In the emergency department you examine a patient complaining of severe maxillary sinus pain. Upon ...

In the emergency department you examine a patient complaining of severe maxillary sinus pain. Upon looking in his mouth, you observe severely degenerated maxillary molars.
 
  The patient admits that he has not been treated by a dentist for many years and recently had an upper posterior toothache. Which of the following is the most likely cause of the patient's pain?
  A) An infection from an upper molar has spread along the inferior alveolar nerve to the maxillary sinus.
  B) An infection has spread via the root of an upper maxillary molar into the maxillary sinus.
  C) Poor dental hygiene has resulted in alveolar bone retraction with accompanying fracture of a tooth and invasion of the maxillary sinus by oral bacteria.
  D) Poor dental hygiene has caused the root of a maxillary molar to break and invade the maxillary sinus.
  E) Poor dental hygiene has weakened the maxillary facial buttress causing both the toothache and sinus pain.