齒源性上顎竇炎的臨床診斷與處置：病例報告

齒源性上顎竇炎可能的病因包含牙周疾病、牙髓感染、牙根斷裂、人工植體造成的感染等。本案例為一位35歲男性，左上第一大臼齒為已根管治療牙齒（previously treated）及症狀型根尖周圍炎（symptomatic apical periodontitis），同時左側有鼻塞、咀嚼鈍痛、頭痛、眼下區域腫脹等症狀數個月。根據症狀與臨床檢查，以及放射線學影像，包括根尖片、環口攝影與錐狀射束電腦斷層掃描檢查，臨床診斷為左上第一大臼齒根尖周圍炎併齒源性上顎竇炎。經會診耳鼻喉科醫師後，治療計畫為予以藥物控制急性症狀與根管重新治療，患者術後症狀明顯改善。術後追蹤六個月，其臨床症狀與根尖病灶獲得明顯改善，且上顎竇炎好轉。本病例報告將提供齒源性上顎竇炎的臨床診斷與治療計畫擬定之探討。

關鍵字

齒源性上顎竇炎；協同治療

並列摘要

Odontogenic sinusitis may result from periodontal disease, dental pulp infection, root fracture and infection caused by implants. This article is going to present a case of a 35-year-old male whose upper left first molar diagnosed as previously treated with symptomatic apical periodontitis. He complained nasal congestion, dull pain while chewing, headache and infraorbital area swelling over left side for several months. According to his symptom, combined clinical examination and radiographic examination such as periapical, panoramic radiography and cone-beam computed tomography, he was diagnosed as previously treated, symptomatic apical periodontitis with odontogenic sinusitis which was originated from the upper left first molar. After consulting the otolaryngologist, the treatment plans were medication for pain and infection control and root canal retreatment. After that, the patient reported that the symptoms improved. The follow-up examination after 6 months revealed sinusitis improvement and satisfactory healing of the apical lesion of upper left first molar. The aim of this article is to present our case and to discuss the clinical diagnosis and treatment planning of apical periodontitis of maxillary molars with maxillary sinusitis.

並列關鍵字

odontogenic maxillary sinusitis ； collaborative therapy

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