Bilateral ectopic third molar in the maxillary sinuses associated with dentigerous cyst: a case report

A dentigerous cyst is an epithelial-lined odontogenic cyst formed by an accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla and the most involved teeth are maxillary canines and maxillary third molar. Dentigerous cysts often displace the related tooth into an ectopic position. In the maxilla when the cyst expands into the sinus, usually causes total or partial occupation of the sinus cavity and can extend to the nose. We report a rare case of a 24-year-old female with bilateral maxillary third molars inside the maxillary sinuses attached to a dentigerous cyst and treated with a minimally invasive endoscopic surgery through the middle meatal meatotomy.

Modified Endoscopic-Assisted Approach for Removal of Ectopic Third Molar in the Maxillary Sinus

This case series describes an alternative approach for removing ectopically erupted tooth in the maxillary sinus using an improved endoscopic approach known as modified endoscopic-assisted sinus surgery (MESS). We reviewed medical charts and radiographs of patients who underwent surgical removal of an ectopic tooth in the maxillary sinus using MESS. The surgical technique consisted of creating a bony window in the maxillary sinus wall with a pre-adapted microplate, which was repositioned after the tooth was removed. For all the patients included in this study, there were no postoperative complications clinically and radiographically. At the time of microplate removal, satisfactory bone regeneration was observed around the bony window margins of the maxillary sinus wall. MESS is an effective technique that modifies and integrates the techniques of the conventional Caldwell-Luc procedure (CLP) and functional endoscopic sinus surgery (FESS) and can be used to remove ectopic tooth in the maxillary sinus by avoiding the risk of postoperative sinus-related complications.

Intra-sinus complex odontoma management simultaneously to oroantral communication closure: Why remove it?

The oroantral communication is considered one of the most frequent complications in oral surgery, especially in extractions of posterior teeth in the maxilla, treatment of cystic lesions, neoplasms, osteomyelitis and trauma in the region of the maxillary sinus, forming fistulas. However, ectopic third molar and lesions such as odontomas are rarely found simultaneously in the maxillary sinus. This report shows a successful treatment performed in a specific case of oroantral communication, associated to an underdiagnosed complex odontoma and an impacted ectopic third molar into the maxillary sinus and discuss the requirement of intervention. The treatment strategy involved clinical and surgical management through the oroantral communication, avoiding additional bone access to the maxillary sinus. This proposal presented a satisfactory result, and at six months after surgery, the patient has an excellent evolution, proving to be a successful strategy.

Remoção cirúrgica de terceiro molar ectópico em seio maxilar – relato de caso

The maxillary sinus is a pneumatic space that, when inside it contains foreign bodies, can trigger infections or inflammations of different severities, causing the appearance of cysts, tumors or the development of chronic sinusitis. Imaging is essential for the correct diagnosis of the case, as well as surgical planning for the removal of the foreign body. The present work aims to describe a clinical-surgical case of a patient with an ectopic third molar in the maxillary sinus, emphasizing the clinical, radiographic characteristics, therapeutic conduct and surgical technique, as well as showing the importance of theoretical and practical knowledge regarding the subject. A 49-year-old female patient attended the university’s dental clinic for surgical removal using the Caldwell-Luc technique of the ectopic upper third molar in the left maxillary sinus. The surgical removal of the ectopic element in the maxillary sinus was effective in the case presented, preventing the patient from future pathologies that could affect the sinus, as well as the symptomatological reduction of sinusitis.