Retrieval of Displaced Root from Maxillary Sinus Using Lateral Wall Antrostomy Approach - A Case Report

During extraction, a tooth root or complete tooth may accidentally be displaced into neighbouring anatomical spaces, such as the maxillary sinus, infratemporal fossa, submandibular space, pterygomandibular space, or lateral pharyngeal space. During the extraction of maxillary molars, ∼55.6% of cases involve palatal roots of the first or second molar, and the remaining 44.4% of cases involve the upper third molar teeth, which get displaced into the maxillary sinus. It is very rare for the disto-buccal root of the tooth to get displaced into the sinus. We present a case in which an attempt to retrieve a fractured disto-buccal root fragment of a maxillary first molar led to its displacement into the maxillary sinus. A water test was positive, confirming the formation of an oro-antral communication (OAC). Cone Beam Computed Tomography showed that a fractured root fragment was present high above the socket, retained by the thickened sinus membrane and mucosa within the maxillary sinus. The displaced root fragment was retrieved using the lateral wall antrostomy approach. The wound was closed using a buccal advancement flap, and no postoperative complications were observed. At the 3-month follow-up, healing was satisfactory. Surgical removal of the displaced root from the maxillary antrum is crucial to prevent sinus infection or other complications. The lateral wall approach can be successfully used to remove the root fragment displaced into the maxillary sinus.