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.