This case report presents a rare case of an ectopic maxillary third molar causing chronic maxillary rhinosinusitis and resulting 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.

Feri Trihandoko completed his Specialist degree in Otorhinolaryngology four years ago from Universitas Gadjah Mada, Indonesia. Since graduating, he has been working as an Otorhinolaryngologist at Universitas Gadjah Mada Academic Hospital. Additionally, he has been serving as a lecturer at the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, where he teaches and mentors medical students and residents.