AMB Volume 40, Issue 3, 2024 Pages 412-415 https://doi.org/10.59393/amb24400316
Diagnostic Challenges and Management of Non-Odontogenic Toothache: A Case of Unilateral Pansinusitis Mimicking Dental Pain
Tsitou V-M., Rallis D., Gergova R.
This case report details the diagnostic challenge and subsequent management of a 38-year-old male patient who presented with severe, sharp, and non-localized pain in the right maxillary distal area. Initially unresponsive to non-steroidal anti-inflammatory drugs and antibiotics, the patient’s symptoms deviated from typical odontogenic pain characteristics. Comprehensive dental examinations revealed minimal pathologies, challenging initial assumptions of dental-origin pain. Advanced diagnostic imaging, including Orthopantomography and Cone Beam Computed Tomography (CBCT), was pivotal in identifying unilateral pansinusitis, with notable obstruction in the maxillary, ethmoid, and frontal sinuses. Further microbiological analysis confirmed a Staphylococcus aureus and anaerobic infection, refocusing the diagnosis to a non-odontogenic source. The patient underwent a targeted 14-day complex antibiotic regimen, supplemented with local treatments including Nasonex nasal spray and saline nasal irrigations. This integrative approach resulted in marked symptom improvement and was instrumental in the patient’s recovery. This case highlights the critical need for thorough evaluation in distinguishing between odontogenic and non-odontogenic sources of orofacial pain, ensuring accurate diagnosis and effective treatment.
Keywords: non-odontogenic toothache, unilateral pansinusitis, orofacial pain, sinusitis- induced toothache
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