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This is a case report of chronic maxillary sinusitis caused by root canal overfillingof Calcipex II (Techno-Dent). A 60 year-old male complained of dull pain in theright maxillary molar area after complicated endodontic treatment using Calcipex IIpaste and was finally diagnosed with a chronic maxillary sinusitis through a clinicaland radiological observation. In the biopsy examination, the periapical granulomacontained a lot of dark and translucent Calcipex II granules which were not stainedwith hematoxylin and eosin. They were usually engulfed by macrophages but rarelyresorbed, resulting in scattering and migrating into antral mucosa. Most of the CalcipexII granules were also accumulated in the cytoplasms of secretory columnar epithelialcells, and small amount of Calcipex II granules were gradually secreted into sinuslumen by exocytosis. However, chronic granulomatous inflammation occurred withoutthe additional recruitment of polymorphonuclear leukocytes (PMNs) and lymphocytes,and many macrophages which engulfed the Calcipex II granules were finally destroyedin the processes of cellular apoptosis. It is presumed that Calcipex II granules are likelyto have a causative role to induce the granulomatous foreign body inflammation in theperiapical region, and subsequently to exacerbate the chronic maxillary sinusitis in thisstudy.

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