Journal of Oral Implantology April 2012 - (Page 189)

CASE LETTER Atraumatic Removalof anAsymptomatic Migrated Dental Implant Into the Maxillary Sinus: A Case Report Spiros Tsodoulos, DDS, MD, PhD Irene Karabouta, DDS, MD, PhD* Margarita Voulgaropoulou, DDS, MsD Christos Georgiou, DDS, MD INTRODUCTION igration of foreign bodies into the maxillary sinuses is a relatively frequent com plication in dental clinical practice. Potential ways of escape for these are penetrating trauma, an oroantral fistula or an iatrogenic displacement during dental procedures such as extractions of teeth, routine endodontic treatment,1 apical surgery or, lately, dental implant placement.2 Most common foreign bodies associated with sinus perforation are displaced fractured roots, whole teeth, dental impression materials, dental burs, guttapercha3 and silver points, amalgam fillings, and dental implants. Examples of more bizarre materials are bullets, pieces of glass, stones, and wood. All of these objects may cause inflammation/sinusitis by interrupting mucociliary clearance or causing a tissue reaction.4 It is widely recognized that prompt and conservative surgical intervention is desirable to remove these foreign bodies from paranasal sinuses but also to treat a possible hyperplasDepartment of Oral and Maxillofacial Surgery, Dental School of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece. * Corresponding author, e-mail: syomo@otenet.gr DOI: 10.1563/AAID-JOI-D-10-00053 M tic or infected sinus mucosa. This early intervention is suggested to prevent or treat the possible sequelae of acute or chronic sinusitis, antrolith formation, mucosal cyst formation, and persistent oroantral communication.5 Extension of infection intracranially, aspergillosis connected with zinc endodontic obstruction materials, or malignant tumors are rare complications of sinus foreign bodies and pathologic conditions.5 Displacement of dental implants into the maxillary sinus can violate the anatomic integrity and interfere with the physiologic mechanisms of the maxillary sinus, creating potential complications, like a foreign-body reaction of conventional sinusitis.6 The failure rate of osseointegration of dental implants is more significant to the maxilla than the mandible because of the anatomy related to the surrounding structures (such as the maxillary sinus), bone quality Class IV (thin cortical bone with spongy or low density), rapid alveolar bone resorption after tooth extraction, maxillary sinus pneumatization, and so on.7 More precisely, due to the insufficient height of the alveolar ridge, the implants often touch or even slightly perforate the Schneiderian membrane of respiratory epithelium, which lines the floor of the antrum.8 Moreover, inadequate implant preparation, drilling or installation errors, and Journal of Oral Implantology 189

Table of Contents for the Digital Edition of Journal of Oral Implantology April 2012

Research Letters: A New Editorial Format for the Rapid Disclosure of Innovative Data and Concepts, Didactic Demonstrations, and Scientific Discussions
Effect of Defective Collagen Synthesis on Epithelial Implant Interface: Lathyritic Model in Dogs. An Experimental Preliminary Study
Presence of Aspartate Aminotransferase in Peri-Implant Crevicular Fluid With and Without Mucositis
Deformation of Implant Abutments After Framework Connection Using Strain Gauges
Implant-Retained Mandibular Bar-Supported Overlay Dentures: A Finite Element Stress Analysis of Four Different Bar Heights
The Efficacy of Mylohyoid Nerve Anesthesia in Dental Implant Placement at the Edetulous Posterior Mandibular Ridge
Metal-Ceramic Screw-Retained Implant Fixed Partial Denture With Intraoral Luted Framework to Improve Passive Fit
A Relaxed Implant Bed: Implants Placed After Two Weeks of Osteotomy With Immediate Loading: A One Year Clinical Trial
A Modified Technique for Removing a Failed Abutment Screw From an Implant With a Custom Guide Tube
Therapy for Missing Lower Medial Incisor by Means of Reduced Diameter Implants
Simplifying the Implant Treatment Plan for an Elderly Patient
The Use of Leukocyte- and Platelet-Rich Fibrin During Immediate Postextractive Implantation and Loading for the Esthetic Replacement of a Fractured Maxillary Central Incisor
Atraumatic Removal of an Asymptomatic Migrated Dental Implant Into the Maxillary Sinus: A Case Report
Tooth-Implant Connection: A Review

Journal of Oral Implantology April 2012