A Dental Implant Foreign Body Discharged Through the Nasal Cavity

We report a rare case of an implant being discharged through the nasal cavity after endoscopic sinus surgery for odontogenic sinusitis caused by the implant. A 74-year-old Japanese woman who presented to us with a 3-month history of postnasal drip and left nasal obstruction had undergone a dental implant at the site of the upper left maxillary second molar 16 years prior to her first visit to our department; a panoramic radiograph obtained at our Department of Dentistry 5 years earlier revealed bone resorption around the implant. At the present visit, the implant was found to be projecting above the floor of the left maxillary sinus, and sinus computed tomography (CT) revealed areas of soft tissue density in the left maxillary sinus and ethmoid sinus and around the implant. Based on the above findings, we made the diagnosis of odontogenic sinusitis related to the implant. We performed endoscopic sinus surgery (ESS), and found drainage from the maxillary sinus and swelling of the mucosa. However, we found no implant at the site of the upper left maxillary second molar, and the patient gave no history of implant removal. Her symptoms disappeared 61 days postoperatively. In a sinus CT obtained 6 months after the ESS, the area of soft tissue density lining the left maxillary sinus was thinner than that found in the sinus CT obtained 3 months after ESS. Finally, the implant was discharged through her nasal cavity 9 months after the ESS.