Accidental displacement and migration of endosseous implants into adjacent craniofacial structures: A review and update

A Gonzalez-Garcia,P Bullon,J Gonzalez-Garcia,M Diniz-Freitas,A Garcia-Garcia

doi:10.4317/medoral.18032

Abstract

Objectives: Accidental displacement of endosseous implants into the maxillary sinus is an unusual but potential complication in implantology procedures due to the special features of the posterior aspect of the maxillary bone; there is also a possibility of migration throughout the upper paranasal sinuses and adjacent structures. The aim of this paper is to review the published literature about accidental displacement and migration of dental implants into the maxillary sinus and other adjacent structures. Study Design: A review has been done based on a search in the main on-line medical databases looking for papers about migration of dental implants published in major oral surgery, periodontal, dental implant and ear-nose-throat journals, using the keywords “implant,” “migration,” “complication,” “foreign body” and “sinus.” Results: 24 articles showing displacement or migration to maxillary, ethmoid and sphenoid sinuses, orbit and cranial fossae, with different degrees of associated symptoms, were identified. Techniques found to solve these clinical issues include Cadwell-Luc approach, transoral endoscopy approach via canine fossae and transnasal functional endoscopy surgery. Conclusion: Before removing the foreign body, a correct diagnosis should be done in order to evaluate the functional status of the ostiomeatal complex and the degree of affectation of paranasal sinuses and other involved structures, determining the size and the exact location of the foreign body. After a complete diagnosis, an indicated procedure for every case would be decided. Key words:Implant, oral surgery, foreign body, paranasal sinuses, displacement, migration.

Highlights

In the last two decades, the osseointegrated rehabilitation for partial or complete edentulous patients has become a routine practice in the medical society, having predictable results on the long term [1], and these techniques have become increasingly widespread
The aim of this paper is to review the published literature on accidental displacement and migration of dental implants into the maxillary sinus and other adjacent structures
Material and Methods This review is based on a search into the main on-line medical databases looking for papers about migration of dental implants published in major oral surgery, periodontal, dental implant and ear-nose-throat (ENT) journals between January 1970 and January 2011, using the keywords “implant,” “migration,” “complication,” “foreign body” and “sinus.” Other relevant papers were identified in the references sections of papers retrieved by the primary search

Summary

Introduction

In the last two decades, the osseointegrated rehabilitation for partial or complete edentulous patients has become a routine practice in the medical society, having predictable results on the long term [1], and these techniques have become increasingly widespread. New surgical techniques to reconstruct the alveolar ridges have arisen in the last decades because of the increasing demand and the unfavorable specific conditions of the alveolar bone. This is the case of different types of bone grafts at the maxillary and mandibular level, alveolar osteogenesis distraction and maxillary sinus floor elevation [3]. The elevation of the maxillary sinuses with bone grafts is a high predictability technique in terms of successful osseointegrated rehabilitation [6], sometimes it is not used for different reasons, conditioning the insertion of short-length implants or with poor stability at this level

Objectives

Results

Conclusion