A Case of Simultaneous Ectopic Tooth Extraction and Removal of Migrated Dental Implant from Maxillary Sinus

When a dental implant migrates to the maxillary sinus it should be extracted immediately as it may cause sinusitis or further migrate to one of the other paranasal sinuses. Although usually detected due to symptoms such as nasal obstruction, nasal discharge, and nasal bleeding, an ectopic tooth in the maxillary sinus can sometimes be revealed incidentally on radiographic examination. Here, we report a case of simultaneous extraction of a dental implant that had migrated to the maxillary sinus and removal of an ectopic tooth that had arisen in the same location. The patient was a 73-year-old man who had received the implant to replace the first left maxillary molar at a local dental office. The implant had subsequently migrated to the left maxillary sinus and the patient was referred to us for its removal. On locating the implant on a CT scan at our hospital, an ectopic tooth was also observed at the base of the maxillary sinus. With patient consent, the decision was made to remove the ectopic tooth and extract the implant simultaneously. Excision of the lateral wall of the maxillary sinus allowed easy extraction of the implant. The ectopic tooth was removed by slightly expanding a fenestration in the sinus wall. Ectopic teeth in the maxillary sinus are sometimes put on follow-up if asymptomatic. Removal should be considered, however, if there is a risk of it becoming infected due to implantation-induced inflammation.