Fixation tack penetration into the maxillary sinus: A case report of a guided bone regeneration procedure complication
Identifieur interne : 001B23 ( Pmc/Corpus ); précédent : 001B22; suivant : 001B24Fixation tack penetration into the maxillary sinus: A case report of a guided bone regeneration procedure complication
Auteurs : Kevin Harrison ; Irma Iskandar ; Hua-Hong ChienSource :
- The American Journal of Case Reports [ 1941-5923 ] ; 2013.
Abstract
Guided bone regeneration (GBR) is an established and predictable procedure used to obtain adequate alveolar bone for the placement of dental implants. Anatomical challenges, such as the proximity of the maxillary sinus, may lead to complications during a GBR procedure. The purpose of this report is to present a unique and hitherto unreported complication of a GBR procedure, i.e., the penetration of a titanium fixation tack into the maxillary sinus.
A unique GBR is presented, where a titanium tack penetrated the maxillary sinus with subsequent migration and loss. Attempts to locate the tack visually during the procedure were unsuccessful. The GBR procedure was aborted and dental radiographs were immediately obtained. The patient was completely asymptomatic during the healing period. Eight weeks later a cone beam computed tomography revealed a non-inflamed sinus with no pathology evident. However, the tack could not be visualized. An otolaryngology consultation was requested and the ensuing sinus endoscopy did not reveal any evidence of the penetrated tack. It is thought that the loose tack migrated completely out of the sinus through the nasal passage.
The use of a pre-operative cone beam computed tomography (CBCT) would have allowed the clinician to assess the exact thickness of the lateral wall of the maxillary sinus and better determine the ideal placement location and/or the feasibility of using a fixation tack in the posterior upper jaw.
Url:
DOI: 10.12659/AJCR.883785
PubMed: 23569561
PubMed Central: 3619038
Links to Exploration step
PMC:3619038Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Fixation tack penetration into the maxillary sinus: A case report of a guided bone regeneration procedure complication</title><author><name sortKey="Harrison, Kevin" sort="Harrison, Kevin" uniqKey="Harrison K" first="Kevin" last="Harrison">Kevin Harrison</name><affiliation><nlm:aff id="af1-amjcaserep-14-43">Private Practice limited to Periodontics and Implant Dentistry, Albuquerque, NM, U.S.A.</nlm:aff></affiliation></author><author><name sortKey="Iskandar, Irma" sort="Iskandar, Irma" uniqKey="Iskandar I" first="Irma" last="Iskandar">Irma Iskandar</name><affiliation><nlm:aff id="af2-amjcaserep-14-43">Private Practice limited to Periodontics and Implant Dentistry, Longview, WA, U.S.A.</nlm:aff></affiliation></author><author><name sortKey="Chien, Hua Hong" sort="Chien, Hua Hong" uniqKey="Chien H" first="Hua-Hong" last="Chien">Hua-Hong Chien</name><affiliation><nlm:aff id="af3-amjcaserep-14-43">Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, U.S.A.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23569561</idno><idno type="pmc">3619038</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619038</idno><idno type="RBID">PMC:3619038</idno><idno type="doi">10.12659/AJCR.883785</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001B23</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001B23</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Fixation tack penetration into the maxillary sinus: A case report of a guided bone regeneration procedure complication</title><author><name sortKey="Harrison, Kevin" sort="Harrison, Kevin" uniqKey="Harrison K" first="Kevin" last="Harrison">Kevin Harrison</name><affiliation><nlm:aff id="af1-amjcaserep-14-43">Private Practice limited to Periodontics and Implant Dentistry, Albuquerque, NM, U.S.A.</nlm:aff></affiliation></author><author><name sortKey="Iskandar, Irma" sort="Iskandar, Irma" uniqKey="Iskandar I" first="Irma" last="Iskandar">Irma Iskandar</name><affiliation><nlm:aff id="af2-amjcaserep-14-43">Private Practice limited to Periodontics and Implant Dentistry, Longview, WA, U.S.A.</nlm:aff></affiliation></author><author><name sortKey="Chien, Hua Hong" sort="Chien, Hua Hong" uniqKey="Chien H" first="Hua-Hong" last="Chien">Hua-Hong Chien</name><affiliation><nlm:aff id="af3-amjcaserep-14-43">Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, U.S.A.</nlm:aff></affiliation></author></analytic><series><title level="j">The American Journal of Case Reports</title><idno type="eISSN">1941-5923</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Background:</title><p>Guided bone regeneration (GBR) is an established and predictable procedure used to obtain adequate alveolar bone for the placement of dental implants. Anatomical challenges, such as the proximity of the maxillary sinus, may lead to complications during a GBR procedure. The purpose of this report is to present a unique and hitherto unreported complication of a GBR procedure, i.e., the penetration of a titanium fixation tack into the maxillary sinus.</p></sec><sec><title>Case Report:</title><p>A unique GBR is presented, where a titanium tack penetrated the maxillary sinus with subsequent migration and loss. Attempts to locate the tack visually during the procedure were unsuccessful. The GBR procedure was aborted and dental radiographs were immediately obtained. The patient was completely asymptomatic during the healing period. Eight weeks later a cone beam computed tomography revealed a non-inflamed sinus with no pathology evident. However, the tack could not be visualized. An otolaryngology consultation was requested and the ensuing sinus endoscopy did not reveal any evidence of the penetrated tack. It is thought that the loose tack migrated completely out of the sinus through the nasal passage.</p></sec><sec><title>Conclusions:</title><p>The use of a pre-operative cone beam computed tomography (CBCT) would have allowed the clinician to assess the exact thickness of the lateral wall of the maxillary sinus and better determine the ideal placement location and/or the feasibility of using a fixation tack in the posterior upper jaw.