Endoscopic Retrieval of Displaced Maxillary Third Molar Crown: A Pediatric Endonasal Approach

Iatrogenic displacement of third molars is a rare but significant complication of dental extractions, particularly in children where unique anatomic and developmental factors pose additional challenges. This report describes the case of a 12-year-old female who presented with a displaced maxillary third molar crown into the left maxillary sinus following dental extraction. This displacement resulted in acute orbital cellulitis, which was initially managed with oral antibiotic therapy. Endoscopic endonasal retrieval of the foreign body 4 months later was recommended after the initial infection was treated to reduce the risk of recurrent orbital and/or sinonasal infections. Surgical planning incorporated intraoperative navigation with existing cone beam computed tomography to minimize radiation exposure. The procedure was successful with no perioperative complications. This case highlights the importance of prompt recognition, careful surgical planning, and utilization of minimally invasive approaches to optimize outcomes while minimizing craniofacial morbidity in pediatric patients.