Dental displacement into the sinus: Radiological diagnosis and targeted surgical strategy

Title: Dental displacement into the sinus: Radiological diagnosis and targeted surgical strategy

Abstract:

Introduction: The displacement of a dental element into the maxillary sinus is a rare but well-documented complication of dental procedures, particularly during poorly controlled tooth extractions or endodontic treatments. Proper management is essential to prevent infectious or functional complications.
Materials and Methods: We report two clinical cases
•Case 1: Displacement of a root fragment of the maxillary right second molar into the sinus during extraction, leading to an oroantral communication and chronic sinusitis. Initial medical treatment was followed by delayed surgical intervention.
• Case 2: Accidental projection of endodontic filling material into the maxillary sinus during a dental procedure.
In both cases, minimally invasive surgical management was performed via a Caldwell-Luc approach assisted by endoscopy, allowing the successful removal of the foreign body.
Results : Postoperative outcomes were favorable in both patients, with resolution of clinical and radiological signs of infection. No recurrence or postoperative complications were observed during the 6-month follow-up.
Discussion : These cases highlight the importance of accurate diagnostic evaluation, especially through three-dimensional imaging (cone beam CT), to precisely localize the foreign body and guide the therapeutic approach. Minimally invasive endoscopic access is an effective and well-tolerated alternative to conventional surgery.
Conclusion : Prevention remains key. In cases of foreign body displacement into the maxillary sinus, a well-adapted diagnostic and therapeutic strategy, combining CBCT imaging and minimally invasive surgery, ensures optimal management and reduces the risk of complications.

Biography:

Dr. Farouk Ghezal earned his Doctor of Dental Surgery (DDS) degree in November 2002. He subsequently obtained a Certificate of Assistant in Oral Pathology and Surgery in December 2006, followed by successful completion of the Hospital-University Assistant Professor Entrance Examination in June 2007. In January 2018, he was awarded a Specialized Medical Studies Diploma in Oral Surgery. Ghezal advanced through academic ranks by passing the Hospital-University Associate Professor Competitive Examination (Maître de Conférences) in October 2019, and most recently, he achieved the position of Full Professor after passing the Hospital-University Full Professor Competitive Examination in June 2023.