TOOTHACHE WITH A MULTIFACTORIAL ETIOLOGY - A CASE-REPORT

A case report of orofacial pain originating from both dental and nonde ntal conditions is presented. The spontaneous throbbing pain initiated from the left maxillary second premolar and spread throughout the ent ire upper part of the face to the frontoparietal area. Root canal trea tment of the maxillary second premolar did not resolve the chief compl aint. Magnetic resonance imaging examination revealed hypertrophy of t he left inferior turbinate and soft tissue haziness in the left maxill ary sinus floor. After antrostomy, submucosal turbinectomy, and endodo ntic treatment, the patient was free from pain. The final diagnosis of this case, in addition to pulpitis, was maxillary sinusitis with chro nic rhinitis. The multiple factors associated with the etiology made t he diagnosis difficult. The mechanism of referred pain from the maxill ary sinus and paranasal mucosa to the maxillary teeth and face is disc ussed.