Aspergillosis of the maxillary sinus as a complication of overfilling rootcanal material into the sinus: Report of two cases

Aspergillosis of the maxillary sinus is a relatively rare disease in nonimm unocompromised patients. In recent years a number of cases of aspergillosis of the maxillary sinus have been reported in association with overextensio n of root canals fillings with certain root canal cements, It has been sugg ested that zinc oxide-based root canal cements might promote the infection with the Aspergillus species. In particular Aspergillus fumigatus has been found to be associated with the maxillary sinus infection. Radiographically the unique appearance of a dense opacity foreign body reaction in the maxi llary sinus was considered a characteristic finding in maxillary sinus aspe rgillosis, Because this association of overfilling of root canal cements an d aspergillosis of the maxillary sinus is not too well known we report two cases of young healthy female patients with the characteristic findings, bo th radiographically and clinically, In both patients the first maxillary mo lar was involved. Patients were symptomless and the diagnosis was made acci dently. However at surgical inspection both patients revealed aspergillomas , including the overextended root canal cement, The surgical procedure is d escribed as are the microscopic findings in both cases showing the characte ristic branching hyphae and conidophores typical of Aspergillus, Overextens ion into the maxillary sinus with root canal cements has to be avoided; mat erial has to be removed from the sinus because otherwise aspergillosis infe ction may ensue.