Endoscopic sinus surgery plays an essential role in systematic treatment of odontogenic maxillary sinusitis

Purpose: Odontogenic maxillary sinusitis (OMS) is frequently encountered in otorhinolaryngologists' clinical practice. Endoscopic sinus surgery (ESS) instead of surgeries in intraoral approach has been widely applied among OMS. However appropriate treatments due to the causes of the OMS as well as the outcome have been less investigated, meanwhile the inherent incidence of OMS may be still on the rise. This study was designed to conclude our systematic treatment within follow-up examination. Materials and methods: In this retrospective study patients confirmed diagnosis of OMS who had systematic follow-up examinations were analyzed. Medical histories of otorhinolaryngologists and dentists were reviewed as well as preoperative examination protocols. Result: Consecutive 29 Patients (10 women, 19 men) were included. 41.4% (12/29) patients experienced facial pain as the most frequent symptom. 69.0% (20/29) patients admitted firstly to otorhinolaryngologists, 13 patients were treated with surgical procedure while 7 patients lacking of surgical indication were transferred to dentists. 31.0% (9/29) patients were advised by dentist for being suspected of maxillary sinusitis, including 7 patients suffered from sinonasal complications of dental treatment (SCDT). Conventional dental treatment (root planning, root end surgery, extraction) was the most common cause. Follow up for a mean of 15.1 (ranges from 6 to 96) months showed 29 patients maintaining open maxillary ostium on endoscopic examination or improving on CT except recurrence in one patient with SCDT. Conclusion: Patients should be inspected by dentists carefully when the patient has symptoms rather than sinusitis-like symptoms, the possibility of OMS should always be considered. Dental examination can help to determine whether a maxillary sinusitis has a dental origin, periodontitis and odontogenic radicular cysts still are the most common causes comparing with iatrogenic factors. Patients treated with ESS showed better tolerance and fewer postsurgical complications. Not all patients with OMS including SDCT need definitely surgery whether ESS or intraoral approach, removing dental focus followed with antibiotics would be optimistic choice. Keywords: Odontogenic maxillary sinusitis, Endoscopic sinus surgery, Intraoral approac

iRoot SP Promotes Osteo/Odontogenesis of Bone Marrow Mesenchymal Stem Cells via Activation of NF-κB and MAPK Signaling Pathways

The regeneration of bone and tooth tissues, and related cellular therapies, has attracted widespread attention. Bone marrow mesenchymal stem cells (BMSCs) are potential candidates for such regeneration. iRoot SP is a premixed bioceramic root canal sealer widely used in clinical settings. However, the effect of iRoot SP on the biological features of BMSCs has not been elucidated. In the present study, we found that 0.2 mg/ml iRoot SP conditioned medium promoted osteo/odontogenic differentiation and enhanced mineralization of BMSCs without affecting the proliferative ability. Mechanistically, the NF-κB and MAPK signaling pathways were activated in SP-treated BMSCs, and differentiation was inhibited when cultured with the specific inhibitor. Taken together, these findings demonstrate that iRoot SP promotes osteo/odontogenic differentiation of BMSCs via the NF-κB and MAPK signaling pathways, which could provide a new theoretical basis for clinical applications of iRoot SP and a new therapeutic target for the regeneration of bone and tooth tissue in the future