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Mycetoma of the maxillary sinus: endodontic and microbiological correlations
Magda Mensi1, Stefano Salgarello, Gabriele Pinsi
1Department of Endodontology and Oral Surgery, University of Brescia Dental School, Piazzale Spedali Civili No. 1, 25123 Brescia, Italy. mensi@med.unibs.it
Objective:
The purpose was to show the capacity of zinc oxide and eugenol to affect the growth of Aspergillus fumigatus.
Study Design:
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.
Insights
Zinc oxide promotes Aspergillus fumigatus growth, while eugenol inhibits it. However, eugenol's antifungal effect diminishes over time, potentially allowing fungal growth in endodontic sealers.
Area of Science:
- Microbiology
- Mycology
- Dental Materials Science
Background:
- Aspergillus fumigatus is an opportunistic fungal pathogen.
- Endodontic sealers are used in root canal therapy.
- Zinc oxide and eugenol are common components in dental materials.
Purpose of the Study:
- To investigate the effect of zinc oxide and eugenol on Aspergillus fumigatus growth.
- To assess the impact of these materials on fungal proliferation in vitro.
Main Methods:
- In vitro microbiological analysis.
- Testing on samples from infected maxillary sinuses.
- Evaluation of three different endodontic sealers.
Main Results:
- Zinc oxide in solution promoted Aspergillus fumigatus growth.
- Eugenol inhibited fungal growth, even when combined with zinc oxide.
- The inhibitory effect of eugenol decreased over a 75-day period.
Conclusions:
- Diminishing eugenol concentration in endodontic sealers may permit zinc oxide to support Aspergillus fumigatus growth.
- Clinical cases of mycetoma years after endodontic therapy support this hypothesis.
- This highlights a potential risk associated with long-term sealer presence.
