Leon Chen’s Modified Valsalva Technique (LCMVT) for Retrieval of Displaced Dental Implants: A Clinical Technique Report

The retrieval of a displaced dental implant from the maxillary sinus-whether through an intraoral lateral window or a transnasal endoscopic route-invariably requires further surgical intervention and a subsequent healing period. For instance, in cases where a lateral window approach was not initially indicated, the accidental displacement of a dental implant into the maxillary sinus often necessitates the creation of such an access, which can lead to patient dissatisfaction. If removal through the lateral window proves unsuccessful, referral to an otolaryngologist may become necessary, and a transnasal endoscopic approach must then be employed. These additional procedures inevitably contribute to increased psychological stress for the patient. Furthermore, the waiting period associated with referrals-scheduling consultations with oral and maxillofacial surgeons or ENT specialists, and potential hospital admission-can significantly heighten patient anxiety. The enlargement of the surgical field may also prolong the healing process, particularly osseointegration, potentially delaying treatment completion by 6 months to over 1 year. Additional surgical interventions increase the psychological burden on both the patient and the original surgeon. In this context, the term "original surgeon" refers to the implantologist who initially performed the implant placement and subsequently referred the patient to the authors for management of a displaced implant in the maxillary sinus. Case 1 details the procedural steps undertaken by the authors to retrieve the displaced implant. In Case 2, the implant was inadvertently displaced into the maxillary sinus by the authors themselves during implant placement; it was subsequently retrieved using the technique described in this report. A new implant was immediately placed following removal, and the oroantral communication was successfully prevented. We introduce a simple and reproducible method for clinicians, known as Leon Chen's Modified Valsalva Technique (LCMVT). Leon Chen's Modified Valsalva Technique (LCMVT) involves seating the patient upright with a slight forward tilt, followed by deep inhalation and breath holding. Approximately 8 mL of normal saline is injected into the osteotomy site, after which the clinician occludes the patient's nostrils. The patient is then instructed to exhale forcefully against the closed airway. This maneuver is repeated several times until the displaced implant is mobilized toward the osteotomy opening. This technique significantly reduces the inconvenience of waiting for subsequent surgical interventions and yields positive feedback from patients.