Challenges In Retrieving Teeth/Roots From Maxillary Sinus : Two Cases

Displacement of teeth/roots into the maxillary sinus is rare occurrence but present significant clinical challenges. We introduce two minimally invasive approaches : endoscopic-assisted socket retrieval and the bony window technique. Case 1: A 30-year-old female experienced palatal root displacement of the left maxillary first molar into the sinus during extraction. The root was successfully retrieved through existing socket under endoscopic guidance using a suction apparatus and nasal forceps, without socket enlargement. Case 2: A 17-year-old male experienced complete displacement of an impacted maxillary wisdom tooth into the sinus. One month after displacement, patient developed sinusitis as result of tooth migration. A bony window was created on the anterior maxillary wall using a piezoelectric osteotome. The tooth was extracted using suction, and the window was repositioned with titanium plate fixation. Osseous integration was successfully confirmed at 5-month follow-up. Conventional methods (Caldwell-Luc, socket access, FESS ) poses risk such as neurovascular injury, alveolar bone loss, or inadequate access for large foreign bodies. Our modified techniques address these limitations: 1. Endoscopic-assisted facilitates precise extraction through the natural socket, ensuring the preservation of bone integrity . 2. Repositionable bony window in Caldwell-Luc modification prevents anterior wall collapse and maintains maxillary contour through careful anatomical reconstruction. All teeth/roots were successfully extracted with minimal damage to maxillary sinus. Endoscopic assistance and the repositionable bony window technique effectively minimize surgical trauma, optimize outcomes, and preserve alveolar bone integrity during the retrieval of teeth and roots from maxillary sinus.