Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2025; 13(5): 95130
Published online Feb 16, 2025. doi: 10.12998/wjcc.v13.i5.95130
Root canal therapy combined with endoscopic sinus surgery for odontogenic sinusitis: Efficacy comparison in a cohort study
Jun-Wen Xiao, Ping Yu, Zhang Zhao
Jun-Wen Xiao, Department of Stomatology, Wuhan No. 9 Hospital, Wuhan 430081, Hubei Province, China
Ping Yu, Department of Otorhinolaryngology, People's Hospital of Xishui County, Huanggang 438200, Hubei Province, China
Zhang Zhao, Department of Otorhinolaryngology, Hubei No. 3 People’s Hospital of Jianghan University, Wuhan 430033, Hubei Province, China
Author contributions: Xiao JW and Yu P completed the conceptualisation and first draft writing of the manuscript; Zhao Z analysed the data and drew the images; all authors reviewed the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Wuhan No. 9 Hospital.
Informed consent statement: The study was conducted using patient data that did not involve any personal or private information. All data were exclusively utilized for the purposes of this research and managed to ensure no harm to the participants. The ethics committee of Wuhan No. 9 Hospital granted a waiver for informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data can be obtained by contacting the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhang Zhao, BMed, Attending Doctor, Department of Otorhinolaryngology, Hubei No. 3 People’s Hospital of Jianghan University, No. 26 Zhongshan Road, Qiaokou District, Wuhan 430033, Hubei Province, China. zhang1413190313@163.com
Received: April 8, 2024
Revised: May 25, 2024
Accepted: June 12, 2024
Published online: February 16, 2025
Processing time: 224 Days and 17.1 Hours
Abstract
BACKGROUND

Odontogenic maxillary sinusitis, often triggered by dental issues like periapical periodontitis, significantly contributes to chronic sinusitis, mainly affecting adults around 50 years old, emphasizing the need for a multidisciplinary diagnostic and treatment approach.

AIM

To investigate the therapeutic effect and clinical value of root canal therapy combined with nasal endoscopic surgery compared with simple root canal therapy in the treatment of severe odontogenic maxillary sinusitis caused by periapical periodontitis.

METHODS

The clinical data, diagnosis, and treatment of 200 patients with severe odontogenic maxillary sinusitis caused by periapical periodontitis from October 2020 to October 2021 were analyzed retrospectively. Among them, 63 patients were treated with simple root canal therapy as the control group, and 137 patients were treated with root canal therapy combined with nasal endoscopic surgery as the observation group. The therapeutic effect, Lund-Kennedy endoscopic score, paranasal sinus Lund-Mackay score, complication rate, recurrence rate, and patient satisfaction were compared between the two groups.

RESULTS

First, we compared the effective rates: 23 cases were cured, 22 were improved, and 8 were ineffective in the control group, yielding a total effective rate of 84.90%. Meanwhile, 97 cases were cured, 34 improved, and 6 were ineffective in the observation group, resulting in a total effective rate of 95.62%. The observation group had a higher total effective rate compared with the control group (P < 0.05). Second, we compared the Lund–Kennedy endoscopic score. Before treatment, no significant difference (P > 0.05) was observed in this score between the two groups. After treatment, the Lund–Kennedy endoscopic score decreased in both groups. The Lund–Kennedy endoscopic score of the observation group at 3 and 6 mo after treatment was lower compared to that of the control group (P < 0.05). Third, we compared the Lund–Mackay score of paranasal sinuses. Before treatment, there was no significant difference in this score between the two groups (P > 0.05). After treatment, the Lund–Mackay scores of paranasal sinuses decreased in both groups. The Lund–Mackay scores of paranasal sinuses in the observation group at 3 and 6 mo after treatment were lower compared to those of the control group (P < 0.05). Fourth, we compared the incidence and recurrence rate of complications. Three months after treatment, no significant difference was found in the incidence and recurrence rate of complications between the observation group (6.56%) and the control group (9.52%) (P > 0.05). However, 6 mo after treatment, the incidence and recurrence rate of complications in the observation group (2.91%) was significantly higher compared to that of the control group (12.69%) (P < 0.05). Fifth, we compared patient satisfaction. Six months after treatment, the patient satisfaction of the observation group (93.43%) was significantly better than that of the control group (84.12%) (P < 0.05).

CONCLUSION

Root canal therapy combined with nasal endoscopic surgery has a good therapeutic effect on severe odontogenic maxillary sinusitis caused by periapical periodontitis, and it can reduce the injury of maxillary sinus mucosa and bone, and significantly reduce the incidence of complications and recurrence rate. Meanwhile, it has high patient satisfaction and remarkable therapeutic effect, which is suggested to be popularized and applied in clinic.

Keywords: Root canal therapy; Nasal endoscopic surgery; Periapical periodontitis; Odontogenic maxillary sinusitis; Therapeutic effect; Clinical value

Core Tip: Combining root canal therapy with nasal endoscopic surgery significantly improves treatment outcomes for severe odontogenic maxillary sinusitis caused by periapical periodontitis, compared to root canal therapy alone. This combination approach not only enhances the total effective rate but also reduces the scores of Lund-Kennedy and Lund-Mackay, indicating a reduction in maxillary sinus mucosa and bone injury. Moreover, it significantly lowers the incidence of complications and recurrence rates, while increasing patient satisfaction. These findings support the broader clinical adoption of this combined treatment strategy.