Removal of a surgical drill displaced from the maxillary sinus after extraction

case report

Abstract

The displacement of foreign bodies in the maxillary sinus after tooth extraction is an uncommon complication, commonly arising from iatrogenesis. The diagnosis is made through the use of imaging tests, which are essential in surgical planning. The objective of this work is to report a clinical case of removal of a surgical drill displaced into the right maxillary sinus after extraction, using the modified Caldwell-Luc technique. Female patient attended Manoel Victorino Hospital complaining of “there is a drill in my jaw”. During the intraoral physical examination, a normal appearance of the mucosa was noted, with no changes in color, volume and absence of fistulas. On radiographic examination, the presence of a radiopaque image in the region of the right maxillary sinus was noted.           The patient underwent surgical treatment with the modified Caldwell-Luc technique to remove the drill. The bone fragment removed to access the maxillary sinus was repositioned and fixed with a 2.0 system titanium plate. On the 15th post-operative day, satisfactory healing was observed in the oral mucosa, and on imaging examination, the presence of synthetic material in the affected region was noted.  The presence of a foreign body in the maxillary sinus can cause reabsorption of the surrounding bone and infectious complications characterized by the inflammation reaction of the mucosa of this sinus. The modified Caldwell-Luc technique is used to gain access to the maxillary sinus, with the advantage of allowing good visualization of the operative field, easy access to the foreign body and promoting better closure of the bone defect. Although rare, foreign bodies in the maxillary sinus can cause local and systemic changes, therefore, surgical removal becomes necessary.