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Pathology · patient case question

Which immediate clinical test is most appropriate to confirm the suspicion raised by this finding?

Patient case: Post-Extraction Sinus Findings

demo: 52-year-old male

chief: Extraction of a non-restorable maxillary first molar.

history: Chronic nasal congestion and post-nasal drip for two years. Non-smoker.

meds: None

findings: After extraction of #14, soft tissue was retrieved from the socket and submitted for histopathology. The report describes pseudostratified ciliated columnar epithelium with a chronic inflammatory infiltrate.

  1. Nose-blowing (Valsalva) test with observation of the socket
  2. Electric pulp testing of the adjacent teeth
  3. Aspiration of the socket with a large-bore needle
  4. Percussion testing of the extraction site
Show answer and explanation

Correct answer: A. Nose-blowing (Valsalva) test with observation of the socket

  • A. Correct. Gentle Valsalva with the nostrils pinched will produce bubbling or air passage through an oroantral communication.
  • B. Pulp testing gives no information about the integrity of the sinus floor.
  • C. Blind aspiration risks enlarging the defect and inoculating the sinus.
  • D. Percussion is uninformative in a fresh extraction socket and merely causes discomfort.

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