Maxillitis

Maxillitis is inflammation of the maxilla, the upper jawbone, and may involve the bone itself or adjacent structures such as the maxillary sinus or surrounding soft tissues. In clinical practice the term is used less often than more precise diagnoses such as maxillary osteomyelitis, maxillofacial cellulitis, or maxillary sinusitis.

Causes include odontogenic infections (such as dental abscess or periodontal infection) that spread to the maxilla, facial trauma, post-surgical infection, and less commonly hematogenous spread or fungal infection. Chronic conditions like diabetes or immune suppression increase risk and may lead to osteomyelitis of the maxilla.

Symptoms vary with the site and severity but commonly include facial swelling and tenderness over the upper jaw, pain, warmth, and fever. Odontogenic maxillitis may present with dental pain or drainage. Involvement of the maxillary sinus can produce nasal congestion, facial pressure, and postnasal discharge.

Evaluation relies on history and physical examination, dental assessment, and imaging. Panoramic radiographs or CT scans can show bone involvement; MRI can assess soft tissue spread. Blood tests may show inflammatory markers. Microbiological cultures may be obtained from drainage or pus to guide antibiotics.

Management depends on severity and cause. Mild soft-tissue infections may respond to antibiotics and dental treatment. Osteomyelitis or extensive infection often requires intravenous antibiotics, sometimes for several weeks, and surgical debridement of necrotic bone. Management of underlying conditions and source control are essential.

Prognosis ranges from full recovery with timely treatment to chronic infection with complications if untreated. Complications can include spread to orbit or intracranial spaces. Prevention focuses on treating dental infections promptly, good oral hygiene, and controlling risk factors such as diabetes.