Maxillary sinus implant removal: modified Caldwell-Luc technique

The installation of immediate implants after tooth extractions is becoming a common practice in the dental clinic. During this surgical procedure, complications such as the displacement of dental implants into the maxillary sinus may occur due to the close relationship between the floor of the maxillary sinus and the upper teeth. In these cases, treatment consists of removing the implant that has been displaced in order to prevent future complications such as maxillary sinusitis and oroantral fistula. The present study aims to present a clinical case in which the removal of the maxillary sinus implant was performed using the modified Caldwell-Luc Technique. The patient sought a private clinic for extraction of the left upper second molar and oral rehabilitation with implants. Even with little bone height between the floor of the maxillary sinus and the crest of the alveolar ridge, the professional opted for immediate implant installation after extraction, but when returning after 90 days, the implant had moved into the sinus. The implant was removed using the modified Caldwell-Luc technique, which consists of making a bone window in the lateral wall of the maxillary sinus, removing the fragment, replacing the bone window, and suturing the previously folded flap. Therefore, it can be concluded that the Caldwell-Luc technique benefits the closure of the bone defect, avoids fistulas and the area of fibrosis in the membrane, being an effective and viable alternative for removing implants in the maxillary sinus region.

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Chronic Maxillary Sinusitis Caused by Denture Lining Material

The Open Dentistry Journal ◽

10.2174/1874210601610010261 ◽

2016 ◽

Vol 10 (1) ◽

pp. 261-267

Author(s):

Tsutomu Sugiura ◽

Kazuhiko Yamamoto ◽

Chie Nakashima ◽

Kazuhiro Murakami ◽

Yumiko Matsusue ◽

...

Keyword(s):

Foreign Body ◽

Maxillary Sinus ◽

Maxillary Sinusitis ◽

Second Molar ◽

Oroantral Fistula ◽

Good Shape ◽

Posterior Maxilla ◽

Lining Material ◽

Chronic Maxillary Sinusitis ◽

The Right

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.

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Maxillary sinusitis of odontogenic origin in relation to ectopic 2.8 associated with follicular dentigerous cyst: Combined transnasal and oral endoscopic approach, a case report

Global Dentistry ◽

10.36879/god.20.000131 ◽

2020 ◽

pp. 1-3

Keyword(s):

Oral Cavity ◽

Maxillary Sinus ◽

Maxillary Sinusitis ◽

Dentigerous Cyst ◽

Amorphous Material ◽

Fungal Spores ◽

Lateral Wall ◽

Healing Time ◽

Vestibular Cortex ◽

Follicular Cyst

Purpose of the study: To describe the management of orosinusal pathology by combined transnasal endoscopy and oral combined. Methods: The 54-year-old patient underwent a dental and otolaryngological evaluation for left odontogenic maxillary sinusitis in relation to plausible dental follicular cyst of ectopic element 2.8. The symptoms reported at the time of access to the hospital were nasal obstruction and nocturnal rhonchopathy. To the ENT evaluation in videorinoscopy with rigid optics, complex deviation of the nasal septum was relevated with not any evident formations or pathological secretions. While on inspection of the oral cavity the mucous membranes appeared unscathed. Alveolus of 1.6 previosuly extracted was evident. The radiological examination, facial CT, revealed the left maxillary sinus almost completely occupied by a cystic appearance, with thin calcified walls and homogeneous content that has a dental element, probably the 2.8, which fenestrates the vestibular cortex of the lateral wall of the maxillary sinus. This lesion erodes the medial wall of the sinus, obliterating the ostio-meatal complex and imprinting the ipsilateral ethmoidal cells. Biohumoral tests showed normal coagulation parameters, indices of renal function, liver and ionemia. The patient under general anesthesia and oral intubation with a combined intervention of the left anterior FESS, intrasulcular flap from dental elements 2.7 to 2.3 with mesial releasing incision, moderate osteotomy, ectopic 2.8 extraction and enucleation of the cystic lesion with simultaneous closure of the orosinusal communication with advancement of the Bichat adipose bolla and closure by first intention. In the same session, the ENT moment is carried out trans nasally for total left uncinectomy, medium antrostomy with the union of the natural ostium and the accessory ostium. Bilateral lower turbinoplasty with bipolar forceps. The patient was then controlled after 15 days and six months, showing good healing and no signs of recurrence at the rhinoscopic check on the physical examination of the oral cavity. Results: based on the clinical and radiological aspect, the diagnosis of a follicular dentigerous cyst (WHO 2017) covered by a multi-layered non-keratinized paving epithelium, with moderate chronic inflammation, including gigantocellular and cholesteric crystals, is reached from the microbiological and histological examination. Necrotic amorphous material coexists including rare hyphae and fungal spores, with therefore mycotic and actinomycotic super infection. Conclusions: The combined oral and nasal intervention, allowed by the collaboration between the oral surgeon and ENT, has made it possible to shorten the healing time and to resolve the pathology without any sign of recurrence.

