Presentation
Male, 33 years-old, feeling smooth discomfort in teeth #3 (16) six months after endodontic treatment. The patient was referred to perform CBCT, to investigate the cause of the discomfort and to analyze the relationship of the periapical lesion with the maxilarry sinus.
Patient Data
Reational osteogenesis in maxillary sinus associated with root canal infection
Note the hipodense images associated to the apex of the teeth #3 (16), in special the disto-bucal root apex, that is compatible with periapical inflammatory lesion. The close relationship of the apex of this maxillary molar with the maxillary sinus, allows that periapical lesion to promote an reactional osteogenesis and displacement of the floor of the maxillary sinus. Its possible to detect the thickening of sinus mucosal around the reactional defect.
Moreover, its possible to detect microdontia of the teeth #1 (18).
Case Discussion
The reactional osteogenesis of the maxillary sinus its unusual and its always combined to a inflammatory process.
This case report an large reactional osteogenesis associated to persistent periapical lesion in a teeth with endodontic treatment.
Note the preservation and the invagination of the cortical of the floor of the maxillary sinus.