‘Don't bite off more than you can chew’

A male patient aged 40 years reported for a routine dental check-up to the Faculty of Dentistry, SEGi University, Malaysia. The patient requested oral prophylaxis and replacement of a missing maxillary left first molar. He reported that a dental implant had been placed three years previously which was ‘hidden in the gums’ around the maxillary left first molar region. An intra-oral peri-apical radiograph was taken around the edentulous maxillary left first molar area (Figure 1) and showed a dental implant in the left maxillary sinus region. Since the implant does not have a cover screw, it can be assumed that the implant was pushed into the maxillary sinus during surgical placement. The patient was informed by an earlier dentist that dental implant treatment had failed and would not cause any problems since the implants were made of biocompatible titanium. Even though the patient was asymptomatic, he was informed about the possibility of the occurrence of maxillary sinusitis and the need to get the implant removed. The patient was referred to an Ear Nose and Throat (ENT) specialist for further evaluation and treatment.