A Stepwise Approach to Managing Bilateral Maxillary Sinus Tracts: A Case Report

This case report describes a rare presentation of bilateral intraoral sinus tracts of odontogenic origin associated with a maxillary right first molar (Universal #3). A key diagnostic challenge was differentiating an endodontic infection from vertical root fracture (VRF) in a previously treated tooth; no J-shaped probing defect was detected. The tooth was managed with single-visit nonsurgical root canal retreatment, resulting in symptom resolution and progressive radiographic healing. At nine-month follow-up, both sinus tracts had completely resolved, and the tooth remained asymptomatic and functional.