Endoscopic removal of an unusual foreign body in the sphenoid sinus: an oral implant

Prevention and management of intra-operative complications in maxillary sinus augmentation: A review

Maxillary sinus floor elevation is usually performed in two different ways: the lateral approach involves the creation of a bony window on the maxillary sinus lateral wall, providing direct access to the sinus cavity for membrane elevation and subsequent graft placement, and the transcrestal approach is considered less invasive. The aim of this article is to describe, based on the literature, how to anticipate, avoid, and manage the intraoperative complications that can occur with both approaches. For both approaches, the most common complication is the sinus membrane perforation. For the lateral approach, an average frequency ranging from 15.7% to 23.1% is reported, but because of the better visibility, their management will be easier compared to the transcrestal approach. Mean perforation rate reported for the transcrestal approach is lower (3.1%-6.4%), but it should be noted that a significant number of perforations cannot be detected and managed given the blind nature of this technique. Anatomical parameters such as sinus width and buccal wall thickness may be a risk factor for one approach and not the other. As it is impossible to assess the resistance of the Schneiderian membrane, the transcrestal approach is more likely to lead to infectious complications in the event of perforation. Others, such as the risk of vascular damage, are encountered only with the lateral approach, which can be prevented easily by dissecting the alveolo-antral artery. For both approaches, prevention is essential and consists in analyzing the anatomy, mastering the surgical technique, and collaborating with the ENT to manage the essentially infectious consequences of intraoperative complications.

Dental Evaluation: Oral Surgery-Related Complications

The article provides an in-depth review focused on diagnosing oral surgery-related complications that may cause odontogenic sinusitis (ODS). It emphasizes the importance of evaluating patients with prior oral surgical procedures to determine whether the prior procedure is an ongoing infectious source of the ODS. Specifically, diagnostic evaluations will be described for detecting oroantral communications and fistulas, dental implant dislocation or protrusion, and whether implants and graft placed in maxillary sinuses are infected. It highlights the role of different oral examination techniques, optimal imaging modalities, and the importance of otolaryngologic collaboration to evaluate for infectious ODS.

Characteristics and management of dental implants displaced into the maxillary sinus: a systematic review

The displacement of dental implants into the maxillary sinus is increasingly reported and may lead to serious complications. Better knowledge of this condition could help clinicians improve their practice, but it is difficult to draw conclusions from the current literature. Therefore, a systematic review was performed to describe the main characteristics of dental implant displacement, as well as its management and temporal evolution over a 31-year period. This review was conducted according to the PRISMA methodology. The PubMed/Scopus electronic databases were searched to December 2021. Risk of bias was assessed using the Joanna Briggs Institute tools. A total of 73 articles reporting 321 patients with displaced dental implants were included. Implants located in the upper first molar site were the most frequently involved (23.7%). Displacement occurred mainly during the first 6 months after implant placement (62.6%). The majority became symptomatic (56.2%), most often due to maxillary sinusitis and/or oroantral communication (44.2%). The surgical approaches to remove displaced implants were the lateral approach (38.1%), the Caldwell-Luc approach (27.2%), and endoscopic nasal surgery (23.1%). This review highlights the importance of preventive measures: avoiding implant displacement by careful pre-implantation radiographic analysis, but also preventing infectious complications through early removal of the displaced implant (PROSPERO CRD42021279473).

Unexpected foreign body induced refractory maxillary sinusitis

Maxillary sinusitis induced by ipsilateral dental manipulation often carries the risk of sinusal foreign body impaction. Adequate evaluation mandates radiological exploration of the sinus. Management requires complete foreign body removal, surgical drainage of the sinus, and closure of any oroantral communication or fistula.

Evaluation of different surgical approaches to remove dental implants from the maxillary sinus

Dental implant surgery on atrophied maxilla has many risks; in some patients, simultaneous sinus lifting with implant placement must be performed to increase the chances of successful implantation; this procedure can cause implant migration. Eleven patients were diagnosed with implant migration into the maxillary sinus in four anatomical areas: the sinus floor above the alveolar bone, near the junction of the sinus and nasal floor, near the floor of the orbit, and the most posterior aspect of the sinus. Surgical removal was performed through four different direct non-endoscopic transoral approaches depending on the location of the displaced implant. Surgical challenges, surgery duration and postoperative complications were reported. The least challenging surgical intervention was noted when removing the displaced implants from the floor of the sinus through the crestal approach. More challenges were experienced during the surgical removal of anteriorly displaced implants near the roof of the orbital floor due to surgical access and the proximity of vital anatomical structures. Bleeding from the pterygoid venous plexus was profound with the posterior lateral approach. The choice of an appropriate surgical approach to retrieve displaced dental implants from the maxillary sinus depends on the location of the implant and the surrounding vital anatomical structures.

