CVE-2022-44264 in Sirona Sidexis
Summary
by MITRE • 01/27/2023
Dentsply Sirona Sidexis <= 4.3 is vulnerable to Unquoted Service Path.
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Analysis
by VulDB Data Team • 04/01/2025
The vulnerability identified as CVE-2022-44264 affects Dentsply Sirona Sidexis version 4.3 and earlier, presenting a critical security weakness related to service path configuration. This issue stems from the improper handling of service paths within the software's installation and execution framework, creating an exploitable condition that can be leveraged by malicious actors to gain unauthorized system access. The vulnerability specifically impacts the Windows service installation process where service paths are not properly quoted, allowing for path manipulation attacks that can lead to privilege escalation and system compromise. This flaw represents a significant concern for dental practices and medical imaging environments that rely on this software for radiographic image management and patient data handling.
The technical nature of this vulnerability falls under CWE-16 - Configuration, which specifically addresses issues related to improper configuration of software components including service paths and installation parameters. When service paths are not properly quoted in Windows service installations, attackers can place malicious executables in directories that are searched before the legitimate service location, effectively hijacking the service execution flow. This occurs because Windows service installations that do not quote paths containing spaces will resolve the path components sequentially, allowing an attacker to place a malicious binary in a directory that appears earlier in the search path. The vulnerability is particularly dangerous because it can be exploited without requiring elevated privileges initially, as the service typically runs with higher privileges than the user context.
The operational impact of this vulnerability extends beyond simple privilege escalation, as it can enable attackers to establish persistent access within dental practice networks that handle sensitive patient health information. In healthcare environments, this represents a severe risk to data confidentiality and integrity, as the compromised system could be used to exfiltrate patient records, manipulate radiographic data, or serve as a foothold for lateral movement within the network infrastructure. The attack vector is particularly concerning because it can be exploited through social engineering or by simply installing malicious software in the vulnerable path, making it accessible to both external attackers and insider threats. Given that dental practices often have limited cybersecurity resources and may not regularly update their medical imaging software, this vulnerability creates a persistent risk that could remain undetected for extended periods.
Organizations should implement immediate mitigations including updating to the latest version of Dentsply Sirona Sidexis software where the vulnerability has been addressed, applying proper service path quoting during installation procedures, and conducting comprehensive vulnerability assessments of all installed services. System administrators should also implement monitoring for suspicious service execution patterns and ensure that only authorized personnel have access to modify service configurations. The mitigation strategy should align with NIST cybersecurity framework guidelines and follow the principle of least privilege, ensuring that services run with minimal required permissions. Additionally, organizations should consider implementing application whitelisting policies and regular security audits to detect and prevent similar configuration vulnerabilities across their entire IT infrastructure, particularly in environments handling sensitive health information that must comply with HIPAA regulations and other data protection standards.