Radiologic Evaluation of Odontogenic Sinusitis and Its Etiologic Factors: Lessons Learned from a Retrospective Study with a Proposed Imaging-Guided Management Pathway

Nelke, Kamil; Morawska-Kochman, Monika; Janeczek, Maciej; Małyszek, Agata; Uranbey, Ömer; Łuczak, Klaudiusz; Nienartowicz, Jan; Maag, India; Caso, Angela Rosa; Dobrzyński, Maciej

doi:10.3390/jcm15103724

This is an early access version, the complete PDF, HTML, and XML versions will be available soon.

Open AccessArticle

Radiologic Evaluation of Odontogenic Sinusitis and Its Etiologic Factors: Lessons Learned from a Retrospective Study with a Proposed Imaging-Guided Management Pathway

by

Kamil Nelke

^1,2,*

,

Monika Morawska-Kochman

³

,

Maciej Janeczek

⁴

,

Agata Małyszek

⁴

,

Ömer Uranbey

⁵

,

Klaudiusz Łuczak

²,

Jan Nienartowicz

⁶,

India Maag

⁷,

Angela Rosa Caso

⁸

and

Maciej Dobrzyński

⁹

¹

Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland

²

Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland

³

Department of Head and Neck Surgery, Otolaryngology Medical University in Wrocław, Borowska 213, 50-556 Wrocław, Poland

⁴

Department of Biostructure and Animal Physiology, Wrocław University of Environmental and Life Sciences, Kożuchowska 1, 51-631 Wrocław, Poland

⁵

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydın Adnan Menderes University, 09010 Aydın, Türkiye

⁶

Maxillo-Facial Surgery Ward, Medical University in Wrocław, Borowska 213, 50-556 Wrocław, Poland

⁷

Private Dental Office, Pawia 56 Street, 54-144 Wrocław, Poland

⁸

Department of Oral and Maxillofacial Surgery, University of Siena, Viale Aldo Moro, 2-Siena SI, 53100 Siena, Italy

⁹

Department of Pediatric Dentistry and Preclinical Dentistry, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland

^*

Author to whom correspondence should be addressed.

J. Clin. Med. 2026, 15(10), 3724; https://doi.org/10.3390/jcm15103724

Submission received: 15 April 2026 / Revised: 30 April 2026 / Accepted: 7 May 2026 / Published: 12 May 2026

(This article belongs to the Special Issue Advances in Rhinosinusitis and Nasal Polyposis: From Emerging Trends and Therapeutic Opportunities to Surgery)

Download Versions Notes

Abstract

Introduction: Odontogenic sinusitis (ODS) is an underrecognized cause of maxillary sinus inflammation and is frequently associated with dental, periodontal, endodontic, and iatrogenic factors. Accurate identification of the odontogenic source is essential for appropriate treatment planning. Cone-beam computed tomography (CBCT) allows detailed evaluation of the maxillary sinus, adjacent teeth, alveolar bone, and periodontal structures, and may improve the radiologic differentiation of ODS. Materials and Methods: This retrospective observational study analyzed radiologic data from patients evaluated and treated by the authors for suspected odontogenic sinusitis between 2019 and 2026. The final study group included 85 patients with CBCT-based evidence of odontogenic pathology affecting the maxillary sinus. CBCT scans were reviewed to identify tooth-related and treatment-related etiologic factors associated with ODS. Based on the radiologic findings, the authors developed a CBCT-based classification of odontogenic etiologies and proposed an imaging-guided management algorithm. Results: CBCT identified a broad spectrum of odontogenic factors associated with maxillary sinus disease. The most relevant radiologic patterns included endodontic and periapical pathology, periodontal or combined endo-periodontal disease, post-extraction inflammatory changes, odontogenic cysts, oro-antral communication or fistula, retained roots or teeth, displaced endodontic materials, and grafting or implant-related complications. These findings were organized into 16 radiologic categories reflecting the principal etiologic pathways of ODS. The proposed classification facilitated correlation between radiologic presentation and the recommended dental, surgical, and otolaryngologic treatment approach. Conclusions: CBCT is a valuable imaging modality for identifying odontogenic causes of maxillary sinus inflammation and provides more precise diagnostic information than conventional radiography alone. A structured CBCT-based evaluation may improve etiologic diagnosis, support multidisciplinary decision-making, and help guide individualized management of patients with ODS.

Keywords: maxillary sinus; odontogenic infection; sinusitis; maxillary sinusitis; tooth-related infection

Share and Cite

MDPI and ACS Style

Nelke, K.; Morawska-Kochman, M.; Janeczek, M.; Małyszek, A.; Uranbey, Ö.; Łuczak, K.; Nienartowicz, J.; Maag, I.; Caso, A.R.; Dobrzyński, M. Radiologic Evaluation of Odontogenic Sinusitis and Its Etiologic Factors: Lessons Learned from a Retrospective Study with a Proposed Imaging-Guided Management Pathway. J. Clin. Med. 2026, 15, 3724. https://doi.org/10.3390/jcm15103724

AMA Style

Nelke K, Morawska-Kochman M, Janeczek M, Małyszek A, Uranbey Ö, Łuczak K, Nienartowicz J, Maag I, Caso AR, Dobrzyński M. Radiologic Evaluation of Odontogenic Sinusitis and Its Etiologic Factors: Lessons Learned from a Retrospective Study with a Proposed Imaging-Guided Management Pathway. Journal of Clinical Medicine. 2026; 15(10):3724. https://doi.org/10.3390/jcm15103724

Chicago/Turabian Style

Nelke, Kamil, Monika Morawska-Kochman, Maciej Janeczek, Agata Małyszek, Ömer Uranbey, Klaudiusz Łuczak, Jan Nienartowicz, India Maag, Angela Rosa Caso, and Maciej Dobrzyński. 2026. "Radiologic Evaluation of Odontogenic Sinusitis and Its Etiologic Factors: Lessons Learned from a Retrospective Study with a Proposed Imaging-Guided Management Pathway" Journal of Clinical Medicine 15, no. 10: 3724. https://doi.org/10.3390/jcm15103724

APA Style

Nelke, K., Morawska-Kochman, M., Janeczek, M., Małyszek, A., Uranbey, Ö., Łuczak, K., Nienartowicz, J., Maag, I., Caso, A. R., & Dobrzyński, M. (2026). Radiologic Evaluation of Odontogenic Sinusitis and Its Etiologic Factors: Lessons Learned from a Retrospective Study with a Proposed Imaging-Guided Management Pathway. Journal of Clinical Medicine, 15(10), 3724. https://doi.org/10.3390/jcm15103724

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Menu

Radiologic Evaluation of Odontogenic Sinusitis and Its Etiologic Factors: Lessons Learned from a Retrospective Study with a Proposed Imaging-Guided Management Pathway

Abstract

Share and Cite

Article Metrics

Article Access Statistics

Further Information

Guidelines

MDPI Initiatives

Follow MDPI