Broken file into maxillary sinus (by Ilya Mer)

This patient was referred to my office due to lingering pain in first upper molar and not succeeded treatment attempt

NSRCT#3.080
Tooth was open for several days
CBCT images show broken file penetrate the maxillary sinus and inflammation  process probably of endodontic origine
CBCT images show broken file penetrate the maxillary sinus and inflammation process probably of endodontic origin
I looked for MB2 canal with separated apex which could explain the sinus inflammation and found two orifices merged un the middle third.
I looked for MB2 canal with separated apex which could explain the sinus inflammation and found two orifices merged un the middle third.
After 4 canals were negotiated and filled with calcium hydroxide pain didn't return longer. The most difficult task was to  clean  an apical portion  of palatal canal and this took me almost the whole second visit.
After 4 canals were negotiated and filled with calcium hydroxide pain didn’t return longer. The most difficult task was to clean an apical portion of palatal canal and this took me almost the whole second visit.
The oburation and access restoration were completed at the third visit, all symptoms gone and the patient was doing well. The question was when to go on MB apico or lets say if apico was needed in this case.
The oburation and access restoration were completed at the third visit, all symptoms gone and the patient was doing well. The question was when to go on MB apico or lets say if apico was needed in this case.

 

 

 

 

 

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