Accidental dental displacement into the maxillary sinus during extraction maneuvers: a case series

Abstract

Background The aims of this study were to describe the clinical findings of patients that suffered teeth displacement into the maxillary sinus, and to report the surgical technique used to solve this complication. Material and Methods A retrospective observational study was conducted involving patients that suffered a displacement of teeth into the maxillary sinus. Demographic and clinical data were recorded from the affected patients and a descriptive statistical analysis was made of the study variables. Results A total of nine patients were enrolled, six males (66.7%) and three females (33.3%), with a mean age of 36.0 years (range 22-54). In five patients (55.5%) the displaced teeth remained asymptomatic; however, dental fragments were retrieved from the maxillary sinus using Caldwell-Luc technique or endoscopic approach. Conclusions Dental displacement into the maxillary sinus during the extraction manoeuvres is an uncommon finding. Even in asymptomatic cases, these displaced teeth should be extracted in order to avoid the development of sinus pathology. Key words: Maxillary sinus, dental root fragment, accidental tooth displacement, extraction, surgical complications, Caldwell-Luc.

Odontogenic maxillary sinusitis and fungus ball development secondary to a dental root retained for more than 25 years. A case report

“…In fact, a recent systematic review of 674 patients with odontogenic sinusitis found 65.7% of the cases to be of iatrogenic origin – the causes including accidental tooth, implant or dental material displacements, and buccosinusal fistulas ( 3 ). The estimated prevalence of the accidental displacement of upper posterior teeth into the maxillary sinus is 0.6-3.8% ( 4 ). When this problem occurs, most authors recommend surgical extraction of the foreign body in order to prevent sinus infection and its possible complications ( 4 , 10 , 11 ).…”

“…The estimated prevalence of the accidental displacement of upper posterior teeth into the maxillary sinus is 0.6-3.8% ( 4 ). When this problem occurs, most authors recommend surgical extraction of the foreign body in order to prevent sinus infection and its possible complications ( 4 , 10 , 11 ).…”

“…In 10-12% of all cases, maxillary sinusitis is of odontogenic origin, due to the intimate anatomical relationship between the teeth in the posterior zone of the upper jaw and the maxillary sinus ( 1 ). The causes of sinus infection of dental origin include apical abscesses, advanced periodontal disease and infected radicular cysts, while the iatrogenic causes include accidental introduction into the maxillary sinus of endodontic material or graft material used for sinus lift procedures, and tooth displacements into the sinus ( 2 - 4 ).…”

Extracciones múltiples en el contexto del COVID 19: Reporte de caso clínico de un cuarto molar

“…33 Durante la planificación se debe realizar exámenes clínicos y radiográficos meticulosos, por ello la utilización de un CBCT como apoyo a la radiografía puede ser de gran ayuda, ya que dentro de las complicaciones está el desplazamiento del tercer molar hacia el seno maxilar o la fosa infratemporal el mismo que puede llevar a desencadenar sinusitis maxilar, no obstante la tasa global de complicaciones relacionadas con este procedimiento es baja. 34 Para evitar traumatismos o perforaciones del seno maxilar se debe considerar: posición anatómica, acceso a los dientes durante la cirugía en donde la extracción quirúrgica que se realiza sin osteotomía representa un riesgo menor del 4,2% y un caso de extracción quirúrgica con osteotomía representa un riesgo mayor del 7,0%; tener cuidado al extraer dientes con raíces bulbosas, tumores, quistes, el uso de fuerzas excesivas e incontrolables durante la extracción, falta de experiencia clínica, mala valoración clínica y radiológica, presencia de seno neumático y la existencia de lesiones periapicales. 18,34,35 Adicionalmente a los factores causales se considera que en este tipo de complicaciones ocurre con mayor frecuencia durante las maniobras de extracción del primer o tercer molar superior, con una prevalencia estimada del 0,6-3,8%; en pacientes de sexo masculino y estadísticamente significativa (p = 0,0368) en los grupos de personas mayores a 40 años).…”

Age- and sex-related changes of the volume of maxillary sinuses quantified via cone beam computed tomography

“…The former consists of undesired intraoperative events (predictable or not), while the latter is a postoperative (Silva et al, 2017). Examples of accidents that involve the MS are the oroantral communication (Polat et al, 2007) and the displacement of foreign bodies into the sinus (Toledano-Serrabona et al, 2021). In these cases, nose bleeding and sinusitis may emerge as complications (Chang et al, 2020).…”