Maxillary Sinusitis As a Complication of an Extruded Gutta-Percha: A Case Report

The purpose of this article is to report the maxillary sinusitis caused by the extruded root canal material into the sinus. A 35-year-old woman was referred to our clinic with facial pain, accompanied by sinusitis, swelling, tenderness to palpation and sensitivity to chewing in the right maxillary region. The radiograph showed extruded gutta-percha (GP) from the apex of the right maxillary second premolar into the maxillary sinus. A well-circumscribed radiopaque mass in relation to the root and extending into the sinus owing to chronic inflammation was easily observed. Surgical management was performed under local anaesthesia. The inflammatory tissue around the apex of the tooth was removed by the help of a curette. The root end and the
extruded GP were resected with a fissure bur, and the sinus was irrigated with saline solution. An initial panoramic radiograph will reveal the proximity of the apices to the maxillary sinus. Using an electronic apex detector, applying a good apical stop, or moderate condensation will help to avoid overfilling or overextending of the endodontic material. Besides, periapical radiographs can also be taken to avoid any mistakes. However, contaminated root canal materials can easily induce maxillar sinusitis or aspergillosis.