Unilateral chronic maxillary rhinosinusitis after bone maxillary graft for dental implant placement: A case report

Odontogenic chronic maxillary rhinosinusitis has to be suspected in patient with a history of dental implant placement just after bone maxillary graft.

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

With the broad indications for dental implantation, complications rates have increased. Dental implant displacement into the maxillary sinus, although rare, can occur during the restoration of maxillary posterior teeth. We performed a 6-year retrospective review and found 3 cases with displaced implants in the maxillary sinus. Detailed information, including surgical indications and dental implant removal methods, is provided. Dental implants can be dislocated to the maxillary sinus perioperatively or postoperatively. Endoscopic sinus surgery can be performed to remove the implant and restore sinus patency. If the implant is displaced to deeper areas (commonly anterior and inferior) of the maxillary sinus, a prelacrimal recess approach can provide a panoramic view of the maxillary sinus and is a good alternative to the Caldwell-Luc operation in terms of mucosal preservation and postoperative complications.

Endoscopic sinus surgery for dental implant displacement into the maxillary sinus-a retrospective clinical study

The aims of this retrospective clinical study were to present our management protocol for the retrieval of impacted dental implants that have become displaced into the maxillary sinus cavity and to define the role of endoscopic sinus surgery in this setting. All 24 patients (25 implants) who underwent surgical retrieval of dental implants displaced into the maxillary sinus between 2012 and 2019 were included. Data on surgical interventions and complications were collected retrospectively. Eleven patients (46%) had chronic sinusitis associated with the migrated implant. All implants were successfully retrieved via transnasal endoscopic approach alone: 80% via a middle meatal antrostomy and 20% via a combined middle and inferior meatal antrostomy. Five patients required a concomitant transoral approach for oro-antral fistula repair. None required a transoral approach for displaced implant retrieval. All patients healed uneventfully without complications. Transnasal endoscopic sinus surgery via a middle meatal antrostomy or a combined middle and inferior antrostomy is recommended as the primary choice for dental implant retrieval from the maxillary sinus. A transoral approach should be performed simultaneously only for oro-antral fistula repair. This surgical protocol proved to be safe and efficient, and it obviated the need for osteotomies of the anterolateral maxillary wall.

A review of rare complications of maxillary sinus floor augmentation

Maxillary sinus floor augmentation (MSFA) is an essential procedure for implant installation in the posterior maxillary area with vertical alveolar bone deficiency. For the past several decades, MSFA has been refined in terms of surgical methods along with technical progress, accumulation of clinical studies, and development of graft materials and surgical instruments. Although some complications in MSFA are inevitable in clinical situations, management of those complications in MSFA has been well established thanks to many clinicians and researchers. Nevertheless, some rare complications may arise and can result in fatal results. Therefore, clinicians should be well aware of such rare situations and complications associated with MSFA. In this review, the authors present several rare complications regarding MSFA, along with corresponding management strategies through a thorough review of the literature.

Risk factors in lateral window sinus elevation surgery

Maxillary sinus augmentation is the most predictable of the pre-prosthetic surgical procedures. There are, however, known and well-documented complications that can and do occur. The most common are the intraoperative complications of sinus membrane perforation and bleeding, and the postoperative complications of sinus graft infections, sinus infections, and sinusitis. The majority of these complications can be prevented, or their incidence greatly reduced, through a thorough understanding of maxillary sinus anatomy, the multifaceted etiologies of these conditions, and the steps that can be taken to avoid them. This volume of Periodontology 2000 will discuss both the preoperative and intraoperative procedures that will prevent these untoward outcomes and the necessary treatment modalities that will limit their adverse effects.

