XP-Finisher as an Alternative to Surgical Approaches in Overextended Gutta Percha Removal from Maxillary Sinus: A Case Report
Iatrogenic complications in endodontic treatment, particularly involving maxillary molars, can present significant clinical challenges due to complex root canal anatomy and their proximity to vital structures such as the maxillary sinus. Among these complications, the inadvertent extrusion of thermo...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&volume=19&issue=8&page=ZD08&issn=0973-709x&id=21417 |
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| Summary: | Iatrogenic complications in endodontic treatment, particularly involving maxillary molars, can present significant clinical challenges due to complex root canal anatomy and their proximity to vital structures such as the maxillary sinus. Among these complications, the inadvertent extrusion of thermoplastic Gutta-Percha (GP) into the maxillary sinus is rare but potentially serious, often requiring surgical intervention. However, advancements in non-surgical techniques offer promising alternatives for managing such cases conservatively. This case report details the successful orthograde retrieval of extruded thermoplastic GP from the maxillary sinus associated with tooth No. 16, which exhibited a C-shaped palatal canal morphology. A 34-year-old male patient presented with discomfort in the maxillary right first molar region following recent root canal therapy. Cone-Beam Computed Tomography (CBCT) revealed GP overextension into the sinus through the palatal canal. Using dental operating microscopy and enhanced irrigation protocols, the extruded GP was safely retrieved with the XP-Endo Finisher instrument. The palatal canal was subsequently re-cleaned and obturated using a controlled, apically limited thermoplastic technique. This case highlights the utility of advanced imaging, magnification, and innovative instrumentation in managing endodontic mishaps without resorting to surgical procedures. Importantly, it demonstrates that orthograde retreatment, when executed with precision, can be a viable and minimally invasive solution for GP extrusion into the sinus. Further clinical studies are recommended to establish standardised protocols and to assess long-term outcomes for such conservative approaches. |
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| ISSN: | 2249-782X 0973-709X |