Spontaneous expulsion of displaced roots from the maxillary sinus: a report of two rare cases

The maxillary sinus is an air-filled, epithelial-lined cavity encased within the maxillary bone. Displacement of a foreign body into the sinus is an uncommon clinical entity. The aetiology is primarily iatrogenic dental manipulation of dental implants, endodontic materials and roots of teeth. The presence of foreign bodies within the sinus can elicit physical irritation to the lining, promote ciliary insufficiency and potentiate secondary infection. In the presence of symptoms or infection, adequate management of roots displaced into the maxillary sinus necessitates complete surgical removal followed by definitive closure of any associated oro-antral communication, with surgical access possible via several methods. This series discusses two cases of spontaneous expulsion of previously displaced root fragments; one which entered the alimentary canal and the other of which was expulsed during an episode of sneezing. This rare complication highlights the importance of pre-operative radiographic imaging (immediately before surgery) to exclude spontaneous expulsion in a bid to avoid unnecessary surgery, and the risk of root expulsion if conservative measures are employed for managing this complication of exodontia.