Transinusal Pathway Removal of an Impacted Third Molar with an Unusual Approach: A Case Report and a Systematic Review of the Literature

Abstract

Background: The purpose of the present case report was to investigate a very rare ectopic third molar removal by a trans-sinusal approach and report the study findings through a systematic review of the literature on this topic. Case presentation: A 38-year-old female patient was visited for pain at the level of the right maxillary region. No relevant medical history was reported. The CBCT tomography assessment revealed an impacted third tooth at the level of the postero-lateral maxilla. Review Methods: An electronic search was performed through Boolean indicators query on Pubmed/Medline, EMBASE, Cochrane Library databases. The clinical reports were identified and selected in order to perform a descriptive analysis. The surgical approach concerned a trans-sinusal access to the site for the ectopic tooth removal with a lateral antrostomy. No evident inflammatory alteration was associated to the ectopic tooth and a non-relevant post-operative sequelae was reported at the follow up. Results: A total of 34 scientific papers were retrieved from the database search. Only two cases reported a wait-and-see radiographical follow-up approach, while the most common treatment was surgical removal, also for asymptomatic cases. Conclusion: The third-molar ectopic tooth into the maxillary sinus is an uncommon occurrence that is beast treated by an in-chair intraoral tran-sinusal approach, with a consistent reduction of the invasivity, a mild morbidity and a successful functional outcome.

Inverted Maxillary Third Molar Impaction within the Maxillary Sinus: A Rare Case Report

“…In a systemic research study conducted by Mavriqi et al, a total of 34 cases were reported for third molars located in the maxillary sinus, with associated symptoms such as headache, sinusitis, facial pain, or totally asymptomatic. They reported the most common locations of the maxillary third molar in the maxillary sinus as presented at the posterior wall (24.13%), lateral wall (22.41%), medial wall (18.96%), inferior wall (17.24%), orbital floor (15.51%), and rarely at the anterior wall (1.72%) of the sinus [ 20 ].…”

“…It has the advantage of visualization of orbital floor defects. The transinusal approach is more invasive but the visibility is significantly better than the endoscopic-assisted approach [ 20 , 24 ]. The suggested surgical intervention in the present case was the transinusal approach, because of the inverted position and the location of the impaction at the posterior wall of the sinus, which presents a high risk of displacement of the tooth into the maxillary sinus.…”

“…Computed tomography (CT) is an elemental diagnostic tool for managing these clinical situations, as orthopantomogram is a less accurate, unreliable X-ray and is limited by distortion and superimposition of anatomical structures. Therefore, use of orthopantomogram can lead to improper diagnosis and management [ 20 ]. In this case, we used CBCT to precisely locate the original site of the impaction.…”

Evaluation of anti-inflammatory properties on the surface of dental implants depending on the type of processing (Part 1)

“…Проте в останні роки нанофункції визначають як нову мету для еволюції поверхонь титанових імплантатів щодо покращення їхніх клінічних характеристик. Посилення активації фосфатази та проліферації остеобластів у кістковій тканині визначали за наявності фторапатиту, що утворюється у результаті взаємодії фториду з гідроксиапатитом [21]. Компанія Straumann розробляла поверхню SLA з хімічним покриттям кристалами хлориду натрію NaCl, хімічну модифікацію та нанотекстуру на основі SLA під комерційною назвою SLActive [22].…”

Surface Coatings of Dental Implants: A Review

“…The interaction of fluoride with hydroxyapatite in bone tissue creates fluorapatite followed by increased osteoblast proliferation and activation of alkaline phosphatase activity [86][87][88]. Because of its outstanding physical and chemical characteristics, particularly its potential for osteoinduction, graphene oxide (GO) is a promising nanomaterial [57,89,90].…”