Clinical oral investigations · 2026
Endodontic-sinus communications: a 10-year retrospective observational study on maxillary posterior teeth.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Bugea Calogero, Cerutti Francesca, Sforza Francesco, Sciancalepore Enrico Nicola, Heranin Stanislav, Pedullà Eugenio, Qorri Erda, Scarano Antonio
Аннотация
OBJECTIVES: To describe the clinical characteristics, anatomical distribution, and long-term outcomes of unintended endodontic-sinus communication involving maxillary posterior teeth that occurred during endodontic treatment.
MATERIALS AND METHODS: This retrospective observational study reviewed clinical records collected over approximately 10 years of routine clinical practice. Among 10,345 maxillary premolars and molars treated endodontically, cases presenting intraoperative endodontic-sinus communication were identified. Preoperative periapical radiographs were obtained in all cases, with cone-beam computed tomography (CBCT) available in selected patients. Endodontic treatment was performed under rubber dam isolation using electronic apex locators and rotary nickel-titanium instruments. The Valsalva maneuver was systematically performed intraoperatively to detect communication. Root canal obturation was completed in one or two visits using bioceramic techniques. Clinical and radiographic follow-up was scheduled at 3, 5, and 10 years.
RESULTS: Thirty-one patients (18 males, 13 females) presented an endodontic-sinus communication, corresponding to an incidence of 0.30% (31/10,345). The affected teeth included 14 maxillary second molars, 15 maxillary first molars, and 2 maxillary second premolars. A total of 32 root-level communications were identified. Vital primary treatments accounted for 22 cases (70.97%), retreatments for 7 cases (22.58%), and necrotic teeth for 2 cases (6.45%). The Valsalva maneuver was positive in all cases. The mean follow-up duration was 48 months (range: 36-120 months). All evaluated teeth remained functional, with no persistent sinus-related symptoms and no need for surgical intervention.
CONCLUSIONS: Unintended endodontic-sinus communication is a rare intraoperative event during treatment of maxillary posterior teeth. Early recognition, strict apical control, and conservative management may allow favorable long-term outcomes without the need for surgical intervention. However, these findings should be interpreted cautiously in light of the retrospective design, limited sample size, and absence of a control group.
MATERIALS AND METHODS: This retrospective observational study reviewed clinical records collected over approximately 10 years of routine clinical practice. Among 10,345 maxillary premolars and molars treated endodontically, cases presenting intraoperative endodontic-sinus communication were identified. Preoperative periapical radiographs were obtained in all cases, with cone-beam computed tomography (CBCT) available in selected patients. Endodontic treatment was performed under rubber dam isolation using electronic apex locators and rotary nickel-titanium instruments. The Valsalva maneuver was systematically performed intraoperatively to detect communication. Root canal obturation was completed in one or two visits using bioceramic techniques. Clinical and radiographic follow-up was scheduled at 3, 5, and 10 years.
RESULTS: Thirty-one patients (18 males, 13 females) presented an endodontic-sinus communication, corresponding to an incidence of 0.30% (31/10,345). The affected teeth included 14 maxillary second molars, 15 maxillary first molars, and 2 maxillary second premolars. A total of 32 root-level communications were identified. Vital primary treatments accounted for 22 cases (70.97%), retreatments for 7 cases (22.58%), and necrotic teeth for 2 cases (6.45%). The Valsalva maneuver was positive in all cases. The mean follow-up duration was 48 months (range: 36-120 months). All evaluated teeth remained functional, with no persistent sinus-related symptoms and no need for surgical intervention.
CONCLUSIONS: Unintended endodontic-sinus communication is a rare intraoperative event during treatment of maxillary posterior teeth. Early recognition, strict apical control, and conservative management may allow favorable long-term outcomes without the need for surgical intervention. However, these findings should be interpreted cautiously in light of the retrospective design, limited sample size, and absence of a control group.