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A 48-year-old lady has had sinusitis for 7 years. The symptoms on the right side is more severe than the left. In the last 6 months, the symptoms have been getting worse associated with toothache on the tooth #3. Tenderness is found on the anterior wall of the right sinus. No caries or deep pockets are found of #3. Pulpal test with Endo Ice is within normal limit. Two PAs do not yield significant finding. CBCT (Fig.) shows radiolucency involving 3 apices of #3. The sinus membrane is significant thicker on the right than the left. Is it possible that chronic sinusitis causes odontogenic infection? Or apical periodontitis worsens the sinusitis on the right side? Root canal therapy is planned for #3. Is this the right treatment?
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Xin Wei, DDS, PhD, MS 1st edition 08/21/2014, last revision 01/22/2017