Australian Dental Journal
The official journal of the Australian Dental Association
LETTERS TO THE EDITOR
Australian Dental Journal 2015; 60: 134–122 doi: 10.1111/adj.12297
Letters may comment on articles published in the Journal and should offer constructive criticism. When appropriate, comment on the letter is sought from the author. Letters to the Editor may also address any aspect of the profession, including education, new modes of practice and concepts of disease and its management. Letters should be brief (no more than two A4 pages).
THE PLIGHT OF AUSTRALIAN DENTAL SCHOOLS
RHINOSINUSITIS IN ORAL MEDICINE AND DENTISTRY
Thank you for the editorial piece about the plight of Australian dental schools in 2014.1 I was moved by your Editorial as it appears that it’s an unfortunate and accurate reﬂection on the current state of Australian dental schools, even in the 21st century. As an academic on the ‘greener’ side but having spent more than four years in a university environment, it is disappointing to see programmes and staff members come and go. I won’t deny that sometimes one does become disheartened and disillusioned in academia. However, there are great rewards when you do achieve a good teaching outcome or be awarded a grant I am an oral health therapist teaching within BDSc and BOralH programmes, and this experience has opened my eyes as a younger academic to the true nature of working within a university environment. In contrast, life can be much more balanced in clinical practice than in academia, which might include planning a syllabus and teaching content for more than 500 students. The university is not for the faint hearted and the risk of burnout is high, especially for young academic staff.2 I urge all dental schools to support their junior staff members, both in teaching and research. In addition to Professor Bartold’s suggestions, a solution that all universities can readily implement is to reduce the administration load and provide an appropriate level of mentoring and reward in both teaching and research. Recruiting the next generation of academics is not difﬁcult nor is it rocket science; just provide mentorship and support, you will see them bloom.
The review article Rhinosinusitis in oral medicine and dentistry was enlightening.1 In addition to these, the following points are noteworthy. Rhinosinusitis can also develop due to maxillary osteomyelitis, supernumerary teeth, tumours like odontomas and osteoma, odontogenic cysts like radicular cysts and dentigerous cysts.2–6 Computed tomography (CT) is the gold standard in the diagnosis of maxillary sinus disease due to its high resolution and ability to visualize bone and soft tissue. Also, it can obtain thin sections and generate multiplanar views for interactive viewing. CT is an excellent tool for diagnosing odontogenic sinusitis. It shows the relationship of the odontogenic origin to the maxillary sinus ﬂoor defect and the diseased tissues. It can also determine the exact location of a foreign body within the maxillary sinus.4 It should be remembered that secondary aspergillosis which is frequently associated with a dental foreign body can appear as a luminal opacity and be mistakenly identiﬁed as calciﬁed dental amalgam.2 Cone beam volumetric computed tomography (CBVCT) is a relatively new tool that produces threedimensional (3D) images, but utilizes lower radiation doses than conventional CT. Bony details are reproduced accurately although soft tissue detail is reduced. The technique is gaining popularity among dentists especially in implant dentistry, as it is valuable in evaluating the thickness of the ﬂoor of the maxillary sinus and also to rule out concurrent sinus disease prior to implantation. It has a higher resolution than conventional CT which is a good advantage, especially in challenging cases of rhinosinusitis of odontogenic origin. CBVCT images can show the amount of obliteration of the maxillary sinus, presence or absence of ﬂuid and the extent to which it is ﬁlled, presence of communications and proximity of teeth to the sinus, thickness and characteristics of cortical plates, presence or absence of foreign bodies and reactive lesions, presence or absence of fractures of root or bone.6,7 Presence of ﬂuid levels within the maxillary sinus is closely correlated with acute bacterial sinusitis, and the volume of sinus ﬂuid is directly proportional to the possibility of
REFERENCES 1. Bartold PM. Dental Schools Left with Holes. Aust Dent J 2014;59:407. 2. Watts J, Robertson N. Burnout in university teaching staff: a systematic literature review. Educ Res 2011;53:33–50.
CAROL TRAN Oral health therapist School of Dentistry The University of Queensland
(Received 26 September 2014.)
© 2015 Australian Dental Association
Letters to the Editor ﬁnding a concurrent odontogenic infection.7 A of sinusitis involving ectopic third molar tooth in illary sinus, with an associated dentigerous obstructing the left nasal cavity was accurately nosed in CT.8
case maxcyst diag-
REFERENCES 1. Ferguson M. Rhinosinusitis in oral medicine and dentistry. Aust Dent J 2014;59:289–295. 2. Lechien JR, Filleul O, Costa de Araoujo P, et al. Chronic maxillary rhinosinusitis of dental origin: a systematic review of 674 patient cases. Int J Otolaryngol 2014;2014:465173. 3. Lopatin AS, Sysolyatin SP, Sysolyatin PG, et al. Chronic maxillary sinusitis of dental origin: is external surgical approach mandatory? Laryngoscope 2002;112:1056–1059. 4. Lee KC, Lee SJ. Clinical features and treatments of odontogenic sinusitis. Yonsei Med J 2010;51:932–937.
5. Costa F, Emanuelli E, Robiony M. Endoscopic surgical treatment of chronic maxillary sinusitis of dental origin. J Oral Maxillofac Surg 2007;65:223–228. 6. Simuntis R, Kubilius R, Vaitkus S. Odontogenic maxillary sinusitis: a review. Stomatologija 2014;16:39–43. 7. Nair UP, Nair MK. Maxillary sinusitis of odontogenic origin: cone-beam volumetric computerized tomography-aided diagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e53–e57. 8. Salib RJ. Sinusitis of dental origin. BMJ 2014;348:g3201.
DR VAGISH KUMAR L S Senior Lecturer Department of Oral Medicine and Radiology Yenepoya Dental College and Hospital Yenepoya Research Center Yenepoya University, Mangalore Karnataka, India
(Received 26 September 2014.)
Aust Dent J 2014;59:29–36 The affiliation of one of the authors, Y Ariza, in the article Biomarkers of cardiovascular disease are increased in untreated chronic periodontitis: a case control study was incorrect. The correct afﬁliation should be: School of Health Sciences, Universidad Icesi, Cali, Colombia The online version has been corrected.
© 2015 Australian Dental Association