The purpose of this study was to define a clear indication for sinus surgical treatment in patients with chronic odontogenic rhinosinusitis after the elimination of the odontogenic causes.

96 patients with chronic odontogenic rhinosinusitis caused by apical periodontitis completed a SNOT-22 questionnaire with incorporated additional symptom “malodor” before treatment. Moreover, they were distributed according to CT radiological criteria such as degree of periapical pathology, the anatomical ratio between maxillary lateral teeth and sinus floor, sinus mucosal thickening, and ostiomeatal complex condition. The elimination of odontogenic cause was performed by extracting the causative tooth. The questionnaire was filled again for 2 weeks, 3 months, and 6 months after treatment. All data were analyzed to search the clear indications for sinus surgical treatment

74 patients had full resolution of symptoms after the dental cause was eliminated. For the other 22 patients, symptoms persisted and sinus surgical treatment was indicated. In the recovered group, the mean SNOT-22 score was different between all periods of measuring, while within a non recovered group, small differences were seen only when compared to before treatment.

This study concluded that the extraction of a causative tooth is an effective treatment of chronic odontogenic rhinosinusitis caused by apical periodontitis.