Ectopic third molar: A rare cause of persistent oroantral fistula and chronic rhinosinusitis

This case report presents a rare case of an ectopic maxillary third molar causing chronic maxillary rhinosinusitis and resulted in persistent oroantral fistula following dental extraction in a 43-year-old male patient. The patient initially presented with a persistent oroantral fistula (OAF) at upper right gingivae around 2nd molar, foul smell accompanied by recurrent right-sided purulent rhinorrhea, facial pain, and liquid coming out of the nasal cavity after gargling, which persisted despite treated with courses of medicine. Radiological investigations revealed an ectopic tooth in the right maxillary sinus. The patient underwent a Caldwell-Luc procedure, to remove the ectopic tooth and pathological tissue. The patient had total resolution of their symptoms following the surgical procedure. This case highlights the importance of considering odontogenic causes in causing persistent oroantral fistula. © 2025 The Authors