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ABSTRACT: A 30-year-old man presenting for routine extraction of a carious upper left first permanent molar subsequently underwent the retrieval of a palatal root that had been displaced into the maxillary sinus. This paper illustrates the principles of the Caldwell-Luc procedure and highlights the issues and management of acute oro-antral communication associated with a displaced root into the sinus. This paper was presented at the Clinical Excellence in Patient Care Symposium, Dunedin on 29 September, 2006.