From Displacement to Recovery: A Case Report on Surgical Root Retrieval in the Maxillary Sinus

Apical displacement of fractured tooth root fragments into the maxillary sinus is a recognised complication during exodontia, particularly in general dental practice. If not appropriately managed, it may lead to adverse sequelae, with heightened risk in medically compromised patients. Although various surgical techniques are described in the literature, management remains case‑specific and sometimes contentious, with no clear guidelines for the dental practitioner. The case presented here is distinctive because it involves a medically compromised patient in whom treatment planning and surgical decision‑making required additional caution to ensure safe, minimally invasive retrieval and successful postoperative recovery.

A 68-year-old medically compromised patient presented with an apically displaced fractured root during extraction of the maxillary left first molar (UL6). Imaging showed that the distobuccal root fragment was entrapped within the Schneiderian membrane of the left maxillary sinus. Surgical intervention for root retrieval was delayed for 2 months due to the patient's concurrent health issues, during which time the patient experienced persistent facial pain. The root fragment was ultimately successfully removed via a conservative buccal alveolar bone window under local anaesthesia, with minimal postoperative complications and full resolution of symptoms.

This case report contributes to the limited evidence base of conservative alternative techniques to the Caldwell-Luc approach for fixed-type displaced root cases in older, medically compromised patients. It supports surgically trained general dentists to safely manage similar cases under local anaesthesia using equipment that is widely available in primary care.