Nogami Shinnosuke, Yamauchi Kensuke, Tanuma Yuji, Odashima Kenji, Matsui Aritsune, Tanaka Kenko, Takahashi Tetsu
Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan.
J Med Case Rep. 2016 Jan 12;10:1. doi: 10.1186/s13256-015-0787-1.
Accidental displacement of a dental implant into the maxillary sinus is an infrequent although not uncommon complication encountered in dental clinical practice, with the main cause thought to be inadequate bone height in the posterior maxilla. We report a case of migration of a dental implant into the maxillary sinus, and discuss the benefits of its removal by a combination of endoscopically assisted and bone repositioning techniques.
A 35-year-old Japanese man with a partially edentulous maxilla underwent implant placement at a private clinic. Three months later, at the time of abutment connection, the implant at the site of his maxillary right first molar was accidentally pushed into the sinus. The hole on the alveolar ridge made for placement of the implant was small and far from the dislocated implant, thus access was achieved in a transoral manner via the frontal wall of his maxillary sinus with an endoscopic approach. Piezoelectric instruments were used to perform an osteotomy. The bone lid was removed, and the implant was identified using a rigid endoscope and removed with a surgical aspirator, followed by repositioning of the bony segment; the area was secured with an absorbable suture. Removal of migrated implants should be considered in order to prevent possible sinusal disease complications.
In the present case, removal of a dental implant displaced into the maxillary sinus by use of a combination of endoscopically assisted and bone repositioning techniques proved to be a safe and reliable procedure.
牙种植体意外移位至上颌窦是牙科临床实践中虽不常见但也时有发生的并发症，主要原因被认为是上颌后部骨高度不足。我们报告一例牙种植体移位至上颌窦的病例，并讨论通过内镜辅助和骨复位技术联合移除种植体的益处。
一名35岁上颌部分牙列缺损的日本男性在一家私人诊所接受种植体植入。三个月后，在连接基台时，其右上颌第一磨牙部位的种植体意外被推入上颌窦。为植入种植体而在牙槽嵴上形成的孔很小，且距离移位的种植体较远，因此通过内镜经上颌窦前壁经口进入。使用压电器械进行截骨术。去除骨盖，用硬质内镜识别种植体并用手术吸引器取出，随后将骨段复位；该区域用可吸收缝线固定。为防止可能的鼻窦疾病并发症，应考虑取出移位的种植体。
在本病例中，使用内镜辅助和骨复位技术联合移除移位至上颌窦的牙种植体被证明是一种安全可靠的方法。
