Clinical progress of teeth and implant displaced into the maxillary sinus : retrospective clinical study

Abstract

Because of the unique anatomical characteristics of the maxillary sinus, a tooth or implant may be accidentally displaced into the maxillary sinus for various reasons. The medical records, including symptoms, clinical examinations, a description of surgery and radiographs, were reviewed for 19 patients who were treated for the displacement of a tooth and implants into the maxillary sinus, between 2003 and 2015. Sixteen cases (84%) were implant displacement, while three other cases (16%) involved tooth displacement. Eleven cases (57.9%) were asymptomatic, while eight cases (42.1%) displayed symptoms. Psychological stress and nasal obstruction were the most common signs and symptoms, followed by nasal discharge, pain, and purulent discharge. Attempts at removal of the displaced material were made in 14 out of 19 (74%) cases; 5 patients (26%) were observed with using antibiotics. For removal, a majority of patients underwent surgery with the Caldwell-Luc approach while using general anesthesia. All of the symptoms disappeared after removing the displaced material. In these cases, clinicians should perform thorough assessments of the local anatomy using radiography prior to treatment. The appropriate healing period and type of treatment should be selected based the patient’s bone quality and bone mass, while avoiding an excessive use of instruments.