Sinusitis of Dental Origin

From: Maarten Meire <maartenmeire@gmail.com>
Reply-To: ROOTS <roots@ls.rxdentistry.com>
Date: Tue, 8 Mar 2011 20:34:08 +0100
To: ROOTS <roots@ls.rxdentistry.com>
Subject: [roots] Sinusitis of dental origin

Hello Rooters,

 

Haven’t
posted for a while, for the same reasons as Bojidar explained. Now
things start to settle (and I get more sleep :-),,) I hope to find more
time to prepare cases.

 

Here is a recall of a case
I did earlier on. This guy had been complaining of chronic sinusitis
(unilaterally) for more than 1 year. He consulted an ENT, who prescribed
medication. Because this didn’t do much, a CT scan was taken. Finally,
he was advised to have his teeth revised. A huge carious lesion on the
distal of tooth 16 was hard to miss. Given the intimate relationship
between the apices of this tooth and the maxillary sinus, the subsequent
pulp necrosis and apical periodontitis were a very likely cause of his
sinus problems.

 

Caries was removed, the distal
wall rebuilt with GIC. Four canals were cleaned, shaped and disinfected
in 2 visits, Ca(OH)2 interim. On the second visit, the buccal swelling
had disappeared and he noted a vast improvement in the earlier symptoms.
Obturation with gutta percha/AH+ warm vertical.

 

1.5
year later, he is symptom-free and the radiograph shows satisfactory
healing of the apical lesions. Sorry for not having pulp chamber
pictures of this one. Welcome your comments!

 

Maarten

Belgium – still without a government!