Abstract

  Root canal therapy consists of a cascade of scientifically-based technical procedures. Failure to follow the standard protocols and lack of knowledge can lead to a number of iatrogenic accidents which are collectively called “endodontic mishaps”. One of the most frequently encountered endodontic mishap is a separation of the endodontic instrument. Heroic attempts to remove separated instrument may lead to dislodgment of instrument in the periapical area. At times such instrument get dislodged in the maxillary sinus when treating upper maxillary molars and canines. Separated instrument in maxillary sinus, irrespective of their origin or nature, act as foreign body and Such objects should normally be removed at the earliest in order to minimize the likelihood of maxillary sinus complications. Studies have shown that some of the objects can cause chronic sinusitis because of the invasion of the sinus by highly virulent bacteria, while some remains asymptomatic. It is an uncommon finding to observe, an asymptomatic dental endodontic instrument in a position so close to the maxillary sinus without any oro-antral fistula formation and/or sinusitis attacks. This paper presents the case of a separated endodontic instrument which was pushed inadvertently in the maxillary sinus of a 41-year-old female patient.

Keywords: CBCT; Endodontic Instrument; Root Canal Treatment; Separation

References

1. Mandel E., et al. “Rotary Ni-Ti profile systems for preparing curved canals in resin blocks: Influence of operator on instrument breakage”. International Endodontic Journal 6 (1999): 436-443.
2. Parashos P., et al. “Factors influencing defects of rotary nickel-titanium endodontic instruments after clinical use”. Journal of Endodontics 10 (2004): 722-725.
3. Poveda R., et al. “Mental nerve paresthesia associated with endodontic paste within the mandibular canal: report of a case”. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology5 (2006): 46-49.
4. Torabinejad M. “Endodontic mishaps: etiology, prevention, and management”. Alpha Omegan 4 (1990): 42-48.
5. Tzanetakis GN., et al. “Prevalence and Management of Instrument Fracture in the Postgraduate Endodontic Program at the Dental School of Athens: A Five-year Retrospective Clinical Study”. Journal of Endodontics 6 (2008): 675-678.
6. Chatterjee K. “Search designs for searching for one among the two-and three-factor interaction effects in the general symmetric and asymmetric factorials”. Annals of the Institute of Statistical Mathematics 4 (1990): 783-803.
7. Parashos P., et al. “Factors influencing defects of rotary nickel-titanium endodontic instruments after clinical use”. Journal of Endodontics 10 (2004): 722-725.
8. Yamaguchi K., et al. “Gross extrusion of endodontic obturation materials into the maxillary sinus: a case report”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 1 (2007): 131-134.
9. Wolf MK., et al. “Preoperative 3D imaging in maxillary sinus: Brief review of the literature and case report”. Quintessence International 7 (2015): 627-631.
10. Kafas P., et al. “Dysaesthesia in the mental nerve distribution triggered by a foreign body: A case report”. Cases Journal 10 (2009): 1-4.
11. Harrison K., et al. “Fixation tack penetration into the maxillary sinus: A case report of a guided bone regeneration procedure complication”. American Journal of Case Reports 14 (2013): 43-47.
12. Sohn DS., et al. “Removal of displaced foreign body from the maxillary sinus using replaceable bony windows and saline irrigation, followed by suctioning of the foreign body”. Implant Dentistry 2 (2011): 112-117.
13. Pang KP., et al. “Migration of a foreign body in the maxillary sinus illustrating natural mucociliary action”. Medical Journal of Malaysia 4 (2005): 523-525.
14. Nagendrababu V., et al. “PRICE 2020 guidelines for reporting case reports in Endodontics: a consensus-based development”. International Endodontic Journal (2020): 619-626.
15. Grossman LI. “Guidelines for the prevention of fracture of root canal instruments”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 5 (1969): 746-752.
