Removal of an Upper Third Molar from the Maxillary Sinus

Abstract

The maxillary sinus or antrum is the largest of the paranasal sinuses. It is located in the maxillary bone and has a proximity to the apexes of upper molars and premolars, which allows it to form a direct link between the sinus and the oral cavity. Dislocation of a foreign body or tooth to the interior of a paranasal sinus is a situation that can occur as a result of car accidents, firearm attacks, or iatrogenic in surgical procedures. Therefore, it is necessary to know how to treat this kind of situation. This study's objective is to report the case of a 23-year-old female patient, leucoderma, who sought treatment from the Surgical Unit at the Dental Faculty of the Federal University of Sergipe. She had a history of pain and edema in the right side of the genian region and two failed attempts at removing dental unit (DU) 18. The extraoral clinical exam revealed intense edema of the left hemiface with signs of infection, excoriation of the labial commissure, hematoma, a body temperature of 39°C, and a limited ability to open her mouth. The patient was medicated and treated surgically. The tooth was removed from the maxillary sinus with caution, as should have been done initially.

Displacement of impacted third molar into maxillary sinus and its removal through Caldwell-Luc approach - A case report

“…Few researchers suggest that the displaced tooth should be removed immediately as there are risks for infection, foreign body reaction, and due to its anatomic location which can lead to the potential for morbidity. [10] The established treatment in case of the displaced tooth is its surgical removal, to prevent future complications. It is stated that in first place retrieval of the tooth should be attempted by placing suction at the opening of tooth socket into the sinus.…”

Removal of Displaced Metallic Foreign Bodies From Maxillary Sinus: Two Cases

“…Although it was shown to have a distortion rate of about 25%, orthopantomography is the most commonly used imaging method for verifying the location of dislocated elements in maxillary sinus 6 . In contrast, CBCT imaging method gives the clearest view, as well as the location the smallest and the most unexpected suspected objects in three dimensions 1 .…”

“…In our cases, Caldwell-Luc technique was used. Major advantages of this technique are providing a broad access and field of vision to the surgery area, having experienced clinicians, being an attempt which they often applied, and absence of serious complications 6,7 . On the other hand, the literature reports possible complications of Caldwell-Luc procedure as; facial asymmetry, nerve damages, dental pulp devitalization and operation-led oroantral fistula formation.…”

“…Another well-known technique is the transalveolar approach at the moment a foreign body penetrates into the sinus. This method is used as a first and urgent step to remove the tooth roots penetrating into the sinus from the socket; however this method can only be applied when the available distance is larger than the size of foreign body 6 . Endoscopic procedures can be used to remove small foreign bodies from paranasal cavities.…”

“…Nevertheless, in order to avoid complications, foreign bodies should be detected on time and removed. The ideal action is to remove the foreign body as soon as it penetrates to the area 6 . In the following stages, the area should be reached with Caldwell-Luc operation or endoscopic approaches 5,7 .…”