Case Report: Dental implant displacement into the contralateral nasal cavity managed by endoscopic retrieval

Dental implant placement in the anterior maxilla requires precise anatomical assessment and strict control of surgical technique due to the proximity of the nasal cavity and maxillary sinuses. Although implant displacement into adjacent structures has been reported, involvement of the nasal cavity remains rare. We report the case of a male patient who developed intraoperative displacement of a dental implant into the contralateral nasal cavity during full-arch maxillary implant placement. The patient presented one day postoperatively and remained asymptomatic. Clinical examination and anterior rhinoscopy were inconclusive. CBCT revealed the implant crossing the midline and perforating the nasal mucosa, findings subsequently confirmed by nasal endoscopy, which localized the implant within the inferior meatus of the left nasal cavity. The exact cause of displacement could not be objectively determined due to the lack of complete intraoperative documentation from the referring institution. However, CBCT findings and clinical context may suggest a possible multifactorial mechanism; this interpretation remains hypothetical and may involve reduced anterior maxillary bone volume, particularly in terms of ridge width, combined with altered control of insertion dynamics, potentially leading to sudden loss of resistance and unintended apical advancement of the implant. The implant was successfully removed using an endoscopic-assisted transnasal approach under general anesthesia, allowing direct visualization and controlled retrieval. The postoperative course was uneventful. This case highlights the importance of thorough preoperative planning, accurate radiological assessment, and careful control of surgical technique in anatomically challenging regions. Early diagnosis using CBCT and endoscopic evaluation is essential, while endoscopic management represents a safe and effective approach for implant retrieval from the nasal cavity.