Tanasiewicz Marta, Bubilek-Bogacz Anna, Twardawa Henryk, Skucha-Nowak Małgorzata, Szklarski Tomasz
Department of Conservative Dentistry with Endodontics, Medical University of Silesia, Bytom, Poland.
Department of Dental Surgery, Medical University of Silesia, Bytom, Poland.
J Dent Sci. 2017 Sep;12(3):296-300. doi: 10.1016/j.jds.2013.02.033. Epub 2013 Apr 9.
Foreign bodies found in the maxillary sinus include tooth roots, burs, dental impression material, root-filling materials, dental implants, and needles. The purpose of this paper was to present an unusual case of a large foreign body of endodontic origin (root-filling material) removed from the maxillary sinus. A 45-year-old generally healthy male patient reported to the Department of Conservative Dentistry with Endodontics of the Medical University of Silesia, because of orbital and buccal pain on the right side of his face and headaches in the preceding 6 months. Those symptoms were associated with the end of endodontic treatment of teeth 14 and 16. Periapical X-rays, including of teeth 14 and 16, showed the presence of root canal filling with extrusion of endodontic obturation material beyond the apices of tooth 14. In the case of tooth 16, a completely filled palatal canal and incompletely filled buccal canals were found. There was also an irregular dimness at the upper edge of the X-ray image. Panoramic radiography and computed tomography demonstrated a foreign body in the right sinus. Sinus exploration was performed via a surgical procedure conducted using topical anesthesia. The root apices of tooth 14 were resected, and foreign substance was removed. The practitioner did not correctly recognize a complication that occurred during endodontic treatment, which resulted in extrusion of endodontic material beyond the root apices of tooth 14. This case emphasizes the potential impact that an involved maxillary sinus may have on endodontic therapy. Detailed diagnostic identification based on the medical interview, physical and histopathological examinations, and diagnostic imaging allowed rapid surgical intervention and prevented local and general complications. It is important to realize that the range of the periapical X-ray projection is not always sufficient.
在上颌窦中发现的异物包括牙根、牙钻、牙科印模材料、根管充填材料、牙种植体和针头。本文的目的是介绍一例罕见的源自牙髓治疗的大型异物（根管充填材料）从上颌窦取出的病例。一名45岁的健康男性患者因右侧面部眼眶和颊部疼痛以及前6个月的头痛，前往西里西亚医科大学保守牙科与牙髓病科就诊。这些症状与14号和16号牙齿的牙髓治疗结束有关。包括14号和16号牙齿在内的根尖X线片显示根管充填，牙髓充填材料超出了14号牙齿根尖。对于16号牙齿，发现腭根管完全充填，颊根管充填不完全。X线图像上缘还存在不规则的模糊影。全景X线摄影和计算机断层扫描显示右侧上颌窦有异物。通过局部麻醉下的外科手术进行鼻窦探查。切除了14号牙齿的根尖，并取出了异物。该从业者未正确识别牙髓治疗期间发生的并发症，导致牙髓材料超出14号牙齿根尖。该病例强调了受累上颌窦可能对牙髓治疗产生的潜在影响。基于医学问诊、体格检查、组织病理学检查和诊断成像进行详细的诊断识别，有助于快速进行手术干预并预防局部和全身并发症。必须认识到根尖X线投影范围并不总是足够的。
