Removal of the Dental Implant Displaced Into the Maxillary Sinus Through the Inferior Nasal Meatus via Transnasal Endoscopy

Abstract

Worldwide, the reconstruction of the posterior edentulous maxilla with dental implants has become a common practice in clinical settings. However, the poor bone condition in this area is sometimes accompanied by complications. Dental implant displacement into the maxillary sinus is viewed as a rare complication. A case of a 72-year-old man in whom an endoscopic technique was used to remove a dental implant that had been mistakenly planted into the maxillary sinus was reported in this study. The authors approached the sinus through the inferior nasal meatus, and the dental implant was removed through the widened ostium. The endoscopic surgical approach described in this study is reliable and minimally invasive for removing residual roots displaced into the maxillary sinus. Therefore, it has been concluded that this clinical procedure is worth using.

Removal of a migrated dental implant from a maxillary sinus through an intraoral approach: A case report

“…Depending on when it occurs, implant migration into the maxillary sinus is classified as early or late displacement. Early displacement can happen at the time of surgery due to an incorrect surgical technique ( 3 ), excessive force during implant placement ( 5 ), surgical inexperience ( 9 ), a poor or a lack of primary stability at the time of implant placement ( 3 , 9 ), inadequate bone quality or quantity ( 3 ), autoimmune reaction, or changes in intranasal sinus pressure ( 2 ). Late displacement may occur after implant loading due to early loading ( 9 ), inflammatory reactions that cause peri-implantitis and bone loss or implant overload, among others ( 3 ).…”

“…It could be explained if it is assumed that the implant breaks through the natural maxillary sinus ostium with the aid of the mucociliary action so that the displaced implant can be accidentally swallowed or aspirated, which may be life-threatening ( 8 ). These complications are rare; however, it can be a cause of odontogenic sinusitis ( 10 ) because it can cause impairment of the mucociliary clearance mechanism ( 2 ) or tissue reaction ( 5 ). The most significant sequela due to foreign bodies in the maxillary sinus is chronic sinusitis with or without nasal polyps, which may cause serious conditions such as pansinusitis, panophthalmitis, and orbital cellulitis ( 1 ).…”

“…After dental implant removal, the sinus window will be covered with a resorbable barrier membrane. This technique (transoral approach) enables improved access and visibility for the removal of the displaced implant ( 3 ) and enables removal of all the granulation tissue due to a direct visual approach, as well as a rapid recovery of the patient´s symptoms ( 5 ).…”

Removal of Displaced Dental Implants in the Maxillary Sinus Using Endoscopic Approaches

“…ESS may necessitate interdisciplinary cooperation and additional oroantral fistula closure. 13 ESS is considered an effective and minimally invasive method to retrieve the implant, but it may be difficult to remove implants located in the anterior and inferior parts of the maxillary sinus. In difficult areas that cannot be approached with an endoscope, the Caldwell-Luc operation is a reasonable alternative.…”

“…Intraoral approaches may include the Caldwell-Luc operation, suction of the foreign body from the oroantral fistula, or the lateral window approach. 13 The intraoral approach has the advantage of facilitating foreign body removal as well as closing the oroantral fistula. However, it does not provide effective treatment to the obstructed sinus ostium and accompanying sinusitis.…”