Zinc as a growth factor for Aspergillus sp. and the antifungal effects of root canal sealants

Odell, Edward; Pertl, Christoph

doi:10.1016/s1079-2104(05)80079-4

Cited by 36 publications

(22 citation statements)

References 28 publications

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“…A variety of predisposing factors may disturb the mucous stream. Accidentally extruded root canal filler within the sinuses may induce inflammation and disrupt mucociliary transport . Since the apices of the upper molars and premolars are close to the maxillary sinus, root canal treatment may cause apical perforation, followed by extrusion of the root canal filler to the sinus .…”

Section: Discussionmentioning

confidence: 99%

A fungal ball within a maxillary sinus with dental root canal filler and rare fungal propagules

Kimura

Enomoto

Maenishi

et al. 2019

Pathology International

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A fungal ball of a maxillary sinus sometimes includes dental treatment‐related foreign material because the sinus is close to the root of the upper teeth. We present a case of right maxillary sinus fungal ball with a gutta‐percha point, a dental root canal filler. X‐ray analysis of the foreign material in the paraffin section of the fungal ball successfully detected zinc, sulfur, and barium, all of which were constituents of the gutta‐percha point. The gutta‐percha point might have facilitated the formation of the fungal ball through disruption of the sinus‐clearing mechanism. Another interesting histological feature of the fungal ball was the finding of calcium oxalate crystals and non‐hyphal fungal elements such as cleistothecia, Hülle cells, and conidial heads. This is the first report of such a combination being found in a specimen of human fungal disease. Although fungal culture was not available in the present case, molecular analysis of the formalin‐fixed paraffin‐embedded tissue of the fungal ball succeeded in revealing only DNA sequences of Aspergillus nidulans and some other environmental Aspergillus spp.

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Section: Discussionmentioning

confidence: 99%

A fungal ball within a maxillary sinus with dental root canal filler and rare fungal propagules

Kimura

Enomoto

Maenishi

et al. 2019

Pathology International

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“…Fungus ball and dental overfilling were particularly correlated to the presence of zinc, which promotes fungus growth. In 1995, Odell and Pertl had already found that zinc in the circulation would suffice for fungi to grow, and that additional zinc would not further enhance growth. Eugenol, used in combination with zinc oxide in dentistry, was found to be antifungal, but Mensi et al postulated that in the course of time, eugenol would gradually lose its inhibitory function, and zinc oxide would then promote fungal growth.…”

Section: Discussionmentioning

confidence: 99%

Potential correlations of dentogenic factors to the development of clinically verified fungus balls: A retrospective computed tomography–based analysis

Tomazic¹,

Dostal

Magyar

et al. 2015

The Laryngoscope

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Objectives/Hypothesis Fungus balls are a common disease of the paranasal sinuses, usually involving the maxillary sinus. To clarify the pathology, we analyzed patients treated for maxillary sinus fungus balls to see whether the latter correlated with dentogenic factors. Study Design Retrospective case analysis. Methods Cases of maxillary sinus fungus balls diagnosed between January 2000 and December 2013 were analyzed retrospectively. Patients' charts were reviewed for diagnosis, gender, and age. Paranasal sinus computed tomography (CT) scans were reviewed according to the side of the fungus ball, calcifications/opacifications, and dentogenic factors. Results In 98/102 patients (96.1%), 157 dentogenic factors could be identified on the side affected by a fungus ball. On the contralateral healthy side, there were 125 dentogenic factors. In four (3.9%) of the patients, no dentogenic pathology was identified on the CT scan. The presence of dentogenic factors (regardless of number) was significantly associated with a fungus ball compared to the healthy side (P = .024, χ2 test, odds ratio: 2.72 [95% confidence interval: 1.02–7.23]). Conclusions Dentogenic factors regardless of type potentially correlate with the presence of maxillary sinus fungus ball. Unlike the overall presence of dentogenic factors, the particular dentogenic factors in an individual patient do not significantly influence the development of fungus balls. After diagnosis of dentogenic pathology in penetrated maxillary sinus floors, patients should be closely monitored and informed about their higher risk of developing a fungus ball. Level of Evidence 4. Laryngoscope, 126:39–43, 2016

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“…Aspergillosis very rarely arises in healthy individuals and more commonly affects insulin-dependent diabetics with poorly controlled disease, immune-compromised patients [18,28] or leukaemic patients [10,16]. Non-invasive aspergillosis of the maxillary sinus may be associated with extrusion of root canal cements into the sinus, and it has been suggested that zinc oxide-based endodontic materials might promote the infection, as zinc may act as a growth factor for Aspergillus [20].…”

Section: Discussionmentioning

confidence: 99%

Combined mucormycosis and aspergillosis of the oro-sinonasal region in a patient affected by Castleman disease

et al. 2004

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One case of aspergillosis and mucormycosis occurring in a patient with stage-IV Castleman disease was investigated. The patient, who had undergone polychemotherapy and was in otherwise good general condition, without lymphadenopathies or imbalance of the immune system, presented with a palatal ulceration that progressively involved the palatal mucosa and bone, the paranasal sinuses and the orbit. Repeated cultural examinations were always negative. He had undergone multiple cytological smears of the inflammatory infiltration and biopsies of both the oral and nasal mucosa, which resulted in extensive necrotic debris and suppurative inflammation, and, on the very last biopsy, fungal hyphae, spores and conidia were also detected. These were large, branching, mostly non-septate hyphae, associated with conidiophores and conidia, the latter appearing dark brown to black in the histological preparations. Following the diagnosis of combined mucormycosis and aspergillosis, the patient underwent prolonged topic and systemic antibiotic treatment that resulted curative. Mucormycosis usually is a fatal complication of head and neck or systemic disorders, leading to severe immune suppression. Nevertheless, early diagnosis may be achieved using a combination of special stains and may lead to effective antibiotic treatment and cure of the patient, even if associated with other opportunistic infections, such as aspergillosis.

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Zinc as a growth factor for Aspergillus sp. and the antifungal effects of root canal sealants

Cited by 36 publications

References 28 publications

A fungal ball within a maxillary sinus with dental root canal filler and rare fungal propagules

A fungal ball within a maxillary sinus with dental root canal filler and rare fungal propagules

Potential correlations of dentogenic factors to the development of clinically verified fungus balls: A retrospective computed tomography–based analysis

Combined mucormycosis and aspergillosis of the oro-sinonasal region in a patient affected by Castleman disease

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