Aim of the study:
Ectopic teeth in the maxillary sinus are a rare clinical condition, often associated with chronic sinusitis, facial pain or nasal obstruction. This case report describes the successful treatment of a young female patient with an idiopathic ectopic wisdom tooth in the medial wall of the left maxillary sinus, causing refractory chronic sinusitis.

Case report:
The surgical approach, challenges, and outcomes are discussed, highlighting the application of a buccal fat pad graft for defect closure. A 28-year-old female patient presented with a history of chronic sinusitis, exacerbated during autumn and winter. Imaging scans revealed an ectopic wisdom tooth in the medial wall of the left maxillary sinus. Surgical removal was performed under general anesthesia via an intraoral approach. The tooth was sectioned into pieces for safe extraction, and a buccal fat pad graft was used to close the anterior sinus wall defect. Postoperatively, the patient experienced complete resolution of symptoms, with no complications.

Conclusion:
This case highlights the importance of considering ectopic teeth in the differential diagnosis of refractory chronic sinusitis. The intraoral approach, tooth sectioning and buccal fat pad graft closure are effective strategies for managing this rare condition. Timely diagnosis, careful surgical planning and attention to potential complications are essential for achieving favourable outcomes.