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ROTAÇÃO DE RETALHO PALATINO COMO ALTERNATIVA DE TRATAMENTO PARA FÍSTULA BUCOSSINUSAL

International Journal of Science Dentistry ◽

10.22409/ijosd.v0i53.39868 ◽

2019 ◽

Author(s):

Eugênio Braz Rodrigues Arantes

Keyword(s):

Maxillary Sinus ◽

Oral Surgery ◽

Maxillary Sinusitis ◽

Direct Path ◽

Surgical Time ◽

Oroantral Fistula ◽

Common Causes ◽

Anatomical Relationship ◽

Relationship Of ◽

Keratinized Mucosa

ResumoA fístula ou comunicação bucossinusal consiste na formação de um trajeto direto entre a cavidade oral e o seio maxilar diagnosticada tardiamente após epitelização da mucosa formando um canal bucossinusal permanente. Na maioria das vezes, essa complicação ocorre em função da relação anatômica do seio maxilar intimamente relacionado com o ápice das raízes dos dentes superiores posteriores. Procedimentos cirúrgicos inadequados relacionados à exodontia dos elementos dentários envolvidos ou extensa pneumatização do seio maxilar podem ser as causas mais comuns dessa patologia. O objetivo do presente trabalho é apresentar um relato de caso clínico de uma fístula bucossinusal pós exodontia e não corrigida imediatamente, tratada através de retalho mucoso palatino vascularizado e rotacionado para fechamento primário. A técnica do retalho palatino mostrou-se uma opção favorável para o fechamento do defeito sinusal em um único tempo cirúrgico, preservando a mucosa queratinizada e a anatomia do sulco vestibular.Palavras-chave: Seio maxilar, sinusite maxilar, fístula bucoantral, cirurgia bucal.AbstractThe bucosinusal fistula or communication consists in the formation of a direct path between the oral cavity and the maxillary sinus diagnosed late after epithelialization of the mucosa forming a permanent bucosinusal canal. Most often, this complication occurs due to the anatomical relationship of the maxillary sinus closely related to the apex of the roots of the posterior superior teeth. Inadequate surgical procedures related to the extraction of the involved dental elements or extensive pneumatization of the maxillary sinus may be the most common causes of this pathology. The aim of the present study is to present a case report of an immediately uncorrected post-extraction bucosinusal fistula treated with a vascularized palatine mucous flap and rotated for primary closure. The palatal flap technique proved to be a favorable option for closing the sinus defect in a single surgical time, preserving the keratinized mucosa and the buccal sulcus anatomy.Key-words: Maxillary sinus, maxillary sinusitis, oroantral fistula, oral surgery.

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Chronic Maxillary Sinusitis Associated with an Unusual Foreign Body: A Case Report

Case Reports in Otolaryngology ◽

10.1155/2012/903714 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Yunus Feyyat Şahin ◽

Togay Muderris ◽

Sami Bercin ◽

Ergun Sevil ◽

Muzaffer Kırıs

Keyword(s):

Foreign Body ◽

Maxillary Sinus ◽

Foreign Bodies ◽

Maxillary Sinusitis ◽

Surgical Removal ◽

Oroantral Fistula ◽

Unusual Foreign Body ◽

Dental Procedures ◽

Chronic Maxillary Sinusitis ◽

Left Maxillary Sinus

Foreign bodies in maxillary sinuses are unusual clinical conditions, and they can cause chronic sinusitis by mucosal irritation. Most cases of foreign bodies in maxillary sinus are related to iatrogenic dental manipulation and only a few cases with non-dental origin are reported. Oroantral fistulas secondary to dental procedures are the most common way of insertion. Treatment is surgical removal of the foreign body either endoscopically or with a combined approach, with Caldwell-Luc procedure if endoscopic approach is inadequate for visualisation. In this case, we present a 24-year-old male patient with unilateral chronic maxillary sinusitis due to a wooden toothpick in left maxillary sinus. The patient had a history of upper second premolar tooth extraction. CT scan revealed sinus opacification with presence of a foreign body in left maxillary sinus extending from the floor of the sinus to the orbital base. The foreign body, a wooden toothpick, was removed with Caldwell-Luc procedure since it was impossible to remove the toothpick endoscopically. There was no obvious oroantral fistula in the time of surgery, but the position of the toothpick made us to think that it was inserted through a previously healed fistula, willingly or accidentally.

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Characteristics of Chronic Maxillary Sinusitis in Patients With a History of Long-term Bisphosphonate Use

American Journal of Rhinology and Allergy ◽

10.1177/1945892419847109 ◽

2019 ◽

Vol 33 (5) ◽

pp. 500-506 ◽

Cited By ~ 1

Author(s):

Chi Sang Hwang ◽

Chunui Lee ◽

Hee Sung Chae ◽

Chun Han ◽

Hyun Woo Yang ◽

...

Keyword(s):

Maxillary Sinus ◽

Chronic Rhinosinusitis ◽

Single Photon ◽

Maxillary Sinusitis ◽

Photon Emission ◽

Clinical Manifestations ◽

Clinical Appearance ◽

Oroantral Fistula ◽

History Of

Background Bisphosphonates are widely used as bone stabilizers, which can cause major side effects including bisphosphonate-related osteonecrosis of the jaw (BRONJ) that occurs more frequently in the mandible. Consequently, there is a need for a detailed investigation of BRONJ of the maxilla and, in particular, of involvement of the maxillary sinus. Objective Our aim was to evaluate the characteristic radiologic and clinical manifestations in patients with maxillary sinusitis and a history of long-term bisphosphonate use. Methods Between January 2015 and July 2018, 55 patients with symptoms consistent with chronic rhinosinusitis who underwent a paranasal sinus computed tomography (CT) and had a history of >12 months of bisphosphonate therapy were included in the analysis. Results Radiologically and clinically evident chronic rhinosinusitis was noted in 24 of the 55 patients, of whom more than half (14/24, 58.3%) had BRONJ. The CT studies demonstrated that the maxillary sinus was involved in all 24 patients, characterized by unilateral involvement (70.8%) and bony remodeling in the posterior maxillary region (90.5%). The evidence of osteitis on CT and/or single-photon emission CT was observed in the majority of cases (19/21, 90.5%) and 12 patients (50.0%) had oroantral fistula. However, there were no differences in the clinical appearance of the diseases with respect to the radiologic aspects. Conclusions Besides its well-known effects on the mandible, long-term bisphosphonate use can also affect the maxillary sinus, with typical clinical and radiological manifestations.

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Maxillary Breathing through Side Window Using Electric Piez and Immediate Placement of Implant

Journal of Oral & Dental Health ◽

10.33140/jodh/02/02/00001 ◽

2018 ◽

Vol 2 (2) ◽

Keyword(s):

Maxillary Sinus ◽

Surgical Planning ◽

Clinical Case ◽

Sinus Lift ◽

Oral Rehabilitation ◽

Side Window ◽

Implant Placement ◽

Immediate Placement ◽

Immediate Implant ◽

Bone Height

The loss of a dental organ generates bony phenomena that decrease the height and thickness of the residual bone. The bone height that exists between the alveolar ridge and the floor of the maxillary sinus plays a fundamental role in the surgical planning of an implant, the use of bone grafts by different techniques of approach allows to increase the bone height favoring the placement of implants and consequently the oral rehabilitation of the patient, the use of the electric piezo offers benefits for the approach of the maxillary sinus. We present a clinical case of a 48-year-old male patient who came for rehabilitation of the edentulous area between teeth 25 and 27 with a deficient bone height of 4.27mm in relation to the maxillary sinus. Maxillary sinus lift is performed through a side window using an electric piezo with immediate implant placement and bone graft.

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Reversible Endoscopic Medial Maxillectomy: Endonasal Approach to Diseases of the Maxillary Sinus

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1701267 ◽

2020 ◽

Vol 24 (02) ◽

pp. e247-e252 ◽

Cited By ~ 1

Author(s):

Miguel Soares Tepedino ◽

Ana Clara Miotello Ferrão ◽

Hana Caroline Morais Higa ◽

Leonardo Lopes Balsalobre Filho ◽

Enrique Iturriaga ◽

...

Keyword(s):

Maxillary Sinus ◽

Maxillary Sinusitis ◽

Case Series ◽

Inferior Turbinate ◽

Lateral Wall ◽

Nasolacrimal Duct ◽

Sinus Disease ◽

Patient Series ◽

Medial Maxillectomy ◽

Maxillary Diseases

Abstract Introduction The endoscopic access has reduced the morbidity associated with external approaches in diseases of the maxillary sinus. A reversible endoscopic medial maxillectomy (REMM) is presented as an alternative for treatment of benign maxillary diseases. Objective To describe the REMM technique and report four cases of patients with benign maxillary sinus conditions treated through this approach. Methods The present study was divided into two parts: anatomical and case series. Two cadaveric dissections confirmed the feasibility of the REMM approach. The same technique was performed on four consecutive patients with benign maxillary sinus disease. Results The cadaveric dissections confirmed wide exposure to the maxillary cavity, preserving the anatomy of the maxillary sinus. In the patient series, one patient presented with an antrochoanal polyp, one had a silent sinus syndrome, one had a chronic maxillary sinusitis secondary to a gunshot, and the last one had an inverted papilloma in the maxillary sinus. In all of the cases, the REMM approach provided excellent access and adequate resection, as well as preservation of the inferior turbinate, nasolacrimal duct, and lateral wall of the nose (including its osteomucosal component). Finally, all of the patients had an uneventful postoperative course. Conclusion The REMM technique is an excellent surgical approach to benign conditions of the maxillary sinus. It has few limitations and appears to be associated with less morbidity than conventional techniques.

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Odontogenic Maxillary Sinusitis: Therapeutic Management of Cases with Oroantral Fistulae

Sinusitis ◽

10.3390/sinusitis5010006 ◽

2021 ◽

Vol 5 (1) ◽

pp. 53-58

Author(s):

Yasutaka Yun ◽

Masao Yagi ◽

Tomofumi Sakagami ◽

Shunsuke Sawada ◽

Yuka Kojima ◽

...

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Maxillary Sinus ◽

Endoscopic Sinus Surgery ◽

Surgical Intervention ◽

Maxillary Sinusitis ◽

Sinus Surgery ◽

Fistula Closure ◽

Treatment Resistant ◽

Oroantral Fistula

Odontogenic maxillary sinusitis (OMS) is a disease in which inflammation from the teeth extend into the maxillary sinus, causing symptoms of unilateral sinusitis. OMS can recur, with some being resistant to antibiotics. In intractable cases, exodontia and endoscopic sinus surgery (ESS) are necessary treatments. Here we report our analysis on the indications for surgical intervention in cases diagnosed with and treated as OMS. We retrospectively examined 186 patients who were diagnosed with sinusitis on a computed tomography (CT) scan. For cases diagnosed with OMS, the site of the causative tooth and the presence or absence of oroantral fistula to the maxillary sinus was examined. In addition, we analyzed the therapeutic efficacy of the initial treatment of antibiotics, and what the indications were for ESS. Among the patients examined, OMS was diagnosed in 44 cases (23.6%). In 14 out of 20 cases that underwent a post-medical treatment CT scan, OMS found to be treatment-resistant. Of these 14 cases, 12 (88%) had oroantral fistulae to the maxillary sinus. In all cases where exodontia, fistula closure surgery, and endoscopic sinus surgery (ESS) were performed, the fistula disappeared and the shadow of inflammation in the paranasal sinus improved. In OMS with oroantral fistula, ESS, exodontia, and fistula closure should be recommended over medication such as macrolide therapy.

