title: Removal of Long-Term Broken Roots Displaced Into the Maxillary Sinus by Endoscopic Assistant.
abstract: OBJECTIVE
  This report presented a patient with 2 long-term broken roots displaced in left maxillary sinus. The residual root fragments made the patient uncomfortable in both mind and body and interfered with prosthodontics work. The application of endoscope combined with piezoelectric device both helps in removing the broken roots successfully with minimally surgical injury and preserves the residual alveolar bone.
  
  
  METHODS
  Computed tomography scans and 3-dimensional reconstructions located the broken roots. A 1.0 cm × 1.5  cm rectangle bone window on anterolateral sinus wall was opened by a piezoelectric device to place the endoscope and forcep into sinus. Two broken roots could be observed clearly via a endoscopic screen. They were removed by a mini goblet forcep completely and efficiently. A whole bone lid was replaced with a biological membrane to help repair bone defect after removing procedure.
  
  
  RESULTS
  The operation is about 20 minutes with endoscope and piezoelectric device helped to save a lot of time and provided excellent visual surgical field. Main postoperative adverse effects were swelling, numbness, and temporal no-vitality for the first premolar (24). Three months later, computed tomography shows the Schneiderian membrane thinned to around 0.8  mm. The bone lid is on its position and starts to perform synostosis. The 24 tooth is still dysesthetic and needs time to recover.
  
  
  CONCLUSIONS
  Endoscopic surgery combined with a piezoelectric device has obvious advantage of minimizing surgical injury and providing excellent visibility of surgical field when removing long-term foreign bodies in maxillary sinus. It is efficient and protects the residual alveolar bone.
authors.affiliation: From the Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Qi Man
authors.initials: QM
authors.lastname: Gao
authors.forename: Chi
authors.initials: C
authors.lastname: Yang
authors.forename: Ling Yan
authors.initials: LY
authors.lastname: Zheng
authors.forename: Ying Kai
authors.initials: YK
authors.lastname: Hu
mesh_terms: D000328:Adult; D001641:Bicuspid / Q000473:pathology; D003791:Dental Pulp Test; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008443:Maxillary Sinus / Q000601:surgery*; D008567:Membranes, Artificial; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D008963:Molar / Q000293:injuries; D008964:Molar, Third / Q000293:injuries; D009297:Nasal Mucosa / Q000601:surgery; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D059745:Piezosurgery / Q000295:instrumentation / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014082:Tooth Fractures / Q000601:surgery*; D014092:Tooth Root / Q000293:injuries* / Q000601:surgery
chemical_list: D008567:Membranes, Artificial