Restorative Dentistry & Endodontics  2014;39(1):63-67

doi:10.5395/rde.2014.39.1.63

Chronic maxillary sinusitis caused by root canal overfilling of Calcipex II.

Jin Woo KIM 1 ; Kyung Mo CHO ; Se Hee PARK ; Soh Ra PARK ; Sang Shin LEE ; Suk Keun LEE

Affiliations

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Keywords

Calcipex II; Foreign body granuloma; Maxillary sinusitis

Country

Republic of Korea

Language

English

MeSH

Abstract

This is a case report of chronic maxillary sinusitis caused by root canal overfilling of Calcipex II (Techno-Dent). A 60 year-old male complained of dull pain in the right maxillary molar area after complicated endodontic treatment using Calcipex II paste and was finally diagnosed with a chronic maxillary sinusitis through a clinical and radiological observation. In the biopsy examination, the periapical granuloma contained a lot of dark and translucent Calcipex II granules which were not stained with hematoxylin and eosin. They were usually engulfed by macrophages but rarely resorbed, resulting in scattering and migrating into antral mucosa. Most of the Calcipex II granules were also accumulated in the cytoplasms of secretory columnar epithelial cells, and small amount of Calcipex II granules were gradually secreted into sinus lumen by exocytosis. However, chronic granulomatous inflammation occurred without the additional recruitment of polymorphonuclear leukocytes (PMNs) and lymphocytes, and many macrophages which engulfed the Calcipex II granules were finally destroyed in the processes of cellular apoptosis. It is presumed that Calcipex II granules are likely to have a causative role to induce the granulomatous foreign body inflammation in the periapical region, and subsequently to exacerbate the chronic maxillary sinusitis in this study.