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Root Displacement into Sinus — NDEB AFK MCQ

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ModerateOral SurgeryRoot Displacement into SinusNDEB AFK

During extraction of a maxillary premolar, the root fractures and the remaining apical fragment is displaced into the maxillary sinus. What is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Prescribe antibiotics, nasal decongestant, and sinus precautions; refer to oral surgery for retrieval via a Caldwell-Luc approach

When a root tip is displaced into the maxillary sinus, it should not be left as it can cause sinusitis and act as a foreign body. Blind attempts to retrieve through the socket risk further displacement. The appropriate management is to prescribe antibiotics (amoxicillin), nasal decongestant, sinus precautions, and refer to an oral and maxillofacial surgeon for definitive retrieval — typically via a Caldwell-Luc approach or endoscopic sinus surgery. Confirm displacement with radiography (periapical, CBCT, or Water's view).

Reference: Hupp – Contemporary Oral and Maxillofacial Surgery, 7th ed., 2019