A healthy 57 year old female presents with sudden discomfort of the last few days presenting in the area of #14. She had some trouble sleeping the previous evening due to the discomfort.
Signs and Symptoms
Teeth #14 was distinctly percussion sensitive as well was #15 although to a lesser degree. Biting sensitivity was limited on all teeth on her left side. There was no remarkable thermal sensitivity. A fiberoptic exam did not reveal any significant fracture patterns. There was no apparent nasal congestion, as she did not complain of any difficulty breathing or nasal drainage. The periapical image did not reveal any apical pathology or caries.
CBCT Exam..
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Sagittal Slice
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Coronal Slice
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Axial Slice
A coronal slice from the CBCT exam reveals no apparent apical pathology yet a distinctly obliterated antrum.
A sagittal slice also confirms the blockage of the maxillary left sinus.
An axial slice confirmed the position of root apices to the floor of the antrum.
Treatment Option
We described the CBCT findings with the patient and visually demonstrated to her the sinus condition. The decision was made for an ENT referral. We have since followed up with her, as she is now approximately 3 weeks out. She was prescribed a course of cephalosporin by her physician, and is now symptom free, with no odontogenic discomfort.
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