Combined Occlusal Therapy For Odontogenic Sinusitis: Case Report

This case discusses the management of right maxillary sinusitis caused by occlusal trauma of the right upper second molar through occlusal adjustment combined with application of an occlusal splint. A 45-year-old male presented with a six-month history of aching pain of the right upper posterior teeth during chewing, accompanied by bruxism. Clinical examination revealed moderate wear on posterior occlusal surfaces, especially on tooth 17, with no mobility, mild percussion pain (±), and slight discomfort of this tooth on biting. CBCT showed widened periodontal ligament space at the palatal root of tooth 17 with slight angular bone resorption around its neck, and mucosal thickening in the right maxillary sinus. Traumatic occlusion and Bruxism was diagnosed. Selective occlusal adjustment and desensitization therapy of tooth 17, and a customized occlusal splint were provided. At 1-week, 1, 3 and 6-month follow-ups, the patient reported complete resolution of symptoms, with CBCT confirming regression of mucosal thickening in the right maxillary sinus. Isolated occlusal adjustment is suitable for simple occlusal interference, providing localized discomfort relief. The combined approach with an occlusal splint offers dual benefits: 1.‌Immediate Protection‌: The splint redistributes occlusal forces, reducing mechanical stress on the traumatized tooth and adjacent sinus mucosa. 2.‌Permanent Optimization‌: Occlusal adjustment eliminates traumatic triggers, promoting periodontal healing and resolving the direct local cause of sinus inflammation. Occlusal trauma can cause non-infectious sinusitis, which can be managed by occlusal adjustment together with splint usage.