J Korean Assoc Oral Maxillofac Surg.  2012 Apr;38(2):110-105. 10.5125/jkaoms.2012.38.2.110.

A lateral approach to the maxillary sinus for simultaneous extraction of an ankylosed maxillary molar and sinus graft: a case report

• Hwang JH
• Choi HS
• Kim KD
• Doh RM
• Park W

• KMID: 2189707
• DOI: http://doi.org/10.5125/jkaoms.2012.38.2.110

Abstract

Ankylosed tooth is defined as 'the discontinuance of normal passive tooth eruption without any mechanical barrier'. Ankylosed tooth treatment is a challenge to dental clinicians. In treatment of maxillary molar ankylosis cases there are risks of oro-antral fistula, displacement of root fragments into the maxillary sinus, as well as the necessity for providing additional sinus bone augmentation for future implant placement. In this study, we suggested a new technique using a piezoelectric device and a lateral side approach to the maxillary sinus leading to the simultaneous removal of the ankylosed maxillary molar and sinus grafting for the purpose of implant site development.

Keyword

Ankylosis; Tooth; Sinus graft; Piezoelectric device; Site development

MeSH Terms

Ankylosis
Displacement (Psychology)
Fistula
Maxillary Sinus
Molar
Tooth
Tooth Eruption
Transplants

Figure

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  Fig. 1 Panoramic radiograph taken at the patient's first visit. An ankylosed right maxillary first molar is noted with full gold crown and root canal.

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  Fig. 2 Periapical view showing root resorption and loss of lamina dura around the infraoccluded tooth.

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  Fig. 3 Computed tomography evaluation showing the fusion of the tooth and alveolar bone segments; this fused apparatus is connected to the maxillary sinus septa.

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  Fig. 4 Lateral approach to the ankylosed tooth after the removal of the anterior wall of the maxillary sinus. The Schneiderian (sinus) membrane was carefully detached from the root surface.

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  Fig. 5 A piezoelectric device was used to cut the residual fused tooth-bone segment to preserve sinus membrane integrity.

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  Fig. 6 The ankylosed tooth was completely removed. Some root-canal filling material was observed over the apex of the adjacent teeth (arrow).

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  Fig. 7 Allogenic graft material was grafted at the defect.

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  Fig. 8 A buccal advancement flap was formed with periosteal releasing incision for closure.

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  Fig. 9 The extracted tooth.

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  Fig. 10 The extracted tooth.

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