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Devlin, H" uniqKey="Devlin H">H Devlin</name></author><author><name sortKey="Ferguson, Mw" uniqKey="Ferguson M">MW Ferguson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sharan, A" uniqKey="Sharan A">A Sharan</name></author><author><name sortKey="Madjar, D" uniqKey="Madjar D">D Madjar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aghaloo, Tl" uniqKey="Aghaloo T">TL Aghaloo</name></author><author><name sortKey="Moy, Pk" uniqKey="Moy P">PK Moy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Donos, N" uniqKey="Donos N">N Donos</name></author><author><name sortKey="Mardas, N" uniqKey="Mardas N">N Mardas</name></author><author><name sortKey="Chadha, V" uniqKey="Chadha V">V Chadha</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mcallister, Bs" uniqKey="Mcallister B">BS McAllister</name></author><author><name sortKey="Haghighat, K" uniqKey="Haghighat K">K Haghighat</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Carpio, L" uniqKey="Carpio L">L Carpio</name></author><author><name sortKey="Loza, J" uniqKey="Loza J">J Loza</name></author><author><name sortKey="Lynch, S" uniqKey="Lynch S">S Lynch</name></author><author><name sortKey="Genco, R" uniqKey="Genco R">R Genco</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fireman, Sm" uniqKey="Fireman S">SM Fireman</name></author><author><name sortKey="Noyek, Am" uniqKey="Noyek A">AM Noyek</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wang, Hl" uniqKey="Wang H">HL Wang</name></author><author><name sortKey="Al Shammari, K" uniqKey="Al Shammari K">K Al-Shammari</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Simion, M" uniqKey="Simion M">M Simion</name></author><author><name sortKey="Baldoni, M" uniqKey="Baldoni M">M Baldoni</name></author><author><name sortKey="Rossi, P" uniqKey="Rossi P">P Rossi</name></author><author><name sortKey="Zaffe, D" uniqKey="Zaffe D">D Zaffe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liston, Pn" uniqKey="Liston P">PN Liston</name></author><author><name sortKey="Walters, Rf" uniqKey="Walters R">RF Walters</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pang, Kp" uniqKey="Pang K">KP Pang</name></author><author><name sortKey="Siow, Jk" uniqKey="Siow J">JK Siow</name></author><author><name sortKey="Tan, Hm" uniqKey="Tan H">HM Tan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamaguchi, K" uniqKey="Yamaguchi K">K Yamaguchi</name></author><author><name sortKey="Matsunaga, T" uniqKey="Matsunaga T">T Matsunaga</name></author><author><name sortKey="Hayashi, Y" uniqKey="Hayashi Y">Y Hayashi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barclay, Jk" uniqKey="Barclay J">JK Barclay</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Winstock, D" uniqKey="Winstock D">D Winstock</name></author><author><name sortKey="Warnakulasuriya, S" uniqKey="Warnakulasuriya S">S Warnakulasuriya</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khoury, F" uniqKey="Khoury F">F Khoury</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Holmes, A" uniqKey="Holmes A">A Holmes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Burnham, R" uniqKey="Burnham R">R Burnham</name></author><author><name sortKey="Bridle, C" uniqKey="Bridle C">C Bridle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Iida, S" uniqKey="Iida S">S Iida</name></author><author><name sortKey="Tanaka, N" uniqKey="Tanaka N">N Tanaka</name></author><author><name sortKey="Kogo, M" uniqKey="Kogo M">M Kogo</name></author><author><name sortKey="Matsuya, T" uniqKey="Matsuya T">T Matsuya</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Galindo, P" uniqKey="Galindo P">P Galindo</name></author><author><name sortKey="Sanchez Fernandez, E" uniqKey="Sanchez Fernandez E">E Sanchez-Fernandez</name></author><author><name sortKey="Avila, G" uniqKey="Avila G">G Avila</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kluppel, Le" uniqKey="Kluppel L">LE Kluppel</name></author><author><name sortKey="Santos, Se" uniqKey="Santos S">SE Santos</name></author><author><name sortKey="Olate, S" uniqKey="Olate S">S Olate</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Regev, E" uniqKey="Regev E">E Regev</name></author><author><name sortKey="Smith, Ra" uniqKey="Smith R">RA Smith</name></author><author><name sortKey="Perrott, Dh" uniqKey="Perrott D">DH Perrott</name></author><author><name sortKey="Pogrel, Ma" uniqKey="Pogrel M">MA Pogrel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Varol, A" uniqKey="Varol A">A Varol</name></author><author><name sortKey="Turker, N" uniqKey="Turker N">N Turker</name></author><author><name sortKey="Goker, K" uniqKey="Goker K">K Goker</name></author><author><name sortKey="Basa, S" uniqKey="Basa S">S Basa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kitamura, A" uniqKey="Kitamura A">A Kitamura</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Haben, Cm" uniqKey="Haben C">CM Haben</name></author><author><name sortKey="Balys, R" uniqKey="Balys R">R Balys</name></author><author><name sortKey="Frenkiel, S" uniqKey="Frenkiel S">S Frenkiel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chiapasco, M" uniqKey="Chiapasco M">M Chiapasco</name></author><author><name sortKey="Felisati, G" uniqKey="Felisati G">G Felisati</name></author><author><name sortKey="Maccari, A" uniqKey="Maccari A">A Maccari</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Felisati, G" uniqKey="Felisati G">G Felisati</name></author><author><name sortKey="Lozza, P" uniqKey="Lozza P">P Lozza</name></author><author><name sortKey="Chiapasco, M" uniqKey="Chiapasco M">M Chiapasco</name></author><author><name sortKey="Borloni, R" uniqKey="Borloni R">R Borloni</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thevoz, F" uniqKey="Thevoz F">F Thevoz</name></author><author><name sortKey="Arza, A" uniqKey="Arza A">A Arza</name></author><author><name sortKey="Jaques, B" uniqKey="Jaques B">B Jaques</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johnson, K" uniqKey="Johnson K">K Johnson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Penttila, Ma" uniqKey="Penttila M">MA Penttila</name></author><author><name sortKey="Rautiainen, Me" uniqKey="Rautiainen M">ME Rautiainen</name></author><author><name sortKey="Pukander, Js" uniqKey="Pukander J">JS Pukander</name></author><author><name sortKey="Karma, Ph" uniqKey="Karma P">PH Karma</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kennedy, Dw" uniqKey="Kennedy D">DW Kennedy</name></author><author><name sortKey="Zinreich, Sj" uniqKey="Zinreich S">SJ Zinreich</name></author><author><name sortKey="Shaalan, H" uniqKey="Shaalan H">H Shaalan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Borgonovo, A" uniqKey="Borgonovo A">A Borgonovo</name></author><author><name sortKey="Fabbri, A" uniqKey="Fabbri A">A Fabbri</name></author><author><name sortKey="Boninsegna, R" uniqKey="Boninsegna R">R Boninsegna</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Westermark, Ah" uniqKey="Westermark A">AH Westermark</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Am J Case Rep</journal-id><journal-id journal-id-type="iso-abbrev">Am J Case Rep</journal-id><journal-id journal-id-type="publisher-id">amjcaserep</journal-id><journal-title-group><journal-title>The American Journal of Case Reports</journal-title></journal-title-group><issn pub-type="epub">1941-5923</issn><publisher><publisher-name>International Scientific Literature, Inc.