Pain
Nasal obstruction, blockageCough
Nasal or postnasal dischargeFatique
Hyposomia, ansomiaEar pain, pressure, fullness
FeverHalitosis
Conjunctival inflammation
Chewing tenderness

Table 2: Local and systemic factors that predispose to sinusitis

SystemicLocal
Cystic fibrosisUpper respiratory tract infection
Immune deficiencySmoking
BronchiectasisDental infections
Immotile cilia syndromeAllergic rhinitis
Decongestant overuse
Adenoid hypertrophy
Barotrauma
Pollutants
Osteomeatal complex abnormalities

Table 3: Odontogenic Sources of Maxillary Pain/Sinusitis

Periapical abscess, granuloma
Peridontal disease
Mucous retention cyst of maxillary Sinus
Foreign object in sinus (tooth root, dental material)
Oral-antral fistula
Odontogenic cyst (radicular, dentigerous)
Odontogenic tumour (ameloblastoma, cemento-ossifying fibroma, squamous cell carcinoma)
Metabolic Diseases (Fibrous Dysplasia, Pagets Disease, Osteopetrosis)

Table 4: Organisms associated with maxillary sinusitis (mean % with range) 31,32,36

Acute SinusitisAdultsChildren
Hemophillus influenzae35 (19-60)41 (36-41)
Streptococcus pneurnoniae34 (23-54)29 (27-32)
Moraxella catarrhalis2 (0-8)26 (23-27)
Staphylococcus aureus4 (0-8)0
Streptococcus pyogenes2 (1-3)2 (2)
Anaerobic species6 (0-10)0
Gram-negative bacteria4 (0-11)2 (2)
Chronic SinusitisAdults
Staphylococcus sp.51 (24-80)
Staphylococcus aureus20 (9-33)
Anaerobic bacteria3 (0-8)
Streptococcus pneurnoniae4 (0-7)
Mixed organisms16

Table 5: Therapeutic agents and their actions.

Type of TherapyActions
AntibioticsTreat infections
DecongestantsIncrease ostial diameter
Facilitates drainage
Topical steroidsReduces inflammation
Reduces mucous secretion
MucoevacuantsThins secretions
Aids drainage

Table 6: Oral antimicrobial therapy for acute bacterial sinsusitis29,36 (approved for use in Canada)

DrugAdult dosagePediatric dosage
Amoxicillin500 mg q8h40 mg/kg daily, in 3 doses
Amoxicillin-clavulanate500/125 mg q8h45/6.4 mg/kg daily, in 2 doses
Clarithromycin500 mg bid15 mg/kg daily, in 2 doses
Cefurixime axetil250 mg bid30 mg/kg daily, in 2 doses
Cefaclor250 mg q8h20-40 mg/kg daily, divided q8-12h
Cefixime400mg bid9 mg/kg daily
TMP-SMX160/800 mg q12h8/40/mg/kg daily, in 2 doses
Erythromycin/40mg/kg daily, in 3 doses Sulfisoxazole


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