Displacement of a Dental Implant into the Pterygoid Fossa: A Clinical Report

The placement of dental implants in the pterygomaxillary region can be advantageous in maxillary complete arch fixed implant-supported prosthetic rehabilitations to avoid bone grafting and sinus elevation surgeries. Pterygomaxillary implants improve implant biomechanics by eliminating distal cantilevers and increasing the anteroposterior spread with reported mean implant survival rates comparable to traditional implant sites. Although only minor surgical complications have been reported in the literature with the placement of dental implants in the pterygomaxillary region this clinical report describes a major surgical complication involving the displacement of a dental implant into the pterygoid fossa.

Retrieval of displaced implants inside the maxillary sinus: two case reports and a short review

Objective

The aims of this paper are to demonstrate two cases of implant migration into the maxillary sinus and to give a short review of the literature on this subject.

Clinical procedure

Two patients were diagnosed with implant migration into the maxillary sinus. After thorough radiographic examination which revealed the exact position of the implants inside the maxillary sinus, removal was performed through a bony window in the anterior-lateral aspect of the maxillary sinus for both cases.

Discussion

Implant displacement into the maxillary sinus can occur intraoperatively or postoperatively either prior to implant loading or after functional loading. Several actors can lead to this complication differing according to the stage of the displacement.

Management of this complication is achieved using four surgical techniques: a. Functional endoscopic sinus surgery, b. intraoral removal by the Caldwell-Luc technique, c. removal through the alveolar bone, d. combination of the last two techniques. If implant displacement into the maxillary sinus remains untreated, it can lead to several complications with various effects.

Conclusion

Migration of dental implants into the maxillary sinus is a rare but severe complication which must be treated as soon as possible.

Displaced Dental Materials in the Maxillary Sinus: An Original Series. Analysis and Definition of a Surgical Decision-Making Process

OBJECTIVES

Displacement of dental materials into the maxillary sinus occurs in daily dental practice; dental implants have become a new common foreign body (FB), as implantation has become routine. The main goal of the present study was to analyze an original series of patients consecutively treated for maxillary sinus FBs. A secondary goal was to propose a decision-making flowchart on the basis of the authors' experience and a critical analysis of literature to select the most appropriate surgical approach.

METHODS

Eleven consecutive patients evaluated for maxillary sinus FBs consisting of dental material were considered.

RESULTS

For removal of the FBs, a nasal endoscopic approach was preferred in 5 cases, a nasal combined approach in 2 cases, an oronasal combined approach in 2 cases, and a lateral window approach in 2 cases. In 2 of 11 cases, complications were reported. A decision-making flowchart to select the best surgical approach is reported.

CONCLUSIONS

The correct choice and application of FB removal techniques allow minimization of unfavorable outcomes and creation of an appropriate environment for new dental treatment. Prospective, large series-based studies will be necessary to confirm the safety and clinical efficacy of the proposed decision-making flowchart.

Removal of the Residual Roots Displaced Into the Maxillary Sinus via Endoscopy

Minimally invasive endoscopic surgery has been developed for various indications in the craniomaxillofacial area. The case report presented in this article is focused on the possibility of removing the residual roots displaced into the maxillary sinus by means of an endoscopic technique. When planning endoscopic surgery to access the residual roots displaced in the maxillary sinus, we performed 2 different approaches into the maxillary sinus, a transnasal approach through the middle or inferior turbinate and transoral approach via the anterior maxillary sinus wall. The endoscopic surgical approach described is reliable and minimally invasive for removing the residual roots displaced into the maxillary sinus. Therefore, we concluded that the application of this clinical procedure is worth promoting.

Retrieval of an Unusually Displaced Implant With Healing Cap Into the Mandibular Canal

Accidental displacement of dental implants into the anatomical spaces is a rare complication that may be accompanied by tissue damage, functional disturbance, psychological distress, and medicolegal conditions. The aim of this report is to present an unusual case of a dental implant that displaced into the mandibular canal and to highlight the importance of adequate preoperative planning and surgical knowledge.

Sinonasal Complications Resulting from Dental Treatment: Outcome-Oriented Proposal of Classification and Surgical Protocol

Background

Odontogenic sinusitis is a relevant infectious condition of the paranasal sinuses. The widespread use of dental implants and reconstructive procedures for dental implant placement has led to new types of complication. To the authors’ knowledge, no publication has extensively examined sinonasal complications resulting from dental treatment, and no classification system allowing standardization and comparison of results is currently available. This study was designed to (a) analyze the results obtained from surgical treatment of complications resulting from dental procedures combining functional endoscopic sinus surgery (FESS) and an intraoral approach and (b) propose a new classification system and standardized treatment protocols for sinonasal complications resulting from dental procedures.

