Remoção de raiz residual do seio maxilar pela técnica de caldwell-luc e selamento da comunicação buco-sinusal usando a bola de bichat: uma revisão integrativa da literatura

Abstract

INTRODUCTION: The maxillary sinus, the largest of the paranasal sinuses, is anatomically close to the oral cavity, which favors the migration of dental roots into it. Dental extractions of upper molars, whose roots are frequently in close contact with the sinus floor, can result in oroantral communication and displacement of root fragments into this cavity. This condition can trigger painful symptoms, infections, headache, and facial pain, requiring surgical removal of the residual root and the use of antibiotic therapy. The Caldwell-Luc surgical technique is widely indicated because it allows direct access and adequate visualization of the maxillary sinus. OBJECTIVES: To address the viability of the Caldwell-Luc technique as a surgical access to the maxillary sinus for the removal of displaced root fragments and the effectiveness of using the Bichat fat pad for sealing the oroantral communication. METHODOLOGY: This is a literature review. For theoretical grounding, a search for studies was conducted in electronic health databases such as PubMed, Google Scholar, SciELO, LILACS, and BVS, considering articles published in the last ten years from reliable sources and addressing foreign bodies in the maxillary sinus, about residual roots. The included works were carefully read, where relevant information was selected for study and comparison purposes. RESULTS: The Caldwell-Luc technique, although old, is still widely used today, mainly due to its ease of execution, excellent visualization of the surgical field, and good cost-benefit ratio for the patient. When associated with closure of the communication with adipose tissue, it further improves the prognosis of the case, as the graft favors healing and the restoration of anatomy and function. CONCLUSION: Despite being an invasive method, within the maxillofacial surgical field, the Caldwell-Luc technique presents excellent results in terms of promoting access and, consequently, resolving clinical symptoms and improving the patient's quality of life. The use of Bichat's fat pad graft for sealing oroantral communication has proven to be a viable alternative with a high success rate due to its highly vascularized and biocompatible nature.