title: Sinonasal complications resulting from dental treatment: outcome-oriented proposal of classification and surgical protocol.
abstract: BACKGROUND
  Odontogenic sinusitis is a relevant infectious condition of the paranasal sinuses. The widespread use of dental implants and reconstructive procedures for dental implant placement has led to new types of complication. To the authors' knowledge, no publication has extensively examined sinonasal complications resulting from dental treatment, and no classification system allowing standardization and comparison of results is currently available. This study was designed to (a) analyze the results obtained from surgical treatment of complications resulting from dental procedures combining functional endoscopic sinus surgery (FESS) and an intraoral approach and (b) propose a new classification system and standardized treatment protocols for sinonasal complications resulting from dental procedures.
  
  
  METHODS
  A total of 257 patients consecutively treated with FESS (136 in conjunction with oral surgery) were included in the study. Different clinical situations were integrated into a new classification system based on the pathogenesis and clinical aspects of each case, with the aim of identifying homogenous treatment groups. Results were evaluated for each class.
  
  
  RESULTS
  Of the 257 patients, 254 were successfully treated with surgery performed according to the proposed protocols. Three of 257 patients required a second surgery, after which they completely recovered. Complications of implant and preimplant surgery (maxillary sinus floor elevation) showed longer recovery times.
  
  
  CONCLUSIONS
  The results obtained are very encouraging. The majority of patients (254/257; 98.8%) were successfully treated with the proposed protocols. These results seem to indicate that the rationalization of surgical treatment protocols according to the initial clinical situation may significantly improve the clinical outcome.
authors.affiliation: Unit of Otolaryngology, Department of Health Sciences, San Paolo Hospital, University of Milan, Via A. di Rudinì 8, Milan, Italy. alberto.saibene@gmail.com
authors.forename: Giovanni
authors.initials: G
authors.lastname: Felisati
authors.forename: Matteo
authors.initials: M
authors.lastname: Chiapasco
authors.forename: Paolo
authors.initials: P
authors.lastname: Lozza
authors.forename: Alberto Maria
authors.initials: AM
authors.lastname: Saibene
authors.forename: Carlotta
authors.initials: C
authors.lastname: Pipolo
authors.forename: Marco
authors.initials: M
authors.lastname: Zaniboni
authors.forename: Federico
authors.initials: F
authors.lastname: Biglioli
authors.forename: Roberto
authors.initials: R
authors.lastname: Borloni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000540:Alveolar Ridge Augmentation / Q000009:adverse effects; D003729:Dental Care / Q000009:adverse effects*; D016321:Dental Care for Aged / Q000009:adverse effects; D015921:Dental Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D008875:Middle Aged; D013516:Oral Surgical Procedures, Preprosthetic / Q000009:adverse effects*; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants