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

ABSTRACT 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.