16. Frota LMA., et al. “Removal of Separated Endodontic K-File with the Aid of Hypodermic Needle and Cyanoacrylate”. Case Reports in Dentistry (2016).
17. Mantri S. “Management of fractured root canal treated mandibular molar with separated endodontic instrument extending in periapical region”. SAGE Open Medical Case Reports 6 (2018): 2050313X1880925.
18. Brito-júnior M., et al. “Alternative Techniques to Remove Fractured Instrument Fragments from the Apical Third of Root Canals: Report of Two Cases 26 (2015): 79-85.
19. Brooks JK and Kleinman JW. “Retrieval of extensive gutta-percha extruded into the maxillary sinus: Use of 3-dimensional cone-beam computed tomography”. Journal of Endodontics 9 (2013): 1189-1193.
20. Shao L., et al. “Removal of Maxillary Sinus Metallic Foreign Body Like a Hand Sewing Needle by Magnetic Iron”. International Journal of Clinical Pediatric Dentistry 1 (2014): 61-64.
21. Barclay JK. “Root in the maxillary sinus”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 2 (1987): 162-164.
22. Winstock D and Warnakulasuriya S. “Impression material presenting in the maxillary antrum as a foreign body”. British Dental Journal 2 (1986): 54-55.
23. Khoury F. “Burs and root tips in the maxillary sinus TT - Bohrer und Wurzelrest in der Kieferhöhle”. Quintessenz7 (1985): 1233-1237.
24. Holmes A. “Sewing needle as an antral foreign body”. British Dental Journal 4 (1987): 153-154.
25. Burnham R and Bridle C. “Aspergillosis of the maxillary sinus secondary to a foreign body (amalgam) in the maxillary antrum”. British Journal of Oral and Maxillofacial Surgery 4 (2009): 313-315.
26. Iida S., et al. “Migration of a dental implant into the maxillary sinus. A case report”. International Journal of Oral and Maxillofacial Surgery 5 (2000): 358-359.
27. Bodet Agusti E., et al. “[Foreign bodies in maxillary sinus]”. Acta Otorrinolaringologica Española 3 (2009): 190-193.
28. Ramos Brito AC., et al. “Detection of Fractured Endodontic Instruments in Root Canals: Comparison between Different Digital Radiography Systems and Cone-beam Computed Tomography”. Journal of Endodontics 4 (2017): 544-549.
29. Jenkins S., et al. “Sealing ability of three materials in the orifice of root canal systems obturated with gutta-percha”. Journal of Endodontics 3 (2016): 225-227.
30. Little RE., et al. “Odontogenic sinusitis: A review of the current literature”. Laryngoscope Investigative Otolaryngology 2 (2018): 110-114.
31. Sgaramella N., et al. “Displacement of Dental Implants Into the Maxillary Sinus: A Retrospective Study of Twenty-One Patients”. Clinical Implant Dentistry and Related Research 1 (2016): 62-72.
32. Chiapasco M., et al. “The management of complications following displacement of oral implants in the paranasal sinuses: a multicenter clinical report and proposed treatment protocols”. International Journal of Oral and Maxillofacial Surgery 12 (2009): 1273-1278.
33. Westermark AH. “Spontaneous removal of foreign bodies from the maxillary sinus: Report of a case”. Journal of Oral and Maxillofacial Surgery 1 (1989): 75-77.
34. Borgonovo A., et al. “Displacement of a dental implant into the maxillary sinus: case series”. Minerva Stomatologica 1-2 (2010): 45-54.
35. Parker W. “In the maxillary sinus” (1953): 100-105.
36. Killey HC. “Possible sequelae when a tooth or root dislodged into the maxillary sinus”. British Dental Journal 116 (1964): 73-77.
37. Asgary S and Ehsani S. “MTA resorption and periradicular healing in an open-apex incisor: A case report”. Saudi Dental Journal 1 (2012): 55-59.
38. Wu MK., et al. “Fluid transport along gutta-percha backfills with and without sealer”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 97.2 (2004): 257-262.
39. Angelopoulos C., et al. “A Comparison of Maxillofacial CBCT and Medical CT”. Atlas of the Oral and Maxillofacial Surgery Clinics of North America 1 (2012): 1-17.

Citation

Citation: Avisha Agrawal., et al. “Accidental Dislodgement of Separated Instrument in the Maxillary Sinus: A Unusual Case". Acta Scientific Dental Sciences 4.11 (2020): 68-73.

Copyright

Copyright: © 2020 Avisha Agrawal., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.