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23569561</article-id><article-id pub-id-type="pmc">3619038</article-id><article-id pub-id-type="doi">10.12659/AJCR.883785</article-id><article-id pub-id-type="publisher-id">883785</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Fixation tack penetration into the maxillary sinus: A case report of a guided bone regeneration procedure complication</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Harrison</surname><given-names>Kevin</given-names></name><xref ref-type="aff" rid="af1-amjcaserep-14-43"><sup>1</sup></xref><xref ref-type="author-notes" rid="fn5-amjcaserep-14-43"><sup>E</sup></xref><xref ref-type="author-notes" rid="fn6-amjcaserep-14-43"><sup>F</sup></xref></contrib><contrib contrib-type="author"><name><surname>Iskandar</surname><given-names>Irma</given-names></name><xref ref-type="aff" rid="af2-amjcaserep-14-43"><sup>2</sup></xref><xref ref-type="author-notes" rid="fn1-amjcaserep-14-43"><sup>A</sup></xref><xref ref-type="author-notes" rid="fn2-amjcaserep-14-43"><sup>B</sup></xref></contrib><contrib contrib-type="author"><name><surname>Chien</surname><given-names>Hua-Hong</given-names></name><xref ref-type="corresp" rid="c1-amjcaserep-14-43"></xref><xref ref-type="aff" rid="af3-amjcaserep-14-43"><sup>3</sup></xref><xref ref-type="author-notes" rid="fn4-amjcaserep-14-43"><sup>D</sup></xref><xref ref-type="author-notes" rid="fn5-amjcaserep-14-43"><sup>E</sup></xref><xref ref-type="author-notes" rid="fn7-amjcaserep-14-43"><sup>G</sup></xref></contrib></contrib-group><aff id="af1-amjcaserep-14-43"><label>1</label>Private Practice limited to Periodontics and Implant Dentistry, Albuquerque, NM, U.S.A.</aff><aff id="af2-amjcaserep-14-43"><label>2</label>Private Practice limited to Periodontics and Implant Dentistry, Longview, WA, U.S.A.</aff><aff id="af3-amjcaserep-14-43"><label>3</label>Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, U.S.A.</aff><author-notes><corresp id="c1-amjcaserep-14-43">Author’s address: Hua-Hong Chien, Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH 43210, U.S.A., e-mail: <email>chien.60@osu.edu</email></corresp><fn><p><bold>Authors’ Contribution:</bold></p></fn><fn id="fn1-amjcaserep-14-43"><label>A</label><p>Study Design</p></fn><fn id="fn2-amjcaserep-14-43"><label>B</label><p>Data Collection</p></fn><fn id="fn3-amjcaserep-14-43"><label>C</label><p>Statistical Analysis</p></fn><fn id="fn4-amjcaserep-14-43"><label>D</label><p>Data Interpretation</p></fn><fn id="fn5-amjcaserep-14-43"><label>E</label><p>Manuscript Preparation</p></fn><fn id="fn6-amjcaserep-14-43"><label>F</label><p>Literature Search</p></fn><fn id="fn7-amjcaserep-14-43"><label>G</label><p>Funds Collection</p></fn></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>18</day><month>2</month><year>2013</year></pub-date><volume>14</volume><fpage>43</fpage><lpage>47</lpage><history><date date-type="received"><day>16</day><month>12</month><year>2012</year></date><date date-type="accepted"><day>08</day><month>2</month><year>2013</year></date></history><permissions><copyright-statement>© Am J Case Rep, 2013</copyright-statement><copyright-year>2013</copyright-year><license><license-p>This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License</license-p></license></permissions><abstract><title>Summary</title><sec><title>Background:</title><p>Guided bone regeneration (GBR) is an established and predictable procedure used to obtain adequate alveolar bone for the placement of dental implants. Anatomical challenges, such as the proximity of the maxillary sinus, may lead to complications during a GBR procedure. The purpose of this report is to present a unique and hitherto unreported complication of a GBR procedure, i.e., the penetration of a titanium fixation tack into the maxillary sinus.</p></sec><sec><title>Case Report:</title><p>A unique GBR is presented, where a titanium tack penetrated the maxillary sinus with subsequent migration and loss. Attempts to locate the tack visually during the procedure were unsuccessful. The GBR procedure was aborted and dental radiographs were immediately obtained. The patient was completely asymptomatic during the healing period. Eight weeks later a cone beam computed tomography revealed a non-inflamed sinus with no pathology evident. However, the tack could not be visualized. An otolaryngology consultation was requested and the ensuing sinus endoscopy did not reveal any evidence of the penetrated tack. It is thought that the loose tack migrated completely out of the sinus through the nasal passage.</p></sec><sec><title>Conclusions:</title><p>The use of a pre-operative cone beam computed tomography (CBCT) would have allowed the clinician to assess the exact thickness of the lateral wall of the maxillary sinus and better determine the ideal placement location and/or the feasibility of using a fixation tack in the posterior upper jaw.</p></sec></abstract><kwd-group><kwd>maxillary sinus</kwd><kwd>complication</kwd><kwd>guided bone regeneration</kwd><kwd>titanium tack</kwd></kwd-group></article-meta></front><body><sec><title>Background</title><p>The alveolar bone loss associated with periodontitis, along with the alveolar atrophy that inevitably occurs subsequent to tooth extraction in adults [<xref ref-type="bibr" rid="b1-amjcaserep-14-43">1</xref>] and the potential post-extraction pneumatization of the maxillary sinus [<xref ref-type="bibr" rid="b2-amjcaserep-14-43">2</xref>], can combine to result in severe vertical and horizontal bone loss in the posterior maxilla. In such cases, the clinician has to meet the challenge of building adequate bone three-dimensionally, prior to dental implant placement.</p><p>When extensive bone loss requires reconstruction of the alveolar process in the posterior maxilla, a commonly employed technique is guided bone regeneration (GBR) [<xref ref-type="bibr" rid="b3-amjcaserep-14-43">3</xref>]. GBR is an established and predictable procedure prior to placement of dental implants, in which a barrier membrane is used for space maintenance over a defect and to exclude connective tissue ingrowth into the wound for a successful outcome [<xref ref-type="bibr" rid="b4-amjcaserep-14-43">4</xref>]. The membranes are essential for a successful outcome because they act as a physical barrier to protect blood clots in the defect, exclude gingival connective tissue, and provide a secluded space into which osteogenic cells from the bone can migrate. The predictability of GBR outcomes depends, in part, on proper technique, which includes stabilization of the membrane [<xref ref-type="bibr" rid="b5-amjcaserep-14-43">5</xref>,<xref ref-type="bibr" rid="b6-amjcaserep-14-43">6</xref>]. Indeed, fixation of a barrier membrane has been reported to significantly reduce post-operative complication and premature membrane exposure [<xref ref-type="bibr" rid="b6-amjcaserep-14-43">6</xref>]. Membrane stabilization can be achieved by different means, such as fixation screws, fixation tacks, or sutures [<xref ref-type="bibr" rid="b5-amjcaserep-14-43">5</xref>]. When GBR is performed in the posterior maxilla, the proximity of the maxillary sinus may become an anatomical limitation [<xref ref-type="bibr" rid="b7-amjcaserep-14-43">7</xref>].