09/29/2026
Another MSEO maxillary sinusitis of endodontic origin
A challenging case due to heavy calcification, an inaccessible distobuccal (DB) canal obstructed by the deep crown margin, and maxillary sinus involvement associated with exudate drainage from the periapical lesions of the MB and palatal (P) roots, which had perforated into the sinus floors.
The patient wished to retain the tooth and restore its function rather than proceed with extraction and implant replacement. After discussing the treatment options, the patient elected to proceed with an endodontic approach, including root canal treatment (RCT) and DB root amputation.
Before completing the RCT and proceeding with the DB root amputation, I wanted to confirm that the maxillary sinus had adequately healed and that the associated edema had resolved. Within three weeks following disinfection and intracanal medication of the MB and P canals, the sinus edema had completely resolved, indicating a favorable response to the initial endodontic treatment.
With the sinus condition stabilized, the RCT was completed, and the DB root amputation was subsequently performed as planned.