{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:30:10Z","timestamp":1785407410773,"version":"3.56.0"},"reference-count":60,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009687","name":"Wroclaw Medical University","doi-asserted-by":"publisher","award":["SUBZ.B180.26.012"],"award-info":[{"award-number":["SUBZ.B180.26.012"]}],"id":[{"id":"10.13039\/501100009687","id-type":"DOI","asserted-by":"publisher"}]},{"award":["SUBZ.B180.26.012"],"award-info":[{"award-number":["SUBZ.B180.26.012"]}],"id":[{"id":"https:\/\/ror.org\/01qpw1b93","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/jcm15103724","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:04:36Z","timestamp":1778601876000},"page":"3724","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiologic Evaluation of Odontogenic Sinusitis and Its Etiologic Factors: Lessons Learned from a Retrospective Study with a Proposed Imaging-Guided Management Pathway"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4215-0798","authenticated-orcid":false,"given":"Kamil","family":"Nelke","sequence":"first","affiliation":[{"name":"Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wroc\u0142aw, Poland"},{"name":"Academy of Applied Sciences, Health Department, Academy of Silesius in Wa\u0142brzych, Zamkowa 4, 58-300 Wa\u0142brzych, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6551-7535","authenticated-orcid":false,"given":"Monika","family":"Morawska-Kochman","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Otolaryngology, Wroc\u0142aw Medical University, Borowska 213, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4357-2271","authenticated-orcid":false,"given":"Maciej","family":"Janeczek","sequence":"additional","affiliation":[{"name":"Department of Biostructure and Animal Physiology, Wroc\u0142aw University of Environmental and Life Sciences, Ko\u017cuchowska 1, 51-631 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5187-5324","authenticated-orcid":false,"given":"Agata","family":"Ma\u0142yszek","sequence":"additional","affiliation":[{"name":"Department of Biostructure and Animal Physiology, Wroc\u0142aw University of Environmental and Life Sciences, Ko\u017cuchowska 1, 51-631 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0628-2419","authenticated-orcid":false,"given":"\u00d6mer","family":"Uranbey","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ayd\u0131n Adnan Menderes University, 09010 Ayd\u0131n, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaudiusz","family":"\u0141uczak","sequence":"additional","affiliation":[{"name":"Academy of Applied Sciences, Health Department, Academy of Silesius in Wa\u0142brzych, Zamkowa 4, 58-300 Wa\u0142brzych, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Nienartowicz","sequence":"additional","affiliation":[{"name":"Maxillo-Facial Surgery Ward, Wroc\u0142aw Medical University, Borowska 213, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"India","family":"Maag","sequence":"additional","affiliation":[{"name":"Private Dental Office, Pawia 56 Street, 54-144 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7738-2967","authenticated-orcid":false,"given":"Angela Rosa","family":"Caso","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, University of Siena, Viale Aldo Moro, 2-Siena SI, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2368-1534","authenticated-orcid":false,"given":"Maciej","family":"Dobrzy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry and Preclinical Dentistry, Wroc\u0142aw Medical University, Krakowska 26, 50-425 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/lio2.147","article-title":"Odontogenic sinusitis: A review of the current literature","volume":"25","author":"Little","year":"2018","journal-title":"Laryngoscope Investig. 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