</p><p>The purpose of this report is to present a unique and hitherto unreported complication of a GBR procedure, i.e., the penetration of a titanium fixation tack into the maxillary sinus. Management of this complication, including otolaryngology consultation, is described.</p></sec><sec><title>Case Report</title><p>A 68-year-old African American female was referred to the Ohio State University Periodontology Clinic for dental implant placement in the upper right quadrant, to restore the missing maxillary right first and second premolars and the hopeless right maxillary canine. The patient’s medical history was positive for hypertension and hypothyroidism, both treated by medication. She reported taking amiloride, hydralazine, metoprolol and levothyroxine. The patient denied any history of sinus infections or diseases.</p><p>The dental history of the maxillary right quadrant included extraction of the second molar and first premolar several years prior, due to caries. Her maxillary right canine was fractured, deemed non-restorable and was treatment planned for extraction and replacement by an implant, while the second premolar had been extracted a few weeks prior to presentation. Clinical examination revealed ridge deficiency (HVC ridge classification: small combination of horizontal and vertical defect C-s) [<xref ref-type="bibr" rid="b8-amjcaserep-14-43">8</xref>] in the area of tooth #4 to #5. Radiographic examination, using panoramic (<xref ref-type="fig" rid="f1-amjcaserep-14-43">Figure 1</xref>) and periapical radiographs (not shown), revealed a bony defect in the area of tooth #4 and the retained root of the canine. The maxillary sinus was free of abnormalities. The treatment plan presented to and accepted by the patient included: GBR to restore the deficient ridge in the first and second premolar area, extraction and socket preservation for the canine, and implant placement.</p><p>Surgery was performed under local anesthesia (2% lidocaine with 1:100,000 epinephrine). A crestal incision was made at the edentulous area of tooth #4 to #5 and connected with the sulcular incisions placed around tooth #3 and #6 to #7. A full-thickness flap was elevated and a buccal bony concavity was noted around tooth #4 and #5 upon reflection. The root of tooth #6 was atraumatically extracted and a fenestration defect identified at the apex. The bony concavity and the socket wall were grafted with 1 c.c. of freeze-dried bone allograft (Straumann AlloGraft GC<sup>®</sup>, Straumann USA LLC, Andover, MA) and a resorbable membrane. A 20×30 mm long-lasting collagen membrane (BioMend Extended<sup>®</sup>, Zimmer Dental Inc, Carlsbad, CA) was trimmed and adapted to the site. One titanium tack (AutoTac<sup>®</sup>; BioHorizons Implant Systems, Inc. Birmingham, AL) was secured through the membrane to the underlying bone mesial to tooth #3 (<xref ref-type="fig" rid="f2-amjcaserep-14-43">Figure 2</xref>; white arrow). A second tack placement was attempted for membrane fixation at the edentulous area corresponding to the apical area of tooth #4. However, upon tack delivery, the buccal cortical plate collapsed and perforation of the sinus membrane occurred with migration and loss of the tack. The GBR procedure was aborted and attempts to visualize and possibly remove the tack were unsuccessful. The patient was informed of the complication and radiographs were obtained. They revealed that the tack had drifted distal to the first molar area (<xref ref-type="fig" rid="f2-amjcaserep-14-43">Figure 2</xref>; black arrow). It was then decided to terminate the surgical procedure. An absorbable collagen wound dressing was placed over the sinus membrane perforation, a long-lasting collagen membrane adapted over the breached lateral bony wall, and flaps were repositioned and sutured for primary closure. At completion of the procedure the patient’s blood pressure was increased and she developed a nosebleed. The patient remained in the dental chair until her vitals became stable and the episode of epistaxis ceased. Post-operative instructions were given and ibuprofen, chlorhexidine gluconate 0.12% oral rinse, amoxicillin (500 mg TID for 1 week), and oxymetazoline nasal spray prescribed. The patient was informed that additional radiographic assessment would be performed, using a cone beam computed tomography (CBCT), in 8 weeks and then a Caldwell-Luc procedure would be scheduled to retrieve the migrated titanium tack. The patient did not experience any significant post-operative complications during the healing phase and subsequent post operative visits. The patient returned in 8 weeks for a CBCT. The CBCT (<xref ref-type="fig" rid="f3-amjcaserep-14-43">Figure 3</xref>) revealed that the maxillary sinus was clear with wide opening of the ostium (<xref ref-type="fig" rid="f3-amjcaserep-14-43">Figure 3D</xref>; white arrow). However, the location of the titanium tack lost during GBR procedure (<xref ref-type="fig" rid="f2-amjcaserep-14-43">Figure 2</xref>; black arrow) was not evident. The patient was then referred to an otolaryngologist for a consultation, approximately 2.5 months after the surgery. The otolaryngologist re-evaluated the CBCT images and performed a nasal endoscopy. The otolaryngologist was unable to locate the titanium tack at that time and believed it had migrated completely out of the sinus through the nasal passage. He re-consulted the patient 2 months later and performed another CBCT and second endoscopy. He could only identify the tack located mesial to tooth #3 (<xref ref-type="fig" rid="f3-amjcaserep-14-43">Figure 3E</xref>; white arrow), which was positioned in the right-anterior-inferior-lateral portion of the maxillary sinus. It appeared to have a very thin covering of mucosa and there was no associated inflammatory response. The otolaryngologist again failed to locate the titanium tack displaced during the GBR procedure. Upon failure to observe the location of the tack after the second CBCT assessment, the assumption was made that the patient may have expelled the tack through the nasal passage. The patient healed uneventfully and was completely asymptomatic, thus the decision was made to leave the tack mesial to the first molar <italic>in situ</italic>. The patient was informed and understood the situation. The otolaryngologist recommended continuation of dental therapy with no other concerns; however, the patient decided not to continue the implant treatment due to the complications she suffered.</p></sec><sec sec-type="discussion"><title>Discussion</title><p>Membrane usage in GBR is crucial for a successful outcome. The importance of membrane fixation during a GBR procedure is not well-documented. However, micromovement of the membrane following the surgery was reported to reduce the bone regeneration by forming a soft tissue layer beneath the membrane [<xref ref-type="bibr" rid="b9-amjcaserep-14-43">9</xref>]. Carpio et al. [<xref ref-type="bibr" rid="b6-amjcaserep-14-43">6</xref>] investigated the effects of membrane fixation on GBR and they found that membrane fixation significantly reduced post-operative complication and premature membrane exposure.