PMC10356538_01
Palatal view of the right first upper molar.
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fig1
Clinical examination revealed no tooth mobility, no swelling, and no pain sensation to percussion and/or chewing (Figure 1).
(a, b, and c) CBCT pre surgery showing the right first upper molar with a palatal radiopaque lesion associated with a cupoliform lesion inside the maxillary sinus.
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Morita, Kyoto, Japan) prescribed for planning the surgery showed a periapical low-intensity area associated with palatine root in contact with the maxillary sinus with the presence in the maxillary sinus of the cupuliform radiopaque lesion of increased size compared with the previous examination (Figures 2(a), 2(b), and 2(c)).
Retrograde preparation of the root performed with ultrasonic microtips.
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fig3
Apical Surgery: AS3D, ACTEON Equipment:SATELEC, Merignac, France), to allow a parallel preparation (Figure 3). After adequate control of the hemostasis by local compression with sterile gauze impregnated with epinephrine, the prepared root-end was dried with paper points and sealed using Super EBA (SE; Harry J.
Aspiration of the liquid content inside the maxillary sinus with a syringe.
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fig4
Afterward, the liquid content inside the lesion was sucked out completely with a syringe, emptying it (Figure 4).
Post-operative periapical radiograph.
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A postoperative periapical radiograph was taken (Figure 5), and the patient was instructed to rinse twice daily with 15 mL chlorhexidine digluconate 0.2% up to 10 days after surgery, and to take amoxicillin and clavulanic acid 1 g, N-acetylcysteine aerosol up to 6 days after surgery, and anti-inflammatory nonsteroidal drugs (ibuprofen 400 mg) twice a day for two days after surgery for swelling and pain control.
CBCT showing a complete remission of the sinus lesion.
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fig6
At the last appointment, the CBCT showed a complete remission of either the periapical lesion or the lesion inside the maxillary sinus (Figure 6).