Kronik Apikal Apseli Dişlerde Gözlemlenen İntraoral Sinüs Yolunun Karakterizasyonu

Abstract

Özdemir. G. Characterization of the intraoral sinus tract observed in teeth with chronic apical abscess, Hacettepe University Faculty of Dentistry Department of Endodontics, Specialization Thesis, Ankara, 2022. Chronic apical abscess is defined as an asymptomatic inflammatory reaction against the infection in the root canal system, which starts gradually and is seen with the intermittent discharge of pus through an existing sinus. Literature search revealed that only a few studies addressed the prevalence of odontogenic sinus tracts. The aim of the present study is to investigate the frequency, physical structure and distribution of the dental sinus tract according to epidemiological age, gender, tooth positions, and to reveal its character. In the cross-sectional analysis study conducted at Hacettepe University Faculty of Dentistry, with the approval of the ethics committee, 105 patients with intraoral sinus tract who were referred to the endodontic unit were analyzed. All patients were evaluated by a single researcher. Patients were examinated clinically and radiographically regarding the parameters including, the location, number, structure of the sinus tract, its relationship with the surrounding tissues and the condition of the tooth and data were recorded in the data collection form. SPSS V23 (Chicago, IL, USA) program was used to evaluate the findings. The analyzes were made with the chi-square test by dividing the data into categories and comparing them in different groups. The significance level was determined as p<0,05. 47 (44,8%) of the patients were male and 58 (55,2%) were female. Of the sinus-related teeth, 76 (72,4%) of them belonged to the upper jaw and 29 (27,6%) of them to the lower jaw. A significant relationship was found between age and jaw relationship (p<0,05). The sinus tract was significantly more common in the maxillary jaw in the 15-45 age group. A significant relationship was found between gender and awareness (p<0,05). When the vertical position of the sinus tract in the jaw and gingiva is examined, the gingival level with the sinus tract in the upper jaw was significantly seen in the buccal mucosa, and in the lower jaw, it was significantly in the mucogingival junction (p<0,05). The sinus opening ending as a peduncle had significantly less inflammatory and bleeding discharge. (p<0,05) In addition, the sinus tract terminating as a peduncle was observed to be significantly larger than 2 mm (p<0,05). A significant correlation was found between age and tissue color around the sinus tract (p<0,05). The sinus tract circumference was significantly redder in patients older than 65 years (p<0,05). The circumference of the sinus tract observed in patients aged 46-65 had significantly more pink/normal tissue color (p< 0,05). Although there is no clear explanation with the formation pattern of the sinus tract observed in patients, there are many cases where the sinus tract occurs. In addition to endodontic diseases; It should not be forgotten that periodontal diseases, vertical root fractures and nonodontogenic diseases may cause sinus tract. Data on the formation of the sinus tract are limited. In order to understand these structural differences, clinical studies with more treatment and follow-up are needed. Keywords: Chronic apical abscess, sinus tract, prevalence, odontogenic fistula, periapical pathology