MIGRATION OF DENTAL IMPLANTS INTO THE SINONASAL COMPLEX: PREDISPOSING FACTORS, DIAGNOSIS, AND SURGICAL MANAGEMENT

Abstract

Displacement of a dental implant into the maxillary sinus, and only exceptionally into the nasal cavity, is an uncommon but clinically important complication of implant therapy in the upper jaw. The posterior maxilla is particularly vulnerable because reduced residual bone height, low bone density, sinus pneumatization, and technically aggressive placement may compromise primary stability. This focused review synthesized clinically useful evidence on risk factors, presentation, imaging, complications, and surgical treatment. The evidence base consists mainly of retrospective series, systematic reviews, and selected case reports with verifiable quantitative data. Across the literature, the leading complication is odontogenic sinusitis, whereas displacement may occur intraoperatively, early after surgery, or later under functional load. Cone-beam computed tomography is the diagnostic standard because it defines implant location, sinus condition, and oroantral communication. Surgical management must be individualized. Transoral access remains useful when direct sinus revision and closure of an oroantral defect are required, while endoscopic transnasal surgery is especially valuable when rhinosinusitis predominates or the implant is located near the ostiomeatal complex. In most patients, early removal is the preferred strategy.