Methods

A total of 257 patients consecutively treated with FESS (136 in conjunction with oral surgery) were included in the study. Different clinical situations were integrated into a new classification system based on the pathogenesis and clinical aspects of each case, with the aim of identifying homogenous treatment groups. Results were evaluated for each class.

Results

Of the 257 patients, 254 were successfully treated with surgery performed according to the proposed protocols. Three of 257 patients required a second surgery, after which they completely recovered. Complications of implant and preimplant surgery (maxillary sinus floor elevation) showed longer recovery times.

Conclusion

The results obtained are very encouraging. The majority of patients (254/257; 98.8%) were successfully treated with the proposed protocols. These results seem to indicate that the rationalization of surgical treatment protocols according to the initial clinical situation may significantly improve the clinical outcome.

Displacement of Dental Implant Into the Submental Space After Surgical Integration

Osseointegrated dental implants are common and widely used to treat edentulism. Implant displacement into the maxillofacial spaces during surgery or after a period of use is a complication recognized in the literature. Foreign objects such as titanium dental implants in the maxillofacial region must be removed because they cause infection due to tissue reaction. In this report, the authors present the case of a patient whose dental implant slipped into the submental space after surgical integration and describe the surgical removal of the implant via an extraoral approach.

Endoscopic Removal of a Dental Implant From Maxillary Sinus

The displacement of a dental implant into the maxillary sinus during surgery or after a period of use is a complication defined in the dental implant clinical practice. This complication arises primarily from inadequate bone height and peri-implant infection. Specifically, foreign objects in the maxillary sinus can cause sinusitis via impaired mucociliary flow and foreign body reactions, so they must be removed. Caldwell-Luc, transnasal, and intraoral endoscopic sinus surgeries have all been used to remove such foreign bodies and lesions from maxillary sinuses. In this article, the authors present the case of a patient whose dental implant slipped into the right maxillary sinus after a period of use and describe the endoscopic removal of said implant via an intraoral approach. The endoscopic removal of the dental implant from the maxillary sinus proved to be a safe, reliable, and minimally invasive method.

Piezoelectric Trapezoidal Osteotomy for the Retrieval of a Displaced Dental Implant in the Osteoporotic Mandibular Body

A female patient in her mid-seventies was referred to our department for the removal of a displaced implant within the right posterior mandible. A trapezoidal window was made using a piezoelectric device. The implant was extracted, and the osteotomized window was replaced without fixation. Caution should be exercised during implant placement in patients with osteoporosis because of the risk of implant displacement. Displaced implants can be easily retrieved by piezoelectric trapezoidal osteotomy.

Transnasal Endoscopy Removal of Dislodged Dental Implant: A Case Report

Displacement of dental implants into the maxillary sinus is a rare complication. This article presents a case of displaced dental implant into maxillary sinus. Retrieval of the dental implant from left maxillary sinus was performed via endoscopic sinus surgery. This case highlighted a delayed referral of a 53-year-old male by a general dental practitioner for management of a dislodged dental implant into the left maxillary antrum. The implant was dislodged during placement of a healing abutment 4 months after implant insertion to replace missing 25. Cone beam computerized tomography revealed the displaced implant was located at the ostium of the left nose. A sudden change in sinonasal pressure when the patient took a deep breath during the procedure may have created a negative pressure and suction effect causing the implant to be dislodged and embedded at the ostium. In view of its position, a referral to an otorhinolaryngologist was made for endoscopic removal of the displaced implant. This case also highlighted the need for inter disciplinary cooperation in the management of such a complication for the best interest of the patients.