</p><p>Migration of foreign bodies in maxillary sinus is a relatively common occurrence in dental clinical practice. Numerous case reports and case series have been published documenting migration of foreign bodies into the maxillary sinus [<xref ref-type="bibr" rid="b10-amjcaserep-14-43">10</xref>–<xref ref-type="bibr" rid="b20-amjcaserep-14-43">20</xref>]. Common foreign bodies associated with sinus perforation include endodontic materials [<xref ref-type="bibr" rid="b12-amjcaserep-14-43">12</xref>], displaced fractured roots [<xref ref-type="bibr" rid="b13-amjcaserep-14-43">13</xref>], dental impression materials [<xref ref-type="bibr" rid="b14-amjcaserep-14-43">14</xref>], dental burs [<xref ref-type="bibr" rid="b15-amjcaserep-14-43">15</xref>], sewing needle [<xref ref-type="bibr" rid="b16-amjcaserep-14-43">16</xref>], amalgam fillings [<xref ref-type="bibr" rid="b17-amjcaserep-14-43">17</xref>] and even dental implants [<xref ref-type="bibr" rid="b18-amjcaserep-14-43">18</xref>–<xref ref-type="bibr" rid="b20-amjcaserep-14-43">20</xref>]. Indeed, one of the most common complications for implant placement in the posterior atrophic maxilla is the invasion of the maxillary sinus, which may lead to infection and subsequently implant failure [<xref ref-type="bibr" rid="b21-amjcaserep-14-43">21</xref>]. The possible mechanisms associated with the displacement of a dental implant into the hyperpneumatized maxillary sinus include the application of excessive force during implant placement and/or the lack of surgical experience [<xref ref-type="bibr" rid="b22-amjcaserep-14-43">22</xref>]. The complication that occurred in this case during the GBR procedure is likely due to the unfamiliarity with the anatomic variations in the maxillary sinus and a lack of surgical experience. Therefore, a careful treatment plan, identification of the maxillary sinus anatomy, and good surgical technique may prevent this complication from happening.</p><p>Sinus pathology, such as sinusitis, may result following introduction of foreign bodies in the maxillary sinus, by interrupting mucociliary clearance or causing a tissue reaction. However, related infectious complications are apparently uncommon and sporadic [<xref ref-type="bibr" rid="b10-amjcaserep-14-43">10</xref>,<xref ref-type="bibr" rid="b18-amjcaserep-14-43">18</xref>,<xref ref-type="bibr" rid="b20-amjcaserep-14-43">20</xref>,<xref ref-type="bibr" rid="b23-amjcaserep-14-43">23</xref>]. Several case reports have documented migrated dental implants with the sinus remaining completely asymptomatic [<xref ref-type="bibr" rid="b19-amjcaserep-14-43">19</xref>,<xref ref-type="bibr" rid="b20-amjcaserep-14-43">20</xref>]. Implant migration in the sinuses can be associated with oroantral communication and/or infection that, in addition to the maxillary sinus, may involve the ethmoidal [<xref ref-type="bibr" rid="b24-amjcaserep-14-43">24</xref>], frontal [<xref ref-type="bibr" rid="b25-amjcaserep-14-43">25</xref>] and sphenoidal [<xref ref-type="bibr" rid="b25-amjcaserep-14-43">25</xref>,<xref ref-type="bibr" rid="b26-amjcaserep-14-43">26</xref>] sinuses. Thevoz et al. [<xref ref-type="bibr" rid="b27-amjcaserep-14-43">27</xref>] found that chronic maxillary sinusitis attributable to a dental foreign body is rare and overestimated. In his review, 9% of 197 maxillary sinusitis cases were classified as “odontogenic”. Intra-sinusal foreign bodies were identified in 5% of the cases: 2% were of dental origin, 1% were dental or radicular remnants, and 2% were “pseudo” foreign bodies of mycotic origin.</p><p>Two main approaches have been proposed for the removal of foreign bodies displaced in the sinuses and to treat the associated infectious complications. These include an intraoral approach with the creation of a bony window in the anterior-lateral wall of the maxillary sinus (Caldwell-Luc) [<xref ref-type="bibr" rid="b19-amjcaserep-14-43">19</xref>,<xref ref-type="bibr" rid="b28-amjcaserep-14-43">28</xref>] and a transnasal approach with functional endoscopic sinus surgery (FESS) [<xref ref-type="bibr" rid="b18-amjcaserep-14-43">18</xref>,<xref ref-type="bibr" rid="b23-amjcaserep-14-43">23</xref>]. The Caldwell-Luc procedure involves opening the sinus directly through the lateral cortical plate by making an osteotomy and visually assessing the area of interest. This is more invasive with increased patient morbidity [<xref ref-type="bibr" rid="b29-amjcaserep-14-43">29</xref>]. FESS allows removal of displaced implants, treatment of paranasal sinusitis and recreation of adequate patency of the natural maxillary ostium with a minimally invasive procedure [<xref ref-type="bibr" rid="b25-amjcaserep-14-43">25</xref>].</p><p>The hiatus semilunaris (or semilunar hiatus) is a crescent-shaped groove in the lateral wall of the nasal cavity just inferior to the ethmoidal bulla. It is the location of the openings for the frontal sinus, maxillary sinus, and anterior ethmoidal sinus. The ostium for the maxillary sinus (<xref ref-type="fig" rid="f3-amjcaserep-14-43">Figure 3D</xref>; white arrow) opens posteriorly in this groove and is the largest ostium within the semilunar hiatus. Kennedy et al. [<xref ref-type="bibr" rid="b30-amjcaserep-14-43">30</xref>] described the normal size of the maxillary ostium to be 5×5 mm. The patency of this opening is the key to sinus health. When blocked, the normal function of mucociliary clearance in the sinus is inhibited. In the present case, it is likely that the displaced titanium tack may have been expelled through the ostium, considering that the tack size is 2.5 mm. There are few reports of foreign bodies spontaneously expelled from the sinus through the ostium. Borgonovo et al. [<xref ref-type="bibr" rid="b31-amjcaserep-14-43">31</xref>] and Pang et al. [<xref ref-type="bibr" rid="b11-amjcaserep-14-43">11</xref>] have demonstrated that relatively heavy metallic objects, such as a dental implant, located in the maxillary sinus are able to migrate to the sinus ostia against gravitational force, by the aid of mucociliary action, and subsequently to be expelled from the nasal cavities. Furthermore, Barclay [<xref ref-type="bibr" rid="b13-amjcaserep-14-43">13</xref>] described a case of a tooth root forced into the sinus and delivered from the pharynx 3 weeks later, as the patient coughed. Westermark [<xref ref-type="bibr" rid="b32-amjcaserep-14-43">32</xref>] reported on chloropercha root-filling particles forced into the sinus during root canal treatment of a maxillary first molar. These particles were able to migrate to and through the maxillary ostium, being spontaneously expelled from the nose. Collectively, these observations indicate the powerful ability of the mucociliary action to help clear the maxillary sinus.