CONDITION / CARRY

Foreign body of the maxillary sinus.

A foreign body of the maxillary sinus is most often a filling material, a root fragment or a dental implant that got into the sinus during dental treatment. It may not bother you for years, but it often causes sinusitis and fungal damage, so it is mostly removed — in particular, endoscopically, through the nose.

Discuss your case How it is treated in the clinic ↓

CONCEPTUAL VISUALIZATION

BRIEFLY

what is it: Filling material, root, implant or other object in the maxillary sinus.
From where: About 60% of foreign bodies in the paranasal sinuses get there during medical, particularly dental, interventions.
What threatens: Sinusitis and fungal ball; filling material with zinc can promote the growth of fungus.
How to treat: They are mostly removed surgically, in particular endoscopically, through the nose.

01 / WHAT IS IT

What is
sinus foreign body.

The roots of the upper teeth, especially the molars, are located very close to the bottom of the maxillary sinus. During root canal filling, tooth extraction or implant placement, the material or the implant itself sometimes gets into the sinus.

Such a foreign body may not cause symptoms for years and be found accidentally on the picture. But inflammation often develops around it - odontogenic sinusitis - or a fungal ball, a dense accumulation of fungus in the sinus.

Not every foreign body is a reason for urgent surgery: small objects sometimes come out on their own in the first week. Decisions are made based on size, type of object and symptoms.

This is general information. The doctor will tell you how to act in your particular case after the CT scan.

02 / SIGNS

How a
foreign body manifests itself.

Manifestations range from an accidental finding without any complaints to acute sinusitis.

Without symptoms

Filling material is often found accidentally on a picture of the teeth or sinuses.

One-sided obstruction

The nose breathes worse on the side of the affected sinus.

Pressure in the cheek

Heaviness or pain under the eye on the same side where the tooth was treated.

Unpleasant smell

Putrid smell and purulent secretions on one side are signs of odontogenic sinusitis.

Chronic sinusitis

03 / REASONS

How it
gets there.

In a series of 27 patients, fragments of teeth (40.27%), implants (18.51%) and whole teeth (14.81%) were most often found in the sinus.

Sealing of channels

Most often — in the treatment of the first upper molars: in a systematic review, they accounted for 59% of cases.

Tooth extraction

The root or the entire tooth can be displaced in the sinus, especially if its bottom is thin.

Implants

They are displaced in the sinus mainly in the first 6 months after installation — in 62.6% of the described cases.

Mushroom ball

Zinc in filling materials can promote the growth of fungus in the sinus.

04 / SEEK MEDICAL ADVICE

When to seek medical advice?

If during the treatment of the tooth you were told that the material or the implant got into the sinus, contact the ENT doctor without delay: the time to removal affects the risk of sinusitis.

103 immediately if:

swelling and redness of the eyelids, pain when moving the eyes, deterioration of vision;
severe headache with high temperature or neck stiffness.

See an ENT doctor in the coming days if:

After treatment or removal of the upper tooth, pain in the cheek, purulent discharge on one side, unpleasant odor, or the implant or root has moved into the sinus appeared. If the filling material was found by accident and there are no complaints, make an appointment for a scheduled consultation.

05 / DIAGNOSTICS

How to define
tactics.

CT scan of the sinuses
Shows the object, its size and position, the condition of the mucous membrane and sinus opening.
Nasal endoscopy
The search for pus in the middle nasal passage is a sign of inflammation.
Examination of the dentist
Evaluation of the causative tooth and connection of the sinus with the mouth.
The solution
Observe or remove - depending on the subject and symptoms.

06 / TREATMENT

How to remove a
foreign body.

There is no single standard yet, but most often the foreign body is removed surgically, and the results are mostly favorable.

Observation

Small items: Small (up to 5 mm) objects without symptoms can be observed in the first week: of the 55 foreign bodies described, 16.4% came out by themselves, half of them in the first week. High-risk items are removed immediately.
A random mushroom ball: In a cohort of 83 patients with an accidentally found fungal ball, an average of 5 years of observation, 94% managed without surgery and complications.

Endoscopic removal

Through the nose, without incisions on the face.

Micropharyngotomy: Through the expanded opening of the sinus, the object is removed under the control of the endoscope. In a series of 24 patients, all 25 implants were removed in this way, without complications.
Mushroom ball: Endoscopic surgery is successful in 98.4% of cases according to a meta-analysis of 14 studies.
Connection with the mouth: If a hole remains in the mouth after tooth extraction, it can be closed through the mouth during the same operation.

Together with the dentist

Tooth treatment: In case of odontogenic sinusitis, the causative tooth is treated and the foreign body is removed; purulent exacerbation is treated with an antibiotic prescribed by a doctor.