The removal of an implant beneath the optic canal by modified endoscopic-assisted sinus surgery

Displacement of dental implants into the maxillary sinus is one of the rare complications during the implant surgery. However, it is always possible that clinicians confront with this unexpected result and patients should be informed ahead of maxillary implant surgery. For clinicians, it is important to be aware of how to deal with the complication, because the migrated implant must be removed as early as possible. There have been several classical ways to approach the maxillary sinus, such as the Caldwell-Luc procedure and endoscopic sinus surgery and these methods still have been chosen by many surgeons although quite a lot of complications exist. In this study, the author introduced a new sinus approach technique, modified endoscopic-assisted sinus surgery (MESS) as an efficient, easy and less complication-inducing sinus approach. A clinical case was described where a displaced dental implant beneath the optic nerve was successfully removed by MESS. Furthermore, essential considerations to avoid medical litigation and maintain close rapport with the patients were discussed when dealing with the case of displaced implant in the maxillary sinus.

Removal of Long-Term Broken Roots Displaced Into the Maxillary Sinus by Endoscopic Assistant

PURPOSE

This report presented a patient with 2 long-term broken roots displaced in left maxillary sinus. The residual root fragments made the patient uncomfortable in both mind and body and interfered with prosthodontics work. The application of endoscope combined with piezoelectric device both helps in removing the broken roots successfully with minimally surgical injury and preserves the residual alveolar bone.

METHODS

Computed tomography scans and 3-dimensional reconstructions located the broken roots. A 1.0 cm × 1.5  cm rectangle bone window on anterolateral sinus wall was opened by a piezoelectric device to place the endoscope and forcep into sinus. Two broken roots could be observed clearly via a endoscopic screen. They were removed by a mini goblet forcep completely and efficiently. A whole bone lid was replaced with a biological membrane to help repair bone defect after removing procedure.

RESULTS

The operation is about 20 minutes with endoscope and piezoelectric device helped to save a lot of time and provided excellent visual surgical field. Main postoperative adverse effects were swelling, numbness, and temporal no-vitality for the first premolar (24). Three months later, computed tomography shows the Schneiderian membrane thinned to around 0.8  mm. The bone lid is on its position and starts to perform synostosis. The 24 tooth is still dysesthetic and needs time to recover.

CONCLUSIONS

Endoscopic surgery combined with a piezoelectric device has obvious advantage of minimizing surgical injury and providing excellent visibility of surgical field when removing long-term foreign bodies in maxillary sinus. It is efficient and protects the residual alveolar bone.

Extraordinary sneeze: Spontaneous transmaxillary-transnasal discharge of a migrated dental implant

This case report describes an extraordinary case of the spontaneous transmaxillary-transnasal discharge of a dental implant, which occurred during a sneeze. The patient was complained of symptoms of acute sinusitis. She underwent a computed tomography scan that revealed a dental implant dislocated in the maxillary sinus. Medical treatment based on antibiotics and mucolytics was administered to the patient in order to prepare her for endoscopic endonasal surgery. The implant was spontaneously discharged two days after during a sneeze. Mucociliary clearance in combination with a local osteolytic inflammatory process and mucolytics therapy are the likely causes of this unusual discharge.

Chronic Maxillary Sinusitis Caused by Denture Lining Material

We report a case of chronic maxillary sinusitis caused by denture lining material entering through an oroantral fistula after tooth extraction. The patient was an 80-year-old female who visited us with a complaint of pus discharge from the right posterior maxilla. She had extraction of the upper right second molar and had her upper denture relined with silicone lining material. The patient noticed swelling of the right cheek and purulent rhinorrhea 20 days before her first visit to our clinic. Oral examination showed an oroantral fistula with a diameter of 3 mm in the posterior alveolar ridge of the right maxilla. Computed tomography revealed a hyperdense foreign body in the right maxillary sinus and thickening of the mucosal lining. Under diagnosis of maxillary sinusitis caused by a foreign body, endoscopic maxillary surgery was performed simultaneously with the removal of the foreign body. The foreign body removed was 12 × 6 mm in size, oval in shape, light pink in color, and compatible with silicone denture lining material. During the follow-up it was observed that the oroantral fistula closed spontaneously after the removal of the foreign body. The maxillary sinus was in a good shape without recurrence of sinusitis seven months after surgery.

Using methylene blue as a marker to find and remove tiny metallic foreign bodies embedded in the soft tissues of children: A randomised controlled trial

BACKGROUND

Embedment of metallic foreign bodies in the soft tissues is commonly encountered in the emergency room. Most foreign bodies are easily removed, but removal is difficult if the foreign body is very small or deeply embedded.

OBJECTIVE

To determine the usefulness of methylene blue staining in the surgical removal of tiny metallic foreign bodies embedded in the soft tissue.

