Endodontic surgical complications related to maxillary sinus involvement

Abstract

The maxillary sinuses are large aerial cavities superior to the oral cavity, which have important implications on oral surgery in general and on endodontic surgery in particular. In cases of maxillary tooth necrosis and infection, microorganisms might be in contact with structures of the maxillary sinus such as Schneiderian membrane, either due to direct contact between the infected tooth apex and the membrane or due to expansion of the bony lesion into the maxillary sinus. Hence, cases of maxillary tooth infection may lead to sinusitis, a complication with important implications for patients, which should be taken into consideration while planning treatment for tooth infection. For endodontic surgery, when a periapical lesion involves the maxillary sinus, removal of the infection should be performed carefully, in order to avoid perforation of the sinus membrane or limit its extension. The sinus cavity must be protected during the apical third preparation and while sealing, for avoiding the extrusion of the filling material into the cavity. As endodontic surgery may involve the maxillary sinus, adequate considerations and measures should be taken while planning and executing the surgery.