氧化锌充填糊剂与霉菌性上颌窦炎的关系

Influence of zinc-containing endodontic obturating pastes on maxillary sinus aspergillosis

目的 根管过度充填常导致氧化锌丁香油酚充填糊剂进入上颌窦内 ,本研究的目的是探讨进入窦腔的充填剂同霉菌性上颌窦炎的关系。方法 回顾分析 33例霉菌性上颌窦炎住院手术患者 ,男 14例 ,女 19例。年龄 2 5～ 6 5岁 ,平均 4 1.3岁 ,其中 12例有患侧上牙行根管治疗史 ,所有患者行鼻内窥镜手术治疗。结果 术中发现 ,窦内发现牙原性异物 6例 ,其中牙根 1例 ,充填材料 5例 ,另外发现 3例窦腔内有超填的根尖裸露。手术后所有病例随访 1～ 2年无复发。结论 含氧化锌充填剂可促使局部霉菌的生长 ,可能是霉菌性上颌窦炎的一个原因 ,根管治疗时应避免超填 。

Objective To explore the relationship between the development of maxillary sinus aspergillosis and the presence of zinc-containing root canal lbturating paste within the antrum.Methods Thirty-three patients with maxillary sinus aspergillosis were included in this study.There were 14 males and 19 females,age ranged from 25 to 65 years old(mean age 41.3).Twelve patients had a history of endodontic therapy.All patients were treated with nasal endoscopic technique.Results Foreign bodies were found in 6 cases,among them teeth roots(1 case),dental fillings(5 case),3 patients had found overextension of filling paste from affected teeth into the maxillary sinus.All cases were cured without recurrence in the follow up of 1～2 years.Conclusion Overfilling of maxillary teeth with a zinc oxide-containing root-filling material might favour the formation of local aspergillosis,it is a possible cause of maxillary sinus aspergillosis.Overextension into the maxillary sinus with root canal cements has to be avoided.Endoscopic approach is a new,reliable method.