METHODS

This prospective study involved 41 children treated between May 2007 and May 2012. The patients were randomly divided into a methylene blue group and a control group. In the control group, foreign bodies were located using a C-arm and removed via direct incision. In the methylene blue group, foreign bodies were located using a C-arm, marked with an injection of methylene blue and then removed surgically. The clinical outcomes, complications, operation time, surgical success rate, incision length, frequency of C-arm use, and length and depth of the foreign body were compared between the two groups.

RESULTS

The surgical success rate was significantly higher in the methylene blue group. The average operation time was significantly shorter in the methylene blue group. The C-arm was used significantly less frequently in the methylene blue group than in the control group. The incision length was significantly shorter in the methylene blue group than in the control group.

CONCLUSIONS

Methylene blue staining facilitated the location and removal of tiny metallic foreign bodies from the soft tissue, and significantly reduced operation time, incision length and radiation exposure compared to the conventional method.

Removal of dental implant displaced into maxillary sinus by combination of endoscopically assisted and bone repositioning techniques: a case report

Background

Accidental displacement of a dental implant into the maxillary sinus is an infrequent although not uncommon complication encountered in dental clinical practice, with the main cause thought to be inadequate bone height in the posterior maxilla. We report a case of migration of a dental implant into the maxillary sinus, and discuss the benefits of its removal by a combination of endoscopically assisted and bone repositioning techniques.

Case presentation

A 35-year-old Japanese man with a partially edentulous maxilla underwent implant placement at a private clinic. Three months later, at the time of abutment connection, the implant at the site of his maxillary right first molar was accidentally pushed into the sinus. The hole on the alveolar ridge made for placement of the implant was small and far from the dislocated implant, thus access was achieved in a transoral manner via the frontal wall of his maxillary sinus with an endoscopic approach. Piezoelectric instruments were used to perform an osteotomy. The bone lid was removed, and the implant was identified using a rigid endoscope and removed with a surgical aspirator, followed by repositioning of the bony segment; the area was secured with an absorbable suture. Removal of migrated implants should be considered in order to prevent possible sinusal disease complications.

Conclusions

In the present case, removal of a dental implant displaced into the maxillary sinus by use of a combination of endoscopically assisted and bone repositioning techniques proved to be a safe and reliable procedure.

Displacement of Dental Implants Into the Maxillary Sinus: A Retrospective Study of Twenty-One Patients

BACKGROUND

One possible complication of implant surgery in the posterior maxilla is the displacement of implants into the maxillary sinus.

PURPOSE

To report on clinical and radiological findings and on biological, surgical, and biomechanical considerations in cases of implant displacement.

MATERIALS AND METHODS

This is a retrospective study of 21 patients referred to the Department of Head and Neck Surgery, Second University of Naples, due to implants displaced into the maxillary sinus. Patient, implant, and treatment data were collected, and 1-year follow-up was made.

RESULTS

A total of 24 displaced implants were diagnosed and surgically removed through an antrostomy in the lateral sinus wall. Implant displacement occurred after functional loading in only one case; in the remaining cases, displacement occurred either perioperatively or postoperatively prior to loading. Besides the displacement, eight patients suffered from maxillary sinusitis, treated with a Caldwell-Luc operation. Healing was uneventful for all patients, and no sinusitis relapse or late postoperative complication was present at 1-year follow-up.

CONCLUSIONS

It is reasonable to affirm that the major cause of displacement of implants is related, most of the time, to incorrect treatment planning and/or a poorly performed surgical procedure. When implant displacement occurs, the displaced foreign body has to be removed in order to avoid sinus pathology.

Implant over implant: an alternative method for solving malpositioned osseointegrated implants at the sinus floor

An implant was malpositioned and osseointegrated at the maxillary sinus floor with no complications. However, unexpected bone formation over the implant made the implant nonfunctional. Because the patient rejected the removal of the implant, it was left in place while another short implant was placed into the newly formed bone in approximately the same position as the old implant to restore the posterior maxillary tooth. Within 6 months, the new implant over the old asymptomatic implant was functional. Radiographs revealed osseointegration and stable periimplant marginal bone level with no signs of infection or inflammation.

