Surgical Removal of a Dental Bur From the Maxillary Sinus Using the Caldwell-Luc Approach: A Case Report

The displacement of foreign bodies into the maxillary sinus is an uncommon complication of dental procedures. Foreign bodies may remain undetected for prolonged periods and be associated with chronic inflammatory changes. This case report describes the surgical removal of a dental bur lodged in the left maxillary sinus using the Caldwell-Luc approach. A 63-year-old woman was referred following the incidental detection of a suspected foreign body on a panoramic radiograph. She reported a history of tooth extraction in the left posterior maxillary region approximately five years earlier, as well as mild nasal congestion and headache. Cone-beam computed tomography (CBCT) revealed a metallic structure consistent in appearance with a No. 702 surgical bur, measuring approximately 24 mm in length, and partial opacification of the maxillary sinus. The instrument was removed via the Caldwell-Luc approach, followed by debridement of the sinus cavity and excision of adjacent reactive tissue. Histopathological examination revealed fibrosis and changes consistent with chronic sinusitis. Postoperative CBCT, performed seven days after surgery, confirmed the complete removal of the instrument. Mild paresthesia in the infraorbital nerve distribution was reported at the seven-day follow-up visit but was no longer present at the 30-day assessment. In this case, cone-beam computed tomography facilitated diagnosis and surgical planning, and the Caldwell-Luc approach enabled successful foreign body removal under the documented clinical and anatomical conditions.