Le Fort I Osteotomy for Removal of an Extensive Complex Odontoma Involving the Maxillary Sinus: A Case Report and Literature Review.

Odontoma is a common odontogenic tumour in the maxillomandibular region, but its occurrence in the maxillary sinus is rare. Small- to medium-sized odontomas can usually be removed without difficulties, depending on their location and proximity to adjacent structures. Nevertheless, access to extensive odontomas may be complicated. The aim of this study was to report a case of surgical removal of an extensive complex odontoma from within the maxillary sinus by using the Le Fort I osteotomy whilst also providing a review of the existing literature on intrasinus complex odontoma, with particular emphasis on surgical management. A 22-year-old male patient presented with an asymptomatic, well-defined radiopaque lesion in the right maxillary sinus, measuring approximately 40 × 25 × 46 mm. The treatment consisted of surgical removal by using the Le Fort I osteotomy to facilitate access, full excision of the lesion and maintenance of bone integrity. Histological analysis revealed disorganised enamel matrix and dentinoid material with areas of calcification, consistent with the diagnosis of complex odontoma. The 1-year follow-up showed good healing, stable occlusion and no complications. Le Fort I osteotomy may be a safe and effective option for extensive intrasinus complex odontomas, particularly when posterior extension limits conventional access. However, its greater surgical complexity and potential morbidity require careful selection based on lesion size and posterior extension within the sinus.