Sinus Infection & Dental Treatment

added on: May 15, 2014

New Patient: Dental Implant Induced Sinus Infection

The current patient was referred to me for evaluation of dental implants that were placed approximately 3 years ago by another Dentist.  The patient reported a history of a chronic sinus infection with drainage since dental implant placement.  Clinically and radiographically, examination revealed two dental implants surgically placed into the sinus without previous bone graft, additionally severe bone loss,  bleeding, and exudate were noted.  I diagnosed the patient with peri-implantits, additional findings included chronic sinusitis.  Therefore, based on severity and long term prognosis, I surgically removed the dental implants.  At the time of surgery, I noted maxillary sinus perforations characterized by severe amounts of exudate and inflammation.  In the past I’ve blogged about sinus augmentations and bone grafts and why they are required.  Unfortunately, this is a perfect example why dental implants require a sufficient amount of bone or severe post operative complications including sinus infection may be a consequence.

Sinus Infections & Dental Treatment

Maxillary sinus bone grafting may be required before dental implant placement due to inadequate bone height.  This procedure is performed to ensure an adequate amount of bone to support dental implants and eliminate communication into the sinus.  Sinus grafts are predictable, with many reports showing a success rate above 90%  3 to 5 years for dental implants placed within the graft.  However, surgical procedures involving dental implants and the maxillary sinus have the potential for complications that may be specific or non-specific.  Perforations of the Schneiderian membrane are the most common cause of inoperative complication reported.  Studies show perforations on average occur 7% to 35% of the procedures.  Post operative complications include swelling, bleeding, exudate (pus), fever, sinusitis (congestion), and infection.  A current study analyzed the amount of complications observed among 70 patients who were treated with sinus bone grafts and implants.  Seven patients presented with specific complications within 3 days of implant placement, and lasted three weeks.  The study concluded that complications observed during the operation may lead to post operative complications, but these complications did not significantly influence dental implant survival rate.

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