The role of dental canal fillings in the development of Aspergillus sinusitis

Summary

Radiopaque concretions in the maxillary sinus in cases of sinusitis are often observed in infections with aspergillosis. For several authors, such features are considered to be typical of these infections. For us this foreign body in most cases is believed to be related to overfilling of the teeth. We have previously drawn attention to this fact. We report 85 cases of aspergillosis of the maxillary sinus. Cases involving immunosuppressed patients were excluded because of very different clinical conditions. A radiopaque foreign body was seen in 94% of the cases. Of this group, 85% were believed to be related to overfilling of maxillary teeth with dental paste, particularly since evidence for endodontic treatment was found in the premolar/molar region. An image of intrasinus dental paste was demonstrated in 12% of the cases as a direct extension of filling paste from affected teeth. The nature of the dental paste is important because the zinc contained can stimulate the growth of Aspergillus fumigatus. In vitro studies in our laboratory also showed that the growth of A. fumigatus was stimulated with a low concentration of zinc.