case_images: PMC11812989_01
case_images: CBCT images, intraoral photographs, and the extracted root stump of case 1. (A and B) CBCT images showing a root stump within the right maxillary sinus. (C) Three-dimensional reconstruction illustrating a root stump in the right maxillary sinus. (D) Ultrasonic bone scalpel creates a window in the lateral wall of the right maxillary sinus and elevation of the sinus membrane. (E) Removal of the root stump using hemostatic forceps. (F) The extracted root stump. (G and H) Postoperative CBCT images showing no foreign bodies in the right maxillary sinus with minor effusion. (I) Three-dimensional reconstruction displaying the bone window in the lateral wall of the right maxillary sinus. CBCT = cone-beam computed tomography.
case_images: medi-104-e41288-g001.jpg
case_images: PMC11812989_01_medi-104-e41288-g001.jpg
case_images: F1
case_images: Preoperative cone-beam computed tomography (CBCT) scans in both upright and supine positions revealed the presence of the root stump, which was adherent to the thickened mucosa of the right maxillary sinus (Fig. 1A and B). The 3-dimensional reconstruction located the root at the bottom of the right maxillary sinus, near the palatal bone wall (Fig. 1C). Once the periosteal stripping reached below the root stump, it was palpable, and the membrane was punctured at this location to move the root under the membrane and slowly toward the bone window, where it was removed with hemostatic forceps (Fig. 1D-F). The surgical site was sutured and postoperative imaging confirmed that no root stumps were left behind. (Fig. 1G-I) The entire procedure took  20 minutes.
case_images: PMC11812989_02
case_images: CBCT images, intraoral photographs, and the extracted root stump of case 2. (A and B) CBCT images showing the root stump within the left maxillary sinus. (C) Elevation and separation of the maxillary sinus membrane following lateral window opening on the left maxillary sinus. (D) The extracted root stump. (E) Three-dimensional reconstruction showing the bone window on the lateral wall of the left maxillary sinus. (F and G) Postoperative CBCT images showing no foreign objects within the left maxillary sinus, with no significant effusion. (H and I) Good healing of the extraction site at position 26, 4 months postoperatively. (J and K) Routine implant placement at site 26, 4 months postoperatively. (L) Completion of implant restoration at site 26. CBCT = cone-beam computed tomography.
case_images: medi-104-e41288-g002.jpg
case_images: PMC11812989_02_medi-104-e41288-g002.jpg
case_images: F2
case_images: Oral CBCT imaging showed the residual root located between the sinus membrane and the bony floor of the maxillary sinus, near the cheek side wall on the sagittal view, without penetrating the mucosa (Fig. 2A and B). A curette was used to lift the root stump under the membrane and slowly move it toward the bone window, where it was removed with hemostatic forceps (Fig. 2C and D). The postoperative CBCT images confirmed that no root stumps were left behind (Fig. 2E-G). Four months after the removal of the root stump, the socket at position 26 healed well with no complications, (Fig. 2H and I), and a dental implant was placed. Follow-up showed good stability of the implant (Fig. 2J-L).