SINUSITIS OF ENDODONTIC ORIGIN – CASE REPORT CLINICAL CASE

Abstract

An Endodontic infectious inflammatory condition can affect the tissues and mucosa of the maxillary sinus adjacent to the root apex, causing an odontogenic sinusitis. The signs and symptoms that define the condition of an endodontic origin is called endo-antral syndrome, characterized by: an endodontic infection in a tooth close to the maxillary sinus, a periapical radiolucent image related to the affected tooth, loss of the lamina dura around the apex corresponding to the radiographic border of the maxillary sinus, radiopaque image in the maxillary sinus over the apex of the involved tooth and variation of radiopacity degrees in the image of the maxillary sinus affected by the inflammatory process, compared to the maxillary sinus on the opposite side. 40-years old patient, female, reported absence of taste and smells after COVID, tinnitus, severe pain in the right side of her face and temporomandibular disorder (TMD). After CBCT, it was observed that teeth 16 and 17 presented a communication between their roots and the maxillary sinus. Retreatment was performed in teeth 16 and 17 with ultrasonic inserts and Reciproc Blue files (VDW-Germany). Three changes of Ultracal XS dressing were performed until the symptom remission. Teeth were filled with BioRoot RCS sealer and gutta percha cones. After filling, a new CBCT was performed and, 3 months after the retreatments’ beginning, bone repair was already observed. Patient reported no more pain, but still presenting tinnitus. We conclude that as long as properly diagnosed, it is possible to treat odontogenic sinusitis through endodontic treatments. The use of CBCT becomes a potential tool for the diagnosis of this condition.