Loss of pulp vitality after maxillary sinus augmentation: a surgical and endodontic approach.

BACKGROUND: Maxillary sinus augmentation is a routine procedure performed in implant dentistry in cases with sinus pneumatization. This study presents a series of clinical cases in which tooth devitalization occurred in conjunction with sinus augmentation. METHODS: In the three cases presented, a sinus-lift procedure was performed that resulted in devitalization of the adjacent teeth. Patients were referred to an endodontist for evaluation and treatment. Vitality of the teeth was determined by the use of a cold test, electric pulp test, and cavity test. The pulp was considered to be necrotic if the tests were negative. RESULTS: In this case series, loss of pulp vitality of two maxillary left second premolars and one maxillary left first molar occurs after sinus-augmentation procedures. The devitalized teeth were free of caries. In one case, two amalgam restorations were present. CONCLUSION: Pulp necrosis may occur in conjunction with a sinus-lift procedure in cases when an adjacent root is in close proximity to the sinus floor and the sinus membrane is elevated over the root apex.