Nonsurgical management of maxillary sinusitis caused by root perforation

The present case report describes the nonsurgical management of maxillary sinusitis of endodontic origin (MSEO) caused by iatrogenic root perforation. A 32-year-old woman had facial pain on her upper posterior teeth. The pain increased when she ran on a treadmill or bent over. Root perforation of the left maxillary second premolar (#25) and its anatomical proximity to the maxillary sinus has been shown on cone-beam computed tomography (CBCT) and clinically detected by the dental operating microscope. Based on these findings, a diagnosis of MSEO with root perforation on #25 was made. The maxillary sinusitis was successfully treated with nonsurgical management of the root perforation using a premixed bioceramic repair material. Many clinicians have a tendency to opt for surgical repair or extraction when they encounter a complex situation involving failing perforated root canals with maxillary sinusitis. To avoid a surgical approach on the posterior maxilla, dentists should consider CBCT taking and nonsurgical repair of root perforation and not attempt to make a final decision of extraction.