A Case of Coexistent Fungal Rhinosinusitis and Actinomycosis Caused by Gutta-Percha Points Extruded Into the Maxillary Sinus

Dental materials can stray into the maxillary sinus, causing maxillary sinusitis. We present a case of coexistent fungal rhinosinusitis and actinomycosis caused by gutta-percha points, a core-filling material used for root canal treatment. A 56-year-old man who had undergone root canal treatment with gutta-percha points visited our oral surgery department with complaints of purulent nasal discharge lasting one month. Panoramic radiography confirmed the presence of the foreign body in the left maxillary sinus. As per his wish for tooth preservation, he was referred to our department for the transnasal removal of the material. Nasal endoscopy revealed purulent nasal discharge in the nasal cavity. Computed tomography revealed a soft tissue density lesion filling the left maxillary sinus with a rod-like and spherical radiopaque mass. We performed endoscopic sinus surgery and removed the soft material, in which Candida and actinomycetes were histologically confirmed. Some dental materials containing zinc oxide, such as gutta-percha points, have been reported to cause fungal rhinosinusitis. To our knowledge, there have been no reports of coexisting fungal rhinosinusitis and actinomycosis caused by dental materials extruded into the maxillary sinus. Clinicians should consider the possibility of fungal rhinosinusitis and actinomycosis when removing extruded dental materials.