OBJECTIVE: We report a rare case of ectopic unerupted tooth in maxillary sinus. CASE REPORT: A 23 year old female presented with oroantral fistula distal to right upper second molar. On radiography, there was an ectopic unerupted tooth in maxillary sinus, removed via sublabial approach with sinuscope. CONCLUSION: This is a rare case of unerupted ectopic tooth in maxillary sinus that presented with oroantral fistula. Opacity in maxillary sinus may be due to unerupted ectopic tooth. Complete removal of tooth along with associated mucosal disease of sinus by INTRODUCTION: Tooth development results from a complicated multi-step interaction between the oral epithelium and the underlying mesenchymal tissue. A series of complex tissue interactions result in the formation of mature teeth. Abnormal tissue interaction during development may potentially result in ectopic tooth development and eruption. Ectopic eruption of a tooth into the dental environment is common, whereas ectopic eruption of a tooth in other sites is rare. Diverse oral anatomical locations can infrequently be the site of an ectopic tooth eruption. Such locations include the nasal cavity, chin, mandibular condyle, coronoid process. One of the sites for an ectopic tooth in a no dental location is the maxillary sinus. Tooth in the maxillary sinus is rare. Due to its rarity, the literature that deals with this is sparse. Ectopic eruption may be associated with one of three distinct processes, Developmental disturbances, pathological processes and iatrogenic activity. The etiology of ectopic teeth is not always known. Impaction of a tooth in the maxillary sinus can be asymptomatic. Such teeth are often discovered serendipitously on radiographs of the skull or teeth. In some cases, patients experience significant symptoms like sinonasal symptoms, oroantral fistula etc. Tooth eruption in the maxillary sinus may cause sinusitis. The treatment of an ectopic maxillary tooth is surgical removal. We present a case of an ectopic third molar which presented in the maxillary sinus presented as oro antral fistula and was removed via endoscopic surgery. CASE REPORT: A 23 years old healthy female was presented for evaluation of pus discharging oro antral fistula distal to right upper second molar. The intra oral examination revealed the right upper third molar was absent. Purulent material from the oro antral fistula was observed. The extra oral examination revealed no signs or symptoms. The patient complained of a headache on the right side of his face for approximately 3 - 4 years. The Xray PNS water's view (figure 1) and lateral view of face (figure 2), and orthopentogram (figure 3) showed a well - defined circular opacity surrounded by a soft tissue mass in the right maxillary sinus. Computed tomography (CT) of
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