Removal of a migrated dental implant from a maxillary sinus through an intraoral approach: a case report

Abstract

Background: The replacement of maxillary posterior teeth often challenges the clinician due to bone resorption after dental exodontia and low bone quality. Currently, attempts are being made to shorten treatment times by pla cing implants simultaneously to sinus lift procedures in borderline cases, which can lead to complications such as displacement of implants into the maxillary sinus. Clinical Case: a 54-year-old patient who was planned for complete rehabilitation of the maxilla through a fixed implant-supported prosthesis on 6 implants. At the level of the 3rd sextant, a sinus lift was performed with a lateral window approach (Caldwell-Luc type) and the simultaneous placement of two implants, one of which migrated into the sinus. The implant was displaced after 4 months when the second stage (uncovering) implant surgery was performed for the connection of the healing abutments. The implant was removed a week after the migration, since it had moved to the tuberosity area in the sinus and the lateral window had been performed in a more mesial posi tion, so the patient was recommended to sleep on the right side to achieve the displacement of the implant to a more favourable area, removing it after a week through the same approach. Discussion: Surgical strategies for the removal of a migrated implant are essentially divided into two main approa ches: endoscopic transoral and endoscopic transnasal (and combined). Conclusions: In case of intra-operative migration of the implant into the sinus, it is recommended to remove it as soon as possible to avoid a possible sinus pathology of iatrogenic origin.