Treatment of dental implant-related maxillary sinusitis with functional endoscopic sinus surgery in combination with an intra-oral approach

The present report describes the case of a patient who underwent maxillary sinusitis right after dental implant installation with sinus lifting. Computed tomography scan revealed a dental implant (#16) was protruded inside the right maxillary sinus and confirmed the obstruction of ostium. A symptom remission was gained with the dual approaches combined by functional endoscopic sinus surgery and an intra-oral approach. Fully recovered function and healing of sinus were identified after 10 months follow-up. We report the case of sinusitis caused by protrusion of implants with sinus floor lift procedures and propose that practitioners should be aware of the possible its complications and management.

Unusual sinonasal foreign body: presentation of three cases

Sinonasal foreign bodies are rare clinical entities. Their presence in the sinuses can originate complications, so their removal is always indicated. We present 3 cases of sinonasal foreign body, indicating their symptoms, imaging findings and surgical removal. Each patient was assessed with computerized tomography of the sinuses, rigid endoscopy, and then surgical removal. We confirmed the presence of the foreign bodies in all 3 cases and then performed a successful surgical removal by transnasal endoscopy. Sinonasal foreign bodies are infrequent entities that require surgical removal to prevent complications, with transnasal endoscopic surgery being the most commonly used surgical approach.

Maxillary sinusitis caused by dental implants extending into the maxillary sinus and the nasal cavities

This report describes the case of a patient who underwent osseointegrated dental implant placement. The implants were misplaced inside the nasal fossae and in the right maxillary sinus, causing chronic purulent sinusitis. CT scan without contrast showed signs of right maxillary sinusitis and confirmed the misplacement of four dental implants that surfaced into the nasal cavities. The imaging also revealed the presence of another implant that emerged inside the maxillary sinus. The patient underwent functional endoscopic sinus surgery with complete symptom remission at the long-term follow-up. We propose that sinusitis caused by protrusion of implants and by sinus floor lift procedures could share common physiopathological patterns and predisposing factors.

Endoscopic retrieval of dental implant from maxillary sinus

AIM

Minimally invasive method for retrieving displaced objects like implants from the maxillary antrum with minimal complications.

BACKGROUND

Minimal invasive endoscopic surgery has been developed for various indications in the craniomaxillofacial area.

CASE DESCRIPTION

In this article, a technique for endoscopic removal of a dental implant displaced into the maxillary sinus is presented. Access to the implant was achieved transorally via the canine fossa. The endoscopic surgical approach described was reliable and minimally invasive for removing dental materials displaced into the maxillary sinus.

CONCLUSION

Transantral endoscopic surgery is a reliable, minimally invasive method for retrieving displaced objects from the maxillary antrum with minimal complications.

Removal of a dental implant displaced into the maxillary sinus by means of the bone lid technique

Background. Rehabilitation of edentulous jaws with implant-supported prosthesis has become a common practice among oral surgeons in the last three decades. This therapy presents a very low incidence of complications. One of them is the displacement of dental implants into the maxillary sinus. Dental implants, such as any other foreign body into the maxillary sinus, should be removed in order to prevent sinusitis. Methods. In this paper, we report a case of dental implant migrated in the maxillary sinus and removed by means of the bone lid technique. Results and Conclusion. The migration of dental implants into the maxillary sinus is rarely reported. Migrated implants should be considered for removal in order to prevent possible sinusal diseases. The implant has been removed without any complications, confirming the bone lid technique to be safe and reliable.

Fixation tack penetration into the maxillary sinus: A case report of a guided bone regeneration procedure complication

Background:

Guided bone regeneration (GBR) is an established and predictable procedure used to obtain adequate alveolar bone for the placement of dental implants. Anatomical challenges, such as the proximity of the maxillary sinus, may lead to complications during a GBR procedure. The purpose of this report is to present a unique and hitherto unreported complication of a GBR procedure, i.e., the penetration of a titanium fixation tack into the maxillary sinus.

Case Report:

A unique GBR is presented, where a titanium tack penetrated the maxillary sinus with subsequent migration and loss. Attempts to locate the tack visually during the procedure were unsuccessful. The GBR procedure was aborted and dental radiographs were immediately obtained. The patient was completely asymptomatic during the healing period. Eight weeks later a cone beam computed tomography revealed a non-inflamed sinus with no pathology evident. However, the tack could not be visualized. An otolaryngology consultation was requested and the ensuing sinus endoscopy did not reveal any evidence of the penetrated tack. It is thought that the loose tack migrated completely out of the sinus through the nasal passage.

