Though rare but there: Gates–Glidden drill finds a gateway to antrum

Abstract

Gates–Glidden drills are commonly use dendodontic instruments which facilitate the development of a straight-line access and coronal enlargement of the root canal. Its prime safety feature is that if the separation of the drill ever occurs during use, the drills are designed in a fashion that it separates near the hub of the drill at the junction of the shank and head to allow easy retrieval of the fractured segment. In this paper, we present an unusual case of a radiopaque structure at the apex of the palatal root with 17 extruding into the maxillary sinus suggestive of an endodontic instrument separation. Three-dimensional images from CBCT scan revealed a 2.1 cm long hyper dense image with well-defined margins within the right maxillary sinus. The patient underwent a Caldwell–Luc approach for removal of the foreign object, which on retrieval was found to be a Gates–Glidden drill. Following the retrieval, the patient remained asymptomatic and the offending tooth was endodontically rehabilitated. Any foreign object should be considered for removal in order to prevent possible sinusal diseases. The extrusion of a Gates–Glidden drill into the maxillary sinus is rarely reported in literature. Our aim is to make the readers aware of the rare occurrence of fractured and displaced Gates–Glidden drill in the maxillary antrum in which case Caldwell–Luc approach is safe and reliable technique to retrieve.