Treatment of Maxillary Sinusitis of Odontogenic Origin: A Case Series.

Odontogenic infection is a possible cause of maxillary sinusitis. In this case series, the authors evaluated patients who presented with maxillary sinusitis symptoms before and after dental treatment. Intraoral periapical radiographs and cone-beam computed tomography (CBCT) scans were performed on three patients whose maxillary sinusitis symptoms included pain, sinus congestion, respiratory complaints, and what appeared on CBCT to be sinus mucosal thickening. In the first of the three cases, root canal treatment was done. The second case entailed root canal treatment and extraction of the second molar, and in the third case endodontic retreatment was performed. Each patient had a pretreatment CBCT taken and one again at a 4- to 12-month post-treatment follow-up visit. All three patients who presented with moderate-severe sinusitis had reduced symptoms after odontogenic treatment. Post-treatment CBCT confirmed near to complete resolution of sinus mucosal thickening in all patients. These cases show that maxillary sinusitis of odontogenic origin can respond favorably to dental treatment. This case series emphasizes the importance of a medical and dental collaboration when determining treatment for patients who present with maxillary sinusitis. Additionally, the use of CBCT was essential for evaluating the maxillary sinus and its associated odontogenic conditions.

Technologic advances in endodontics.

This article addresses technologic advances in endodontics pertaining to new and emerging technology. Cone-beam computed tomography and optical occurrence tomography are 2 new imaging technologies that can assist the practitioner in the diagnosis of pulpal disease. The self-adjusting file and the Apexum device can be used for instrumentation and bulk debridement of an apical lesion, respectively. Neodymium:yttrium-aluminum-garnet laser, erbium:chromium:yttrium-scandium-gallium-garnet laser, EndoActivator, EndoVac, and light-activated disinfection may assist the practitioner in cleaning the root canal system. Computed tomography-guided surgery shows promise in making endodontic surgery easier, as does mineral trioxide aggregate cement for regenerative endodontic procedures.

Mandibular first molars with three mesial canals.

Five clinical cases demonstrate the presence of a middle mesial canal in the mandibular first permanent molar. This is not an extra canal but rather the sequelae of instrumenting the isthmus between the mesiobuccal and mesiolingual canals.