Orthodontic tooth movement through the maxillary sinus in an adult with multiple missing teeth

This case report describes the successful orthodontic tooth movement through the maxillary sinus in an adult patient. A 41-year-old Asian woman had severe lip protrusion and multiple missing posterior teeth. Her orthodontic treatment included the extraction of 2 teeth, maximum retraction of the incisors using the extraction spaces and the existing spaces from the missing molars, and closure of all remaining spaces. Even though the treatment time was extended because of the anatomic and biologic challenges associated with moving posterior teeth over a long distance through the maxillary sinus, a successful outcome was obtained, with significant bone modeling of the maxillary sinus. The results demonstrate that a carefully selected force system can overcome the anatomic limitations of moving tooth against the cortical bone of the maxillary sinus wall in adult patients.