Maxillary Sinusitis Caused by Dental Implants Extending into the Maxillary Sinus and the Nasal Cavities

Abstract

This report describes the case of a patient who underwent osseointegrated dental implant placement. The implants were misplaced inside