The
n e w e ng l a n d j o u r na l
of
m e dic i n e
images in clinical medicine Lindsey R. Baden, M.D., Editor
Dental Implant in the Ethmoid Sinus A
B
C MT
LW NS
A
57-year-old woman presented with recurrent sinusitis of the Alberto Schreiber, M.D. left maxillary sinus. Computed tomography showed the presence of a foreign Davide Lombardi, M.D. body in the left ethmoid sinus (Panel A). The patient had received an endos- University of Brescia seous implant in the upper jaw 2 years earlier without complication. On transoral Brescia, Italy examination, the implant was unexpectedly absent; the mucosa covering the alveolar [email protected] process was intact, and the remaining teeth were healthy. During endoscopic surgery, a dental implant in the ostiomeatal complex was visualized (Panel B; LW denotes lateral nasal wall, MT middle turbinate, and NS nasal septum) and extracted (Panel C; units of measurement are centimeters). The patient was discharged the day after surgery, with rapid relief of symptoms. Eight months later, she reported no residual symptoms; on nasal endoscopy, the maxillary sinusotomy was patent with normal mucosa. Displacement of dental implants into the sinus may be the result of improper positioning or the late consequence of periimplantitis and bone resorption.
DOI: 10.1056/NEJMicm1305466 Copyright © 2013 Massachusetts Medical Society.
n engl j med 369;17
nejm.org
october 24, 2013
e23
The New England Journal of Medicine Downloaded from nejm.org at NYU WASHINGTON SQUARE CAMPUS on June 1, 2015. For personal use only. No other uses without permission. Copyright © 2013 Massachusetts Medical Society. All rights reserved.
n e w e ng l a n d j o u r na l
of
m e dic i n e
images in clinical medicine Lindsey R. Baden, M.D., Editor
Dental Implant in the Ethmoid Sinus A
B
C MT
LW NS
A
57-year-old woman presented with recurrent sinusitis of the Alberto Schreiber, M.D. left maxillary sinus. Computed tomography showed the presence of a foreign Davide Lombardi, M.D. body in the left ethmoid sinus (Panel A). The patient had received an endos- University of Brescia seous implant in the upper jaw 2 years earlier without complication. On transoral Brescia, Italy examination, the implant was unexpectedly absent; the mucosa covering the alveolar [email protected] process was intact, and the remaining teeth were healthy. During endoscopic surgery, a dental implant in the ostiomeatal complex was visualized (Panel B; LW denotes lateral nasal wall, MT middle turbinate, and NS nasal septum) and extracted (Panel C; units of measurement are centimeters). The patient was discharged the day after surgery, with rapid relief of symptoms. Eight months later, she reported no residual symptoms; on nasal endoscopy, the maxillary sinusotomy was patent with normal mucosa. Displacement of dental implants into the sinus may be the result of improper positioning or the late consequence of periimplantitis and bone resorption.
DOI: 10.1056/NEJMicm1305466 Copyright © 2013 Massachusetts Medical Society.
n engl j med 369;17
nejm.org
october 24, 2013
e23
The New England Journal of Medicine Downloaded from nejm.org at NYU WASHINGTON SQUARE CAMPUS on June 1, 2015. For personal use only. No other uses without permission. Copyright © 2013 Massachusetts Medical Society. All rights reserved.
