Featured Case

Maxillary Sinusitis Mimicking Root Canal Pain

CBCT scan showing teeth #2 and #3 with roots extending into the maxillary sinus floor

Roots Near Sinus

Radiograph

Before During Final

1 Visit Moderate Difficulty Resolved Follow-up

CBCT 3D Imaging Pulp Vitality Testing Percussion Testing Differential Diagnosis

Patient Profile

Adult patient reporting discomfort in the upper right area after chewing during the holidays, with concurrent sinus issues and no temperature sensitivity

Clinical Challenge

Symptoms mimicked endodontic pathology in teeth #2, #3, and #4, but clinical and radiographic findings were normal — differential diagnosis required to rule out non-odontogenic origin

Approach

Comprehensive clinical examination with percussion, palpation, and mobility testing combined with CBCT 3D imaging to evaluate the relationship between tooth roots and the maxillary sinus

Outcome

No endodontic treatment recommended. Patient was advised of sinus remedies that resolved symptoms completely, avoiding an unnecessary root canal procedure

Chief Complaint

The patient reports discomfort after chewing in the upper right area over the holidays, with no temperature sensitivity, and concurrent sinus issues.

Clinical Findings

Clinical examination of teeth #2, #3, and #4 shows no mobility, normal response to percussion and palpation, and no significant findings. Radiographically, the maxillary sinus is proximal to the apical tissues of these teeth. No pathology noted.

Diagnosis

Normal Pulp; Normal Apical Tissues for teeth #2, #3, and #4.

Discussion & Recommendation

No endodontic treatment is recommended at this time as there is no evidence of pulpal or periapical pathology. Symptoms may be non-odontogenic, potentially related to sinus pressure, as the patient reported sinus issues concurrent with the discomfort, and the roots of the upper right teeth are anatomically close to the sinus membrane, which could transmit pressure and mimic tooth pain. Prognosis is favorable if symptoms resolve with sinus issue resolution.

Outcome

The patient was advised of sinus remedies rather than an endodontic procedure. Symptoms resolved completely without any dental treatment, saving the patient from a costly and unnecessary root canal. This case demonstrates how a detailed consultation with CBCT imaging can prevent misdiagnosis and unnecessary treatment.

Clinical Disclaimer: These cases are presented for educational purposes and published with appropriate patient consent. Patient identifying information has been removed in compliance with HIPAA regulations. Individual results may vary. All radiographic images and case descriptions represent actual patient treatment outcomes.

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