07 / AT THE VALIKHNOVSKY CLINIC

How do we
treat it.

Foreign bodies of the maxillary sinus at Dr. Valikhnovsky's Institute of Surgery are removed in the "New Nose" direction - endoscopically, through the nostrils.

DIRECTION TO THE CLINIC A new nose Shape, support and breathing of the nose: septum, concha, sinuses, consequences of injuries, failed operations and removal of tumors. Go to direction

What do we do in this condition

Endoscopic microhygrotomy with removal of a foreign body — through the enlarged natural opening of the sinus.
Revision of the ostiomeatal complex — restoration of outflow from the sinus after removal.

Rostislav Valikhnovsky

Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovsky Institute of Surgery.

About the doctor ORCID

How is the treatment in us

ConsultationConversation, endoscopy of the nose, review of CT and dental images.
PlanWhether removal is necessary, what kind of access, what to do with the tooth — together with the dentist.
OperationEndoscopically, through the nostrils.
RecoverySwelling in the nose passes gradually; the doctor will explain what is possible and what should be avoided after the operation.
ControlExamination with endoscopy to ensure that the sinus is ventilated.

Discuss your case to call

08 / QUESTIONS AND ANSWERS

Frequently asked
questions.

Short answers. What is right for you, the doctor will tell you during the consultation.

The filling material got into the sinus - what to do?

Contact an ENT doctor and do a CT scan. The material may not bother you for years, but it often causes sinusitis or a fungal ball; time to removal affects the risk of sinusitis.

Is it possible not to delete?

Sometimes yes: small objects without symptoms are observed, and an accidental fungal ball in most patients for 5 years did not cause complications. The decision is made after CT.

How is the implant removed from the sinus?

In a systematic review, 321 patients used a lateral approach (38.1%), Caldwell-Luc surgery (27.2%), and transnasal endoscopy (23.1%). Endoscopic access is done without an incision in the mouth.

What is a mushroom ball?

A dense accumulation of fungus in the sinus, does not germinate in the tissue. Often associated with filling material; endoscopic surgery is successful in 98.4% of cases.

Are antibiotics necessary?

Without removing the foreign body and treating the tooth, they usually do not solve the problem. A purulent exacerbation is treated with an antibiotic prescribed by a doctor.

Is it possible to put implants after that?

Yes, after the sinus has healed. The terms are determined by the ENT specialist and the dentist together.

09 / SOURCES

Sources

10 sources · reviews, guidelines and studiesShowCollapse

Endodontic filling material extrusion into the maxillary sinus: clinical presentation, microbiology, management, and outcomes — a systematic reviewOdontology, 2026doi:10.1007/s10266-026-01469-2 ↗
Riding the Mucociliary Escalator: A Risk-Stratified Approach to Maxillary Sinus Foreign Body ManagementJournal of Oral and Maxillofacial Surgery, 2026doi:10.1016/j.joms.2026.06.173 ↗
Foreign Bodies of Dental Iatrogenic Origin Displaced in the Maxillary Sinus — A Safety and Efficacy Analysis of a Retrospective StudyAnnals of Maxillofacial Surgery, 2022doi:10.4103/ams.ams_190_21 ↗
Characteristics and management of dental implants displaced into the maxillary sinus: a systematic reviewInternational Journal of Oral and Maxillofacial Surgery, 2023doi:10.1016/j.ijom.2022.06.009 ↗
Implants Displaced Into the Maxillary Sinus: A Systematic ReviewImplant Dentistry, 2016doi:10.1097/ID.0000000000000408 ↗
Endoscopic sinus surgery for dental implant displacement into the maxillary sinus — a retrospective clinical studyInternational Journal of Oral and Maxillofacial Surgery, 2020doi:10.1016/j.ijom.2020.01.009 ↗
Odontogenic sinusitis maxillaris: A retrospective study of 121 cases with surgical interventionJournal of Cranio-Maxillofacial Surgery, 2017doi:10.1016/j.jcms.2017.01.023 ↗
Treatment of Paranasal Sinus Fungus Ball: A Systematic Review and Meta-AnalysisAnnals of Otology, Rhinology & Laryngology, 2021doi:10.1177/00034894211002431 ↗
Maxillary fungus ball: zinc-oxide endodontic materials as a risk factorActa Otorhinolaryngologica Italica, 2015pubmed.ncbi.nlm.nih.gov/26019392 ↗
Natural history of incidental paranasal sinus fungal balls: evidence from a decade-long imaging-based cohortRhinology, 2025doi:10.4193/Rhin25.117 ↗

The figures on the page are from these sources.

VALIKHNOVSKI SURGERY PARTNERS

The material
got into the sinus?

Send a CT scan or picture and describe what was treated and when. The doctor will tell if it needs to be removed and how.

to call Send an appeal