</p></sec><sec sec-type="conclusions"><title>Conclusions</title><p>The use of a pre-operative CBCT would have allowed the clinician to assess the exact thickness of the lateral wall of the maxillary sinus and better determine the ideal placement location and/or the feasibility of using a fixation tack in the posterior upper jaw. In areas of thin bone the use of fixation tacks or screws should be attempted with extreme caution to avoid sinus penetration. In the case presented herein, the patient was completely asymptomatic and healed uneventfully with no further treatment needed. The decision to purposely remove foreign bodies from the maxillary sinus depends on patient signs and symptoms, as well as the size of the foreign body. Consultation with an otolaryngologist and radiographic examinations and analyses are necessary.</p></sec></body><back><ack><p>The authors thank Dr. Dimitris N. Tatakis, Division of Periodontology, College of Dentistry, The Ohio State University, for his assistance in the preparation of this manuscript.</p></ack><fn-group><fn><p><bold>Conflicts of interest</bold></p><p>None.</p></fn></fn-group><ref-list><title>References:</title><ref id="b1-amjcaserep-14-43"><label>1.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Devlin</surname><given-names>H</given-names></name><name><surname>Ferguson</surname><given-names>MW</given-names></name></person-group><article-title>Alveolar ridge resorption and mandibular atrophy. A review of the role of local and systemic factors</article-title><source>Br Dent J</source><year>1991</year><volume>170</volume><fpage>101</fpage><lpage>4</lpage><pub-id pub-id-type="pmid">2007065</pub-id></element-citation></ref><ref id="b2-amjcaserep-14-43"><label>2.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sharan</surname><given-names>A</given-names></name><name><surname>Madjar</surname><given-names>D</given-names></name></person-group><article-title>Maxillary sinus pneumatization following extractions: a radiographic study</article-title><source>Int J Oral Maxillofac Implants</source><year>2008</year><volume>23</volume><fpage>48</fpage><lpage>56</lpage><pub-id pub-id-type="pmid">18416412</pub-id></element-citation></ref><ref id="b3-amjcaserep-14-43"><label>3.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Aghaloo</surname><given-names>TL</given-names></name><name><surname>Moy</surname><given-names>PK</given-names></name></person-group><article-title>Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement?</article-title><source>Int J Oral Maxillofac Implants</source><year>2007</year><volume>22</volume><issue>Suppl</issue><fpage>49</fpage><lpage>70</lpage><pub-id pub-id-type="pmid">18437791</pub-id></element-citation></ref><ref id="b4-amjcaserep-14-43"><label>4.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Donos</surname><given-names>N</given-names></name><name><surname>Mardas</surname><given-names>N</given-names></name><name><surname>Chadha</surname><given-names>V</given-names></name></person-group><article-title>Clinical outcomes of implants following lateral bone augmentation: systematic assessment of available options (barrier membranes, bone grafts, split osteotomy)</article-title><source>J Clin Periodontol</source><year>2008</year><volume>35</volume><fpage>173</fpage><lpage>202</lpage><pub-id pub-id-type="pmid">18724850</pub-id></element-citation></ref><ref id="b5-amjcaserep-14-43"><label>5.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>McAllister</surname><given-names>BS</given-names></name><name><surname>Haghighat</surname><given-names>K</given-names></name></person-group><article-title>Bone augmentation techniques</article-title><source>J Periodontol</source><year>2007</year><volume>78</volume><fpage>377</fpage><lpage>96</lpage><pub-id pub-id-type="pmid">17335361</pub-id></element-citation></ref><ref id="b6-amjcaserep-14-43"><label>6.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Carpio</surname><given-names>L</given-names></name><name><surname>Loza</surname><given-names>J</given-names></name><name><surname>Lynch</surname><given-names>S</given-names></name><name><surname>Genco</surname><given-names>R</given-names></name></person-group><article-title>Guided bone regeneration around endosseous implants with anorganic bovine bone mineral. A randomized controlled trial comparing bioabsorbable versus non-resorbable barriers</article-title><source>J Periodontol</source><year>2000</year><volume>71</volume><fpage>1743</fpage><lpage>49</lpage><pub-id pub-id-type="pmid">11128923</pub-id></element-citation></ref><ref id="b7-amjcaserep-14-43"><label>7.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Fireman</surname><given-names>SM</given-names></name><name><surname>Noyek</surname><given-names>AM</given-names></name></person-group><article-title>Dental anatomy and radiology and the maxillary sinus</article-title><source>Otolaryngol Clin North Am</source><year>1976</year><volume>9</volume><fpage>83</fpage><lpage>91</lpage><pub-id pub-id-type="pmid">1246435</pub-id></element-citation></ref><ref id="b8-amjcaserep-14-43"><label>8.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname><given-names>HL</given-names></name><name><surname>Al-Shammari</surname><given-names>K</given-names></name></person-group><article-title>HVC ridge deficiency classification: a therapeutically oriented classification</article-title><source>Int J Periodontics Restorative Dent</source><year>2002</year><volume>22</volume><fpage>335</fpage><lpage>43</lpage><pub-id pub-id-type="pmid">12212680</pub-id></element-citation></ref><ref id="b9-amjcaserep-14-43"><label>9.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Simion</surname><given-names>M</given-names></name><name><surname>Baldoni</surname><given-names>M</given-names></name><name><surname>Rossi</surname><given-names>P</given-names></name><name><surname>Zaffe</surname><given-names>D</given-names></name></person-group><article-title>A comparative study of the effectiveness of e-PTFE membranes with and without early exposure during the healing period</article-title><source>Int J Periodontics Restorative Dent</source><year>1994</year><volume>14</volume><fpage>166</fpage><lpage>80</lpage><pub-id pub-id-type="pmid">7928132</pub-id></element-citation></ref><ref id="b10-amjcaserep-14-43"><label>10.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Liston</surname><given-names>PN</given-names></name><name><surname>Walters</surname><given-names>RF</given-names></name></person-group><article-title>Foreign bodies in the maxillary antrum: a case report</article-title><source>Aust Dent J</source><year>2002</year><volume>47</volume><fpage>344</fpage><lpage>46</lpage><pub-id pub-id-type="pmid">12587772</pub-id></element-citation></ref><ref id="b11-amjcaserep-14-43"><label>11.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pang</surname><given-names>KP</given-names></name><name><surname>Siow</surname><given-names>JK</given-names></name><name><surname>Tan</surname><given-names>HM</given-names></name></person-group><article-title>Migration of a foreign body in the maxillary sinus illustrating natural mucociliary action</article-title><source>Med J Malaysia</source><year>2005</year><volume>60</volume><fpage>383</fpage><lpage>85</lpage><pub-id pub-id-type="pmid">16379200</pub-id></element-citation></ref><ref id="b12-amjcaserep-14-43"><label>12.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yamaguchi</surname><given-names>K</given-names></name><name><surname>Matsunaga</surname><given-names>T</given-names></name><name><surname>Hayashi</surname><given-names>Y</given-names></name></person-group><article-title>Gross extrusion of endodontic obturation materials into the maxillary sinus: a case report</article-title><source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source><year>2007</year><volume>104</volume><fpage>131</fpage><lpage>34</lpage><pub-id pub-id-type="pmid">17368059</pub-id></element-citation></ref><ref id="b13-amjcaserep-14-43"><label>13.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Barclay</surname><given-names>JK</given-names></name></person-group><article-title>Root in the maxillary sinus</article-title><source>Oral Surg Oral Med Oral Pathol</source><year>1987</year><volume>64</volume><fpage>162</fpage><lpage>64</lpage><pub-id pub-id-type="pmid">3476894</pub-id></element-citation></ref><ref id="b14-amjcaserep-14-43"><label>14.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Winstock</surname><given-names>D</given-names></name><name><surname>Warnakulasuriya</surname><given-names>S</given-names></name></person-group><article-title>Impression material presenting in the maxillary antrum as a foreign body</article-title><source>Br Dent J</source><year>1986</year><volume>160</volume><fpage>54</fpage><lpage>55</lpage><pub-id pub-id-type="pmid">3466605</pub-id></element-citation></ref><ref id="b15-amjcaserep-14-43"><label>15.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Khoury</surname><given-names>F</given-names></name></person-group><article-title>Burs and root tips in the maxillary sinus</article-title><source>Quintessenz</source><year>1985</year><volume>36</volume><fpage>1233</fpage><lpage>37</lpage><pub-id pub-id-type="pmid">3867916</pub-id></element-citation></ref><ref id="b16-amjcaserep-14-43"><label>16.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Holmes</surname><given-names>A</given-names></name></person-group><article-title>Sewing needle as an antral foreign body</article-title><source>Br Dent J</source><year>1987</year><volume>162</volume><fpage>153</fpage><lpage>54</lpage><pub-id pub-id-type="pmid">3468991</pub-id></element-citation></ref><ref id="b17-amjcaserep-14-43"><label>17.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Burnham</surname><given-names>R</given-names></name><name><surname>Bridle</surname><given-names>C</given-names></name></person-group><article-title>Aspergillosis of the maxillary sinus secondary to a foreign body (amalgam) in the maxillary antrum</article-title><source>Br J Oral Maxillofac Surg</source><year>2009</year><volume>47</volume><fpage>313</fpage><lpage>15</lpage><pub-id pub-id-type="pmid">19250722</pub-id></element-citation></ref><ref id="b18-amjcaserep-14-43"><label>18.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Iida</surname><given-names>S</given-names></name><name><surname>Tanaka</surname><given-names>N</given-names></name><name><surname>Kogo</surname><given-names>M</given-names></name><name><surname>Matsuya</surname><given-names>T</given-names></name></person-group><article-title>Migration of a dental implant into the maxillary sinus. A case report</article-title><source>Int J Oral Maxillofac Surg</source><year>2000</year><volume>29</volume><fpage>358</fpage><lpage>59</lpage><pub-id pub-id-type="pmid">11071239</pub-id></element-citation></ref><ref id="b19-amjcaserep-14-43"><label>19.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Galindo</surname><given-names>P</given-names></name><name><surname>Sanchez-Fernandez</surname><given-names>E</given-names></name><name><surname>Avila</surname><given-names>G</given-names></name><etal></etal></person-group><article-title>Migration of implants into the maxillary sinus: two clinical cases</article-title><source>Int J Oral Maxillofac Implants</source><year>2005</year><volume>20</volume><fpage>291</fpage><lpage>95</lpage><pub-id pub-id-type="pmid">15839124</pub-id></element-citation></ref><ref id="b20-amjcaserep-14-43"><label>20.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kluppel</surname><given-names>LE</given-names></name><name><surname>Santos</surname><given-names>SE</given-names></name><name><surname>Olate</surname><given-names>S</given-names></name><etal></etal></person-group><article-title>Implant migration into maxillary sinus: description of two asymptomatic cases</article-title><source>Oral Maxillofac Surg</source><year>2010</year><volume>14</volume><fpage>63</fpage><lpage>66</lpage><pub-id pub-id-type="pmid">19865837</pub-id></element-citation></ref><ref id="b21-amjcaserep-14-43"><label>21.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Regev</surname><given-names>E</given-names></name><name><surname>Smith</surname><given-names>RA</given-names></name><name><surname>Perrott</surname><given-names>DH</given-names></name><name><surname>Pogrel</surname><given-names>MA</given-names></name></person-group><article-title>Maxillary sinus complications related to endosseous implants</article-title><source>Int J Oral Maxillofac Implants</source><year>1995</year><volume>10</volume><fpage>451</fpage><lpage>61</lpage><pub-id pub-id-type="pmid">7672848</pub-id></element-citation></ref><ref id="b22-amjcaserep-14-43"><label>22.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Varol</surname><given-names>A</given-names></name><name><surname>Turker</surname><given-names>N</given-names></name><name><surname>Goker</surname><given-names>K</given-names></name><name><surname>Basa</surname><given-names>S</given-names></name></person-group><article-title>Endoscopic retrieval of dental implants from the maxillary sinus</article-title><source>Int J Oral Maxillofac Implants</source><year>2006</year><volume>21</volume><fpage>801</fpage><lpage>4</lpage><pub-id pub-id-type="pmid">17066644</pub-id></element-citation></ref><ref id="b23-amjcaserep-14-43"><label>23.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kitamura</surname><given-names>A</given-names></name></person-group><article-title>Removal of a migrated dental implant from a maxillary sinus by transnasal endoscopy</article-title><source>Br J Oral Maxillofac Surg</source><year>2007</year><volume>45</volume><fpage>410</fpage><lpage>11</lpage><pub-id pub-id-type="pmid">16457911</pub-id></element-citation></ref><ref id="b24-amjcaserep-14-43"><label>24.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Haben</surname><given-names>CM</given-names></name><name><surname>Balys</surname><given-names>R</given-names></name><name><surname>Frenkiel</surname><given-names>S</given-names></name></person-group><article-title>Dental implant migration into the ethmoid sinus</article-title><source>J Otolaryngol</source><year>2003</year><volume>32</volume><fpage>342</fpage><lpage>44</lpage><pub-id pub-id-type="pmid">14974869</pub-id></element-citation></ref><ref id="b25-amjcaserep-14-43"><label>25.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chiapasco</surname><given-names>M</given-names></name><name><surname>Felisati</surname><given-names>G</given-names></name><name><surname>Maccari</surname><given-names>A</given-names></name><etal></etal></person-group><article-title>The management of complications following displacement of oral implants in the paranasal sinuses: a multicenter clinical report and proposed treatment protocols</article-title><source>Int J Oral Maxillofac Surg</source><year>2009</year><volume>38</volume><fpage>1273</fpage><lpage>78</lpage><pub-id pub-id-type="pmid">19781911</pub-id></element-citation></ref><ref id="b26-amjcaserep-14-43"><label>26.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Felisati</surname><given-names>G</given-names></name><name><surname>Lozza</surname><given-names>P</given-names></name><name><surname>Chiapasco</surname><given-names>M</given-names></name><name><surname>Borloni</surname><given-names>R</given-names></name></person-group><article-title>Endoscopic removal of an unusual foreign body in the sphenoid sinus: an oral implant</article-title><source>Clin Oral Implants Res</source><year>2007</year><volume>18</volume><fpage>776</fpage><lpage>80</lpage><pub-id pub-id-type="pmid">17868385</pub-id></element-citation></ref><ref id="b27-amjcaserep-14-43"><label>27.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Thevoz</surname><given-names>F</given-names></name><name><surname>Arza</surname><given-names>A</given-names></name><name><surname>Jaques</surname><given-names>B</given-names></name></person-group><article-title>Dental foreign body sinusitis</article-title><source>Schweiz Med Wochenschr</source><year>2000</year><issue>Suppl.125</issue><fpage>30S</fpage><lpage>34S</lpage><pub-id pub-id-type="pmid">11141934</pub-id></element-citation></ref><ref id="b28-amjcaserep-14-43"><label>28.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Johnson</surname><given-names>K</given-names></name></person-group><article-title>A study of the dimensional changes occurring in the maxilla following tooth extraction</article-title><source>Aust Dent J</source><year>1969</year><volume>14</volume><fpage>241</fpage><lpage>44</lpage><pub-id pub-id-type="pmid">5259350</pub-id></element-citation></ref><ref id="b29-amjcaserep-14-43"><label>29.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Penttila</surname><given-names>MA</given-names></name><name><surname>Rautiainen</surname><given-names>ME</given-names></name><name><surname>Pukander</surname><given-names>JS</given-names></name><name><surname>Karma</surname><given-names>PH</given-names></name></person-group><article-title>Endoscopic versus Caldwell-Luc approach in chronic maxillary sinusitis: comparison of symptoms at one-year follow-up</article-title><source>Rhinology</source><year>1994</year><volume>32</volume><fpage>161</fpage><lpage>65</lpage><pub-id pub-id-type="pmid">7701222</pub-id></element-citation></ref><ref id="b30-amjcaserep-14-43"><label>30.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kennedy</surname><given-names>DW</given-names></name><name><surname>Zinreich</surname><given-names>SJ</given-names></name><name><surname>Shaalan</surname><given-names>H</given-names></name><etal></etal></person-group><article-title>Endoscopic middle meatal antrostomy: theory, technique, and patency</article-title><source>Laryngoscope</source><year>1987</year><volume>97</volume><fpage>1</fpage><lpage>9</lpage><pub-id pub-id-type="pmid">3613804</pub-id></element-citation></ref><ref id="b31-amjcaserep-14-43"><label>31.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Borgonovo</surname><given-names>A</given-names></name><name><surname>Fabbri</surname><given-names>A</given-names></name><name><surname>Boninsegna</surname><given-names>R</given-names></name><etal></etal></person-group><article-title>Displacement of a dental implant into the maxillary sinus: case series</article-title><source>Minerva Stomatol</source><year>2010</year><volume>59</volume><fpage>45</fpage><lpage>54</lpage><pub-id pub-id-type="pmid">20212409</pub-id></element-citation></ref><ref id="b32-amjcaserep-14-43"><label>32.</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Westermark</surname><given-names>AH</given-names></name></person-group><article-title>Spontaneous removal of foreign bodies from the maxillary sinus: report of a case</article-title><source>J Oral Maxillofac Surg</source><year>1989</year><volume>47</volume><fpage>75</fpage><lpage>77</lpage><pub-id pub-id-type="pmid">2911061</pub-id></element-citation></ref></ref-list></back><floats-group><fig id="f1-amjcaserep-14-43" position="float"><label>Figure 1.</label><caption><p>Pre-operative panoramic radiograph: Note a titanium zygomatic plate that was previously placed and unrelated to this case report.</p></caption><graphic xlink:href="amjcaserep-14-43-g001"></graphic></fig><fig id="f2-amjcaserep-14-43" position="float"><label>Figure 2.</label><caption><p>Post-operative panoramic radiograph immediately after tack displacement. The displaced tack is indicated by black arrow, while the non-displaced tack is indicated by a white arrow. Note the right maxillary canine area, where socket preservation was performed following extraction of the canine root.</p></caption><graphic xlink:href="amjcaserep-14-43-g002"></graphic></fig><fig id="f3-amjcaserep-14-43" position="float"><label>Figure 3.</label><caption><p>Post-operative (8-week) CBCT. (<bold>A</bold>) Axial view of CBCT demonstrating view of interest. (<bold>B</bold>) Panoramic view of CBCT: non-displaced tack (white arrow). Tack superiorly to sinus is a titanium zygomatic plate previously placed and unrelated to this case report. (<bold>C–E</bold>) Coronal views demonstrating the non-displaced tack (white arrow in blue box) and a clear, open ostium (white arrow in red box). The displaced tack was not seen on these CBCT images.</p></caption><graphic xlink:href="amjcaserep-14-43-g003"></graphic></fig></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/EdenteV2/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001B23 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 001B23 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Santé
|area= EdenteV2
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:3619038
|texte= Fixation tack penetration into the maxillary sinus: A case report of a guided bone regeneration procedure complication
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:23569561" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a EdenteV2
| This area was generated with Dilib version V0.6.32. |  |