A novel technique for surgical removal of impacted maxillary teeth partially embedded in maxillary sinus

Introduction: Inverted impacted unilateral maxillary canines particularly in edentulous arch are rarest of rare. Surgical removal for such teeth is indicated when it interferes with prosthesis, fistula, associated with pathology etc. The etiological factors associated with impacted maxillary canines are premature loss of primary teeth, lack of arch length, inappropriate angulations, ectopic locations, associated pathological lesions. The ideal management of an impacted maxillary canine requires multidisciplinary approach of orthodontist and Oral and Maxillofacial Surgeon. Management of this teeth poses particular challenge to the surgeons owing to its difficult discrete position and its relation to adjacent structures like maxillary sinus which increase the rate of complication for surgical removal. The treatment modalities range from observation to surgical removal of impacted teeth.

Materials and Methods: 25 patients with impacted canines embedded in maxillary sinus were included in the study. Surgical removal was undertaken using a novel technique where the teeth is anchored with a wire to prevent displacement into the sinus. Parameters like time of surgery, complications, breakage at the point of anchor, tooth dislaced into sinus were recorded.

Conclusion: Surgical removal of such teeth poses a challenge to surgeons owing to its difficult position and relation to adjacent structures. Slippage into maxillary sinus and causing further complications like fistula, infected sinus always remained a dilemma to surgeons. Engaging the impacted teeth with wire is a simple and effective technique to prevent displacement into sinus and ease the surgical removal with minimal complications.