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. 2022 Jan-Jun;12(1):33-38.
doi: 10.4103/ams.ams_190_21. Epub 2022 Aug 16.

Foreign Bodies of Dental Iatrogenic Origin Displaced in the Maxillary Sinus - A Safety and Efficacy Analysis of a Retrospective Study

Ioannis Tilaveridis  1 , Anatoli Stefanidou  1 , Athanassios Kyrgidis  1 , Stavros Tilaveridis  1 , Sofia Tilaveridou  1 , Lambros Zouloumis  1
Affiliations

Foreign Bodies of Dental Iatrogenic Origin Displaced in the Maxillary Sinus - A Safety and Efficacy Analysis of a Retrospective Study

Ioannis Tilaveridis et al. Ann Maxillofac Surg. 2022 Jan-Jun.

Abstract

Introduction: Foreign bodies (FB) of the paranasal sinuses are an uncommon clinical entities with the maxillary sinuses being those most frequently affected. According to the literature, 60% of paranasal sinus FB are of iatrogenic origin, while 25% are of traumatic origin. This article aims to present an iatrogenic origin series of cases of FB displaced or projecting into the maxillary sinus.

Materials and methods: In this retrospective study, the presence of the foreign body was revealed with radiologic methods and confirmed during the operation with macroscopic or later with histopathologic examination. All cases were treated with osteoplasty with vascularised pedicled bone flap or through minimally invasive intraoral procedure.

Results: A total of 27 patients were included in our study, 14 men and 13 women. The age range was 18-65 years with mean age of 46.14 (standard deviation = 10.35) years. Foreign body was displaced fragments of teeth in 11 patients (40.27%), complete teeth in four patients (14.81%), dental implants in five patients (18.51%), dental impression material in 2 cases (7,40%), gutta percha cone in two patients (7.40%), endodontic sealer associated with aspergillosis in two patients (7.40%), and dental burr in one patient (3.7%). The time between dental foreign body displacement and the surgical intervention for its removal was critical for the occurrence of sinusitis. All operated patients remained asymptomatic during a follow-up of at least 1 year.

Discussion: Prompt intervention for removal of FB eliminates the risk for chronic inflammation of the affected maxillary sinus and reduces the odds for sequelae.

Keywords: Dental implants; foreign bodies; maxillary sinus; sinusitis; tooth roots.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Plain radiographic view sinus X-ray showing displacement of the left maxillary third molar into the sinus. (b) Transverse section of computed tomography confirms the displacement of the third molar into the left maxillary sinus
Figure 2
Figure 2
Intraoperative view of case with impression material displaced into the right maxillary sinus
Figure 3
Figure 3
(a) A part of orthopantomogram showing the presence of gutta percha cone of endodontically treated maxillary second molar projecting far away from the apex of the tooth root into the maxillary sinus (b) Transverse section of computed tomography from the same patient showing the exact position of the foreign material into the right maxillary sinus
Figure 4
Figure 4
A straight burr impinged into the left maxillary sinus
Figure 5
Figure 5
(a). A tooth root displaced into the right maxillary sinus is obvious in orthopantomogram. (b). A coronal section of computed tomography confirms the exact position of the tooth root. (c). Intraoral osteoplasty for access the right maxillary sinus. (d). Removal of the foreign body
Figure 6
Figure 6
(a) Dental implant displaced into the left maxillary sinus. (b) Intraoral removal of the displaced implant
See this image and copyright information in PMC

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