Conclusions:

The use of a pre-operative cone beam computed tomography (CBCT) would have allowed the clinician to assess the exact thickness of the lateral wall of the maxillary sinus and better determine the ideal placement location and/or the feasibility of using a fixation tack in the posterior upper jaw.

Accidental displacement and migration of endosseous implants into adjacent craniofacial structures: a review and update

Objectives: Accidental displacement of endosseous implants into the maxillary sinus is an unusual but potential complication in implantology procedures due to the special features of the posterior aspect of the maxillary bone; there is also a possibility of migration throughout the upper paranasal sinuses and adjacent structures. The aim of this paper is to review the published literature about accidental displacement and migration of dental implants into the maxillary sinus and other adjacent structures. Study Design: A review has been done based on a search in the main on-line medical databases looking for papers about migration of dental implants published in major oral surgery, periodontal, dental implant and ear-nose-throat journals, using the keywords “implant,” “migration,” “complication,” “foreign body” and “sinus.” Results: 24 articles showing displacement or migration to maxillary, ethmoid and sphenoid sinuses, orbit and cranial fossae, with different degrees of associated symptoms, were identified. Techniques found to solve these clinical issues include Cadwell-Luc approach, transoral endoscopy approach via canine fossae and transnasal functional endoscopy surgery. Conclusion: Before removing the foreign body, a correct diagnosis should be done in order to evaluate the functional status of the ostiomeatal complex and the degree of affectation of paranasal sinuses and other involved structures, determining the size and the exact location of the foreign body. After a complete diagnosis, an indicated procedure for every case would be decided.

Key words:Implant, oral surgery, foreign body, paranasal sinuses, displacement, migration.

Displacement of three dental implants into the maxillary sinus in two patients. Report of two cases

INTRODUCTION

Reconstruction of the posterior edentulous maxilla with dental implants has become a popular practice worldwide. However, the poor bone quality and quantity in this area is sometimes related with complications. Dental implant displacement into the maxillary sinus is a rare complication.

CASE REPORT

In the present paper, we present two patients with three implants displaced into the maxillary sinus. The implants were removed soon after their displacement, using the classic intraoral approach, through the anterior wall of the maxillary sinus. The operation was performed under local anesthesia for both of the patients. The postoperative course was uneventful for both of the patients without any wound dehiscence. Recovery remained uneventful, without any signs of postoperative sinusitis.

DISCUSSION

Implant displacement into the maxillary sinus is of rare occurrence and usually related to inadequate bone quality and quantity. Dental implants into the maxillary sinus usually act as foreign bodies and should be removed, to avoid the development of sinus complications. Removal of dental implants from the maxillary sinus can be performed either with functional endoscopic sinus surgery, or with intraoral operation through the anterior maxillary wall especially in fresh cases and in the presence of oroantral communication.

Chronic foreign body of the nasal cavity and sphenoid sinus: surgical implications

Chronic sinonasal foreign bodies present unique surgical challenges including tissue integration and anatomic migration. A patient with a history of multiple surgeries for cleft lip, palate, and nasal deformity presented with radiographic findings of a 4.3-cm linear foreign body traversing the nasal cavity and sphenoid sinus. Mucosalization and integration into the sphenoid rostrum were noted at the time of surgery. Endoscopic surgery techniques facilitated removal of the overlying mucosa and encasing bone, allowing successful surgical extraction. On inspection, the foreign body was consistent with a retained Kirschner wire. Potential pathophysiologic and management implications of this case are discussed.

Removal of a migrated dental implant from the maxillary sinus after 7 years: a case report

BACKGROUND

The accidental displacement of dental implants into the maxillary sinus is an infrequent but possible complication in dental clinical practice. The main cause of implant displacement is the inadequate bone height in the posterior maxilla. This event usually occurs during surgery, and it is more rarely reported in the post-operative period, especially with long-term follow-ups.

CASE REPORT

Here, a case of an implant migrated inside the maxillary sinus at the time of abutment connection and removed 7 years later is described.

DISCUSSION

Postoperative recovery was uneventful. To the author's best knowledge, this case represents the first report concerning migration of an oral implant into the maxillary sinus removed after 7 years.