Migrated Dental Implants into the Maxillary Sinus: Therapeutic Management. Scoping Review

The small amount of bone tissue can increase the risk of dental implant migration into the maxillary sinus. Treatment options include endoscopic or Caldwell-Luc techniques, as well as implant preservation in the sinus, with consideration given to patient symptoms, implant location, diameter, and length.

To compare the clinical outcomes of various techniques for retrieving implants that have migrated to the maxillary sinus, based on current literature.

A systematic search was conducted using MESH and non-MESH terms for the endoscopic technique ("dental implant, migration, maxillary sinus, endoscopic") and the Caldwell-Luc technique using words such as "dental implants, foreign-body, migration, maxillary sinus" and non-MESH terms such as "technique Caldwell-Luc, removal" with the operators AND/OR. Only case reports published between 2000 and 2022 were included in the analysis.

A total of 70 initial articles were obtained. Duplicate articles were eliminated, leaving 56 articles. Titles and abstracts of these articles were reviewed, and 37 studies were excluded. A total of 19 articles were included in the study, of which four were eliminated due to eligibility criteria. The study included five case reports on the Caldwell-Luc technique and 10 on the endoscopic procedure. In a total of 19 patients, 23 implants migrated into the sinus. Fifteen patients reported late implant migration (occurring after one month) and four experienced immediate migration (within 0-15 days), with a range of 2 days to 15 years. Of the 19 cases, 12 presented symptoms such as unilateral nasal obstruction, purulent secretions, unilateral facial pain, pain on percussion, and foul odor, while the remaining seven patients were asymptomatic. Only one case was reported to have presented with an absence of reossification of the lateral access window and thickening of Schneider's membrane after implant removal using the Caldwell-Luc technique.

The endoscopic approach resulted in no complications during or after removal of the migrated implant from the maxillary sinus. Despite having more significant morbidity, the Caldwell-Luc technique provides better access and visibility for implants in areas the endoscopic technique cannot reach. Asymptomatic patients can preserve the implant in the maxillary sinus with rigorous follow-up and the possibility of later complications.