CASE REPORT Implant migration into maxillary sinus: description of two asymptomatic cases Leandro Eduardo Kluppel & Saulo Ellery Santos & Sergio Olate & Francisco Wagner Vasconcelos Freire Filho & Roger William Fernandes Moreira & Márcio de Moraes Published online: 29 October 2009 # Springer-Verlag 2009 Abstract Background Rehabilitation of edentulous jaws with dental implants has become a usual practice around the world. A very low incidence of complications is associated with this therapy. One of them is migration of dental implants into maxillary sinus. Foreign bodies inside maxillary sinus should be removed because they can cause sinusitis, but if any symptoms are present, preservation alone can be indicated. Implant removal and bone reconstruction on the same procedure reduce treatment time and allow rehabilitation with implant-supported prosthesis. Methods In the present study, we report two cases of dental implants displaced into maxillary sinus that receive different treatment. Results In one of them, implant removal and sinus lift were carried out on same procedure while on the other preservation alone was advocated. Conclusion Both treatment modalities treatments allowed installation of implant-supported prosthesis. Keywords Implant migration . Dental implant complications . Maxillary sinus Introduction A rare complication associated with placement of dental implants in the posterior maxilla is migration into the maxillary sinus [1–5] or even into sphenoid sinus [6, 7]. Placement of dental implants without sinus lifting in greatly pneumatized sinuses, surgical inexperience, application of heavy force during implant insertion, existence of untreated perforation of the antral base after drilling sequence, and excessive tapping during sinus osteotomy procedure have been proposed as mechanism for implant migration [8]. Implant migration to the maxillary sinus may be followed by signs of infection or oroantral communication. This way, paranasal sinus function will be appearing altered after the implant migration. Basically, three treatment modalities have been proposed in the literature: removal of the dental implant from the sinus through endoscopic surgery or osteoplastic approach through the facial wall of the maxillary sinus; removal of the implant and bone grafting on the same surgical step; and follow-up alone [1, 9]. The variations of treatment area are associated principally with symptoms of migration, but a recent report of Chiapasco et al. [9] suggested that all implant in the sinus must be removed by probably further complications. Two reports of dental implants into maxillary sinus will be presented, and different treatment modalities will be discussed. L. E. Kluppel : S. E. Santos : S. Olate Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil F. W. V. Freire Filho Oral and Maxillofacial Surgery, Fortaleza University, Fortaleza, Brazil R. W. F. Moreira : M. de Moraes (*) Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division Piracicaba Dental School, State University of Campinas-UNICAMP, CP 52, CEP 13.414-903, Piracicaba, SP, Brazil e-mail: mmoraes@fop.unicamp.br e-mail: solate@fop.unicamp.br Oral Maxillofac Surg (2010) 14:63–66 DOI 10.1007/s10006-009-0184-2