Resolution of Odontogenic Sinusitis after RCT Retreatment

The use of CBCT in endodontics is helpful in the diagnosis and treatment of sinusitis of odontogenic origin.  The following case demonstrates how proper endodontic treatment will resolve an asymptomatic sinusitis of odontogenic origin.

Pt reports swelling, throbbing, percussion pain but reports no sinus symptoms of congestion, drainage, restricted airflow through the nose or sinus headaches.



CBCT take for further evaluation of prior RCT.  CBCT shows missed MB#2, thickened sinus membrane, large pa lesion on MB with elevated sinus floor (halo effect). DX: Prior RCT with acute apical abscess & odontogenis sinusitis.

Missed MB#2 canal seen in axial view.



Slight halo effect

RCT Retx completed.

7 Month Recall



7 month recall.  Pt is asymptomatic. CBCT shows resolution of the previously thickened sinus membrane, healing of periapical lesion, previous elevation of the sinus floor has resolved.  All signs and symptoms have resolved.

 

Pulpal Regeneration on a Carious, Immature, Necrotic Molar

Most pulpal regeneration cases are done on traumatically injured anterior teeth.  The following case is a pulpal regeneration on an immature, necrotic tooth #19 due to coronal decay.

This regenerative procedure was done in a single visit, NaOCl irrigation, MTA barriers, flowable composite over MTA and Luxacore resin buildup.  Proper coronal coverage will help preserve this tooth until a permanent crown can be made. No further endodontic therapy is needed on this tooth.