Relationship Between Maxillary Fungal Sinusitis and Odontogenic Infection, Dental Implant

Background and Objectives One of the common causes of chronic bacterial sinusitis is odontogenic infection, which has recently attracted attention and many studies are being conducted. However, studies on the relationship between chronic fungal sinusitis and odontogenic infection, which are commonly encountered in clinical practice, are still lacking. In this study, we investigated the association between chronic fungal sinusitis, odontogenic infection and dental implant.Subjects and Method We retrospectively reviewed medical records and paranasal sinus (PNS) CT scans of 198 patients who were treated in our institution for maxillary fungal sinusitis between March 2010 and October 2020.Results We defined two groups of maxillary sinuses (MS) according to the presence of fungal ball (fungal group; n=204 vs. normal group; n=192). Fungal sinusitis was diagnosed in all 204 cases of the fungal group. In the normal group, the mean MS volume was 17.0±6.2 mL, and in the fungal group, the mean MS volume was 13.8±5.2 mL. The volumes of MS were statistically small in the fungal group (p<0.001). In 141 (69.1%) of 204 sinuses in the fungal group, findings suggestive of odontogenic infection were confirmed on the PNS CT scans and were statistically significant (p<0.001, odds ratio=2.537). Of 204 sinuses in the fungal group, 26 (12.7%) had dental implants and were not statistically significant (p=0.107, odds ratio=1.724).Conclusion This study suggests odontogenic infection to be a risk factor for developing fungal sinusitis in the ipsilateral maxillary sinus.