Mycetoma of the maxillary sinus: endodontic and microbiological correlations.
OBJECTIVE
The purpose was to show the capacity of zinc oxide and eugenol to affect the growth of Aspergillus fumigatus.


METHODS
An in vitro microbiological analysis was conducted on samples from infected maxillary sinuses and on 3 different endodontic sealers.


RESULTS
Tests showed that zinc oxide in solution favors the growth of Aspergillus fumigatus, while eugenol inhibits this growth, even when mixed with zinc oxide powder. This inhibiting effect decreases over time. A reduced effectiveness was demonstrated over a 75-day period.


CONCLUSIONS
The hypothesis is that the diminishing concentration of eugenol over time in endodontic sealers allows the zinc oxide to support growth of Aspergillus fumigatus. This is reinforced by clinical experience, where mycetoma has developed years after endodontic therapy with excess sealer in the maxillary sinus.
Mensi
Magda
M
Department of Endodontology and Oral Surgery, University of Brescia Dental School, Piazzale Spedali Civili No. 1, 25123 Brescia, Italy. mensi@med.unibs.it
Salgarello
Stefano
S
Pinsi
Gabriele
G
Piccioni
Michela
M
D000935:Antifungal Agents / Q000494:pharmacology; D001232:Aspergillus fumigatus / Q000187:drug effects / Q000254:growth & development; D003907:Dexamethasone / Q000009:adverse effects; D004338:Drug Combinations; D005054:Eugenol / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D005557:Formaldehyde / Q000009:adverse effects; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects; D008297:Male; D015523:Maxillary Sinusitis / Q000209:etiology* / Q000382:microbiology; D008875:Middle Aged; D008271:Mycetoma / Q000209:etiology* / Q000382:microbiology; D012387:Root Canal Filling Materials / Q000009:adverse effects*; D012389:Root Canal Obturation / Q000009:adverse effects*; D013943:Thymol / Q000009:adverse effects / Q000031:analogs & derivatives*; D015034:Zinc Oxide / Q000009:adverse effects; D015035:Zinc Oxide-Eugenol Cement / Q000009:adverse effects*
D000935:Antifungal Agents; D004338:Drug Combinations; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; C011244:corticosteroid methanetriol mixture; D005557:Formaldehyde; D013943:Thymol; D005054:Eugenol; D003907:Dexamethasone; C003799:N2 Dental Cement; C076543:Kerr Pulp Canal Sealer; D015034:Zinc Oxide; D006854:Hydrocortisone