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Microbial landscape and immune status in maxillary sinusitis of stomatogenic origin

Medicni perspektivi (Medical perspectives) ◽

10.26641/2307-0404.2021.3.242157 ◽

2021 ◽

Vol 26 (3) ◽

pp. 145-151

Author(s):

I.V. Kovach ◽

S.D. Varzhapetian ◽

Kh.A. Bunyatyan ◽

O.E. Reyzvikh ◽

A.A. Babenya ◽

...

Keyword(s):

Oral Cavity ◽

Maxillary Sinus ◽

Maxillary Sinusitis ◽

Venous Blood ◽

Allergic Sensitization ◽

Microbial Flora ◽

Total Serum ◽

Gram Positive ◽

Oroantral Fistula ◽

Gram Positive Cocci

Oroanthral fistula (anastomosis) is an element preventing the restoration of homeostasis in the maxillary sinus due to the constant flow of microbes from the oral cavity. It is also contributes to frequent exacerbations of maxillary sinusitis. Saprophytic gram-positive cocci and fungi of the oral cavity are dominating representatives of the microbial flora in the maxillary sinus. As the result of research, we found that in the case of maxillary sinusitis with oroantral fistula fungi made up 25.0% of microbiota, gram-positive bacteria – 41.7%, gram-negative bacteria – 33.3%. Gram-positive cocci from the Staphylococcus genus (Staphylococcus aureus and Staphylococcus epidermidis) and fungi (Candida albicans) comprised the biggest proportion of microbial flora that 33.3% and 16.7%, respectively. Slightly decreased levels of monocytes in venous blood was noted in 69.2% of patients. The average value of total serum IgE in group with oroantal fistula was 226.2 (70.4) IU/ml, the result exceeded normal limits almost in 2.26 times. Large circulating immune complexes (CICs) were normal in all patients in the group with iatrogenic maxillary sinusitis. The average lavels of small size CICs was 170.2 (4.23) ОU, which is in 1.06 times higher the upper limit of the norm (160 ОU). Elevated levels of total Ig E in serum of patients with oroanthral fistula indicates allergic sensitization. The detection of increased levels of CICs with small and medium sizes in serum may indicate a susceptibility of this category of patients to the development of immunopathological reactions.

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An endoscopic study on the prevalence of the accessory maxillary ostium in chronic sinusitis patients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195211 ◽

2019 ◽

Vol 6 (1) ◽

pp. 40

Author(s):

Ramesh Varadharajan ◽

Swara Sahithya ◽

Ranjitha Venkatesan ◽

Agaman Gunasekaran ◽

Sneha Suresh

Keyword(s):

Maxillary Sinus ◽

Paranasal Sinuses ◽

Chronic Sinusitis ◽

Maxillary Sinusitis ◽

Lateral Wall ◽

Nasal Endoscopy ◽

Nasal Sinus ◽

X Ray ◽

Chronic Maxillary Sinusitis ◽

The Common

Background: Chronic maxillary sinusitis is one of the common ENT problems. Accessory maxillary ostium (AMO) has been postulated in many publications to play a role in the development of chronic maxillary sinusitis. AMO is found in the medial wall of maxillary sinus and located in the lateral wall of the nose. It’s been frequently identified in the routine nasal endoscopy. The variations in the location of AMO have been evaluated by nasal endoscopy in live subjects or through cadaver dissections by many authors. This live study is conducted to identify the prevalence of AMO during nasal endoscopic evaluation of chronic sinusitis patients.Methods: 52 adult patients with symptoms of chronic sinusitis attending the ENT outpatient department were selected and subjected to X-ray of the paranasal sinuses and laboratory tests. Nasal endoscopy was done in all patients to identify the presence and location of the AMO and the results presented. Results: In the 52 patients studied the X-ray of the paranasal sinuses showed positive signs of sinusitis in 32 patients (61.5%). During nasal endoscopy in those 32 patients AMO was identified in 20 patients (62.5%).Conclusions: In patients presenting with symptoms of chronic sinusitis, apart from routine X-ray of the para nasal sinus, identification of the AMO during nasal endoscopy provides an additional evidence of obstruction of the natural ostia of the maxillary sinus. This will be valuable information to the surgeon who is contemplating on a surgical treatment to manage the chronic sinusitis.

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