Surgical removal of impacted amalgam from the maxillary sinus after furcation perforation in maxillary sinus during tooth restoration:A case report

Introduction: Foreign bodies in maxillary sinuses are classified as either traumatic or iatrogenic. The routes of entry of metal foreign bodies, such as dental amalgam, are usually oroantral fistulas or traumas. The present report explains a rare case of a procedural accident that during a dental procedure. Case Report: A 30-year-old man presented to the dental office for a restorative procedure on his upper right second molar. During the dental procedure, furcation area and the inferior wall of maxillary sinus were penetrated. After packing of amalgam and suspected bleeding in the area, radiography revealed amalgam beyond the furcation area within the right maxillary sinus. The tooth was extracted and the patient was referred to a maxillofacial surgeon for treatment. Conclusion: Foreign bodies in paranasal sinuses, especially metal objects such as amalgam, must be removed to prevent chronic mucosal irritation or malignant mucosal alterations even if they are asymptomatic. Thus, it is recommended that dentists pay attention to the creation of oroantral fistulas during dental procedures and existence of foreign bodies in sinuses and refer the patient to a specialist, if necessary, to prevent potential complications.   Key words: Dental amalgam, Maxillary sinus, Sinusitis