Migrating Dental Implants Into the Maxillary Sinus; Evaluation of Different Direct Trans-Oral Surgical Approaches
Background: Dental implant surgery in atrophied maxilla has many risks, in some patients simultaneous sinus lifting with implant placement must be performed to increase the chances of successful implant which can cause implant migration. The aim of this study was to illustrate different surgical approaches to remove displaced dental implants into the maxillary sinus. Methods: Eleven patients were diagnosed with implant migration into the maxillary sinus. Radiographs were taken to identify the
... n to identify the exact location of these implants which showed that they can be displaced in four anatomical area: sinus floor above the alveolar bone, near the junction of the sinus and nasal floor, near the floor of the orbit, and the most posterior aspect the sinus. The surgical removal was performed through four different trans-oral approaches depending on the location of the displaced implant. The surgical challenges, duration of surgery and postoperative complications were reported.Results: The least challenging surgical intervention was noted when removing the displaced implants from the floor of the sinus. More challenges were experienced during the surgical removal of anteriorly displaced implants near the nasal cavity using the Caldwell-Luc technique (anterior window) with noted difficulty to differentiate between the nasal cavity and maxillary sinus. Implant displacement into the maxillary sinus roof near the orbital floor can be technically challenging due to surgical access and the proximity of vital anatomical structures. Bleeding from the pterygoid venous plexus was profound with posterior lateral approach. Discussion: The choice of the appropriate surgical approach to retrieve displaced dental implants into the maxillary sinus depends on the implant's location and the surrounding vital anatomical structures.