Clinical Resolution of Recurrent Sinusitis after Removal of Surgical Drill in the Maxillary Sinus: Case Report

This report describes the clinical resolution of recurrent sinusitis after removing a surgical drill from the maxillary sinus (MS) using the modified Caldwell-Luc technique. A 52-year-old male presented at the Oral and Maxillofacial Surgery Clinic of Araçatuba School of Dentistry - UNESP, complaining of recurrent headaches, sinusitis, and facial edema for one year, following the extraction of tooth #26 and subsequent oroantral communication. Physical examination revealed edema in the left midface, effacement of the fornix fundus, erythema, and an active fistula near tooth #23. A panoramic radiograph showed a radiopaque foreign body in the left MS. Cone beam computed tomography (CBCT) revealed hyperdense material resembling a surgical drill, bone fenestration, and residual roots. The MS was accessed using the modified Caldwell-Luc technique, expanding the previous bone fenestration to remove the drill, perform curettage, and irrigate the sinus. The fistula was excised, and residual roots of tooth #24 were extracted. The patient remained under clinical and radiographic follow-up with no complications. Complementary imaging is crucial for diagnosis and surgical planning, and the modified Caldwell-Luc technique is effective for foreign body removal in the MS, offering a low-cost solution, complete sinus cleansing, and prevention of oroantral fistula recurrence.