Tooth Filling Material (Amalgam) in the Maxillary Sinus

Foreign Material in The Maxillary Sinus: Dental Amalgam

Foreign Body in The Right Maxillary Sinus: Dental Amalgam

During dental procedures, fillers can displaced into the maxillary sinuses. The photograph shows a female patient who had problems with a previously dental filling procedure . Tooth fillings (amalgam) are seen in the metal vision on the right maxillary sinus inner wall.

Foreign body in the paranasal sinuses

Foreign body is a rare condition in the paranasal sinuses. It is frequently seen in the maxillary sinus and frontal sinus. Dental intervention and trauma play a role in the etiology. It should be kept in mind that foreign bodies in the maxillary sinus may be due to the substances used in dental intervention in patients with a history of dental intervention. Endoscopic Sinus Surgery and Caldwell-Luc approach can be used in combination. During the operation of the maxillary tooth roots it must be careful intraoperatively may extend into the sinuses.

How can amalgam reach the maxillary sinus?

Dental practitioners often experience instrument fractures during root canal treatment. However, these fractures usually occur within the root canals. It is not unusual for high-speed rotating tools to attach and advance to important anatomical landmarks. Practitioners should take great care not to accidentally insert foreign bodies into the maxillary antrum during dental treatment, and especially during endodontic treatment (source >> An Iatrogenic Foreign Body in the Maxillary Sinus: Report of an Unusual Case).

Dental amalgam in the maxillarıy sinus may cause iatrogenic sinusitis!

As a result of dental amalgam placement within the paranasal sinuses, recurrent inflammatory response and sinusitis may occur due to amalgam. Sometimes this can be confused with paranasal sinus neoplasms (source link >> Inflammatory reaction to foreign body (amalgam) in the maxillary sinus misdiagnosed as an ethmoid tumor).

Symptoms of amalgam in the maxillarıy sinus

Foreign bodies in the maxillary sinus are not unusual findings. Many cases have been reported on foreign bodies such as teeth, dental amalgam, sticks, matchstick, gutta-percha point, lumps, and even bullets. Occasionally, metal foreign bodies are found in the paranasal sinuses. Often, the material is caused by trauma or displacament through an oro-central fistula. They rarely occur as a complication of the dental procedure. Iatrogenic dental bur placement in the maxillary sinus is also seen in the literature.

Patients may have pain in the involved sinus, headache, nasal congestion, purulent nasal discharge, cheek fistula, facial neuralgia, and bloating with an oro-antral fistula as is the case. A foreign body may also appear in different positions within the sinus. For example, an inserted tooth changes its position in the maxillary sinus with the change in the patient's head position, unless trapped between the sinus wall and the mucosa. Foreign bodies begin to become involved and may be a nidus for calcification (source link >> Unusual Foreign Body In The Maxillary Antrum:A Case Report).

Diagnosis of  amalgam in the maxillarıy sinus

The foreign body in the maxillary antrum may present as an acute phenomenon or remain silent for years. Some patients have swelling of the cheek, runny nose, oro-antral fistula, and so on. Computed tomography scanning is helpful in diagnosis and should be performed in all suspected cases except routine radiographic examinations. Some are even masked as a neoplastic lesion. A routine radiographic examination indicates a diagnosis of foreign body in the maxillary sinus. If there is no significant difference in the CT scan, an anthroscopy is performed to confirm the diagnosis. Some patients may also give a history of dental procedures that contribute more to the diagnosis.

Treatment of foreign body in the maxillary sinus

Foreign body removal is performed by both the caldwel-luc method and minimally invasive endoscopic assisted surgery.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
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Fax: +90 212 542 74 47




  1. Thanks for taking the time to share this informative post with us. Your articles are always filled with so much detailed information and can't wait to read more. Have a wonderful rest of your day and keep up the posts.
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  2. I love your dentistry post, even though i am dental lab technician.


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