Endodontic material diffusion in the pathogenesis of maxillary sinus aspergillosis
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Data
2013-06
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Resumo
One undesirable sequela of root canal treatment is the overextension of endodontic
material into the maxillary sinus, which may represent a risk factor for maxillary sinus
aspergillosis (MSA). Diverse clinical presentations of aspergillosis have been reported and
they vary depending on the immune status of the host. The noninvasive form called Aspergillus
mycetoma occurs mostly in healthy people. This report describes a case of MSA associated
with root canal overfi lling in a 27-year-old healthy man. The patient had been asymptomatic
for 6 years after root canal treatment. Radiography revealed a diffuse radiopaque mass inside
the left maxillary sinus, with radiolucent areas near the cortical bone of the maxillary sinus.
Computed tomography (CT) showed the presence of material with a density similar to that of
soft tissue. Imaging fi ndings suggested that the calcifi cation fi lled the left maxillary antrum,
without expansion or bone destruction. The lesion was removed, and microscopic examination
of the specimen revealed an infl ammatory process with numerous dichotomized fungal
structures (compatible with Aspergillus sp.). Histopathological features were compatible
with aspergillosis. Treatment consisted of surgery and adjunctive anti-fungal therapy with
itraconazole. Clinical and radiographic follow-up revealed no recurrence of the lesion.
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Palavras-chave
Aspergillosis, Maxillary sinus, Endodontic treatment, Aspergilose, Material diffusion, Tratamento endodôntico, Difusão de material, Seio maxilar
Citação
FLORENZANO, Stéfano et al. Endodontic material diffusion in the pathogenesis of maxillary sinus aspergollosis. Stomatos, Canoas, v. 19, n. 36, p. 36-43, jan./jun. 2013.