Bacteriological and clinical studies of 50 cases of dental maxillary sinusitis

Abstract

Cultures of aerobic and anaerobic bacteria were analyzed in a case of unilateral sinusitis involving purulent nasal discharge with a foul-smelling odor emanating from one side of the middle nasal passage. The relationship between sinus lesions and dental infection was examined for the presence of dental maxillary sinusitis using cone-beam computed tomography. Seventy-two strains were isolated and identified from 50 cases.

Aerobic bacteria were found in 3 cases (3 strains) and microaerophilic Streptococci in 10 cases (10 strains). There were 59 strains of obligatory anaerobes, 78.8% of which were gram-negative rods (Fusobacterium nucleatum, 45.8%; Prevotella, 30.5%) and gram-positive cocci (Parvimonas, 22%). Based on a report by Japanese oral surgeons (Muroki, 1986), gram-positive Veillonella and Peptostreptococcus accounted for 80% and gram-negative bacilli Bacteroides accounted for 2.9%.

In addition, Kaneko (2015) reported that anaerobes are less common, while facultative anaerobic bacteria are more common. The reason for the apparent differences between the author’s data and historical data is that Fusobacterium and Bacteroides are oxygen-sensitive and take longer to form colonies, leading to gram-negative bacteria and a low detection rate if the culture conditions are not ideal. Fifty patients received a diagnosis of dental sinusitis. Dental infection, apical periodontitis, foreign bodies such as dental implants, and oroantral fistulae were diagnosed as the causes of dental maxillary sinusitis. In vitro antibacterial activity was favorable for CVA/AMPC in 3 kinds of bacteria, and purulent nasal discharge ceased in 22 of 25 patients treated with CVA/AMPC at the first visit.