Abstract
Introduction: Teeth displacement in the maxillary sinus is one of the most frequently described peri-extraction complications in oral surgery. Roots or whole teeth accidentally displaced during an avulsion process are the most common cause of foreign bodies in the maxillary sinus. It exposes the patient to more or less serious complications that can go as far as development of pneumonia or septic thrombosis of the cavernous sinus in rare cases. Several therapeutic solutions can be proposed to manage this complication, ranging from therapeutic abstention to the removal of the dental component using various techniques. Corpus: The pedagogical objectives of this article are to explain the main characteristics of this complication as well as its treatment. Through a systematic review of the literature according to the PRISMA methodology, the risk factors, prevention, diagnosis, complications, and management of teeth displacement will be discussed. A treatment decision tree will be proposed to guide practitioners in the management of a tooth or dental root displaced into the sinus. Conclusion: This article summarizes the importance of pre-extraction radiographic examinations for preventive purposes and their analysis to guide the practitioner in the choice of an appropriate surgical technique. Furthermore, the surgical management in almost all cases must be carried out early to prevent later infectious complications.
Highlights
Teeth displacement in the maxillary sinus is one of the most frequently described peri-extraction complications in oral surgery without a precise quantification in the literature [1]
There are various diagnostic ways to confirm that a tooth would be mainly explained by a preoperative X-ray analysis or tooth root is displaced into the maxillary sinus
– Loss of dental substances or unfavorable anatomical features: complex avulsion with a fracture risk – Proximity to the sinus: + + + palatal roots of molars or premolars – Significant sinus pneumatization: age-related, progressive edentulous and ethnic (e.g. Asians have less voluminous sinuses). Of these 18 cases, 15 were symptomatic, and of these, 10 (66.7%) had late or very late management. These results show that most cases eventually develop complications over time and that rapid management is indicated
Summary
Abstract -- Introduction: Teeth displacement in the maxillary sinus is one of the most frequently described periextraction complications in oral surgery. Several therapeutic solutions can be proposed to manage this complication, ranging from therapeutic abstention to the removal of the dental component using various techniques. Through a systematic review of the literature according to the PRISMA methodology, the risk factors, prevention, diagnosis, complications, and management of teeth displacement will be discussed. A treatment decision tree will be proposed to guide practitioners in the management of a tooth or dental root displaced into the sinus. Conclusion: This article summarizes the importance of pre-extraction radiographic examinations for preventive purposes and their analysis to guide the practitioner in the choice of an appropriate surgical technique. The surgical management in almost all cases must be carried out early to prevent later infectious complications
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