PMC9150996_01
OPG (a) and CBCT 3D scan (b). A considerable size of the lesion and translocation of tooth 13 are visible (arrow).
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We performed an orthopantomogram (OPG) and CBCT (Cone-Beam Computed Tomography) which revealed a massive cyst-like lesion in the right maxillary sinus with translocation of tooth 13 (Figure 1) what confirmed our initial diagnosis.
Intraoral view on operative region. Pus discharge is still present despite antimicrobial treatment.
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Despite the antimicrobial treatment, pus discharge was still present (Figure 2).
Tooth 53 is removed and oroantral fistula is excised.
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Under general anesthesia (87.5 mg of propofol and 100 mug of phentanyl) with monitoring of oxygen saturation and heart rate (by pulse oximeter attached to patient's finger), tooth 53 was removed and the fistula was excised (Figure 3).
After incision and mucoperiosteal flap reflection, tooth 13 is visible. The anterior wall of maxillary sinus has been resorbed by the cyst.
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The flap was reflected with anterior part of the cyst attached to it as the anterior wall of maxillary sinus was completely resorbed and tooth 13 became visible immediately (Figure 4).
The wound closed with resorbable sutures. Depth of the vestibule is decreased due to the necessity of closing oroantral fistula.
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The wound after tooth 53 extraction was sutured with a horizontal mattress (Novosyn 2/0). (Figure 5).
Intraoral view on operative area 2 months after surgery. Tooth 13 has started its eruption.
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On the third appointment, the eruption of the tooth 13 was noticed, so the patient was referred for subsequent orthodontic treatment (Figure 6).