PMC3379539_01
Panoramic radiograph showing the maxillary left second premolar that is impacted and in an inverted position. The precise relation
of the tooth with the maxillary sinus cannot be identified.
TODENTJ-6-90_F1.jpg
PMC3379539_01_TODENTJ-6-90_F1.jpg
F1
A close-up of the panoramic radiograph (Fig. 1) showed that the maxillary left second premolar was impacted and in an inverted position, and its apical third was dilacerated towards the distal direction, and there was an opaque area in the maxillary sinus related to the impacted premolar apex.
Saggital view showing the relation of the tooth to the maxillary sinus, root dilaceration and mucosal thickening in the maxillary
sinus.
TODENTJ-6-90_F2.jpg
PMC3379539_01_TODENTJ-6-90_F2.jpg
F2
The saggital view (Fig. 2) showed root dilaceration more clearly, and the mucosal thickening in the left maxillary sinus explained the opacification observed in the panoramic radiograph.
CBCT cross-sectional views showing the tooth crown protruding into the maxillary sinus.
TODENTJ-6-90_F3.jpg
PMC3379539_01_TODENTJ-6-90_F3.jpg
F3
Analysis of the cross-sectional view (Fig. 3) showed the tooth crown protruding into the maxillary sinus.
Surgical access to the maxillary sinus for performing
exodontia with preservation of the alveolar bone.
TODENTJ-6-90_F4.jpg
PMC3379539_01_TODENTJ-6-90_F4.jpg
F4
Patient management under local anesthesia, access to the maxillary sinus was obtained by raising a mucoperiosteal flap and performing osteotomy of the lateral maxillary wall (Fig. 4).