title: Image-guided, endoscopic removal of migrated titanium dental implants from maxillary sinus: two cases.
abstract: OBJECTIVE
  We present two cases of dental implant migration into the maxillary sinus, with subsequent removal via image-guided, transnasal endoscopy.
  
  
  METHODS
  Presentation of clinical cases, together with a literature review of alternative surgical techniques, the theories behind implant migration, and the benefits of an image-guided, endoscopic approach.
  
  
  RESULTS
  One patient was asymptomatic, and the other had begun to experience sinogenic symptoms after implant displacement. Both patients presented to the ENT clinic, and both underwent the BrainLab protocol to generate computed tomography images for navigational reconstruction. Transnasal endoscopy was carried out with this guidance, and the implants were removed successfully in both cases. Previously used surgical techniques such as the Caldwell-Luc procedure or extraction through the tooth socket have higher rates of conversion to open procedures, more damage to the nasal sinuses and higher post-operative complication rates compared with the transnasal endoscopic approach.
  
  
  CONCLUSIONS
  Both patients underwent successful removal of their migrated dental implants with no complications, and neither required any follow-up intervention.
authors.affiliation: Department of ENT, Imperial College, London, UK. p_ramotar@hotmail.com
authors.forename: H
authors.initials: H
authors.lastname: Ramotar
authors.forename: M-C
authors.initials: MC
authors.lastname: Jaberoo
authors.forename: N K F
authors.initials: NK
authors.lastname: Koo Ng
authors.forename: M A
authors.initials: MA
authors.lastname: Pulido
authors.forename: H A
authors.initials: HA
authors.lastname: Saleh
mesh_terms: D015921:Dental Implants; D020878:Device Removal / Q000379:methods; D003952:Diagnostic Imaging; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D008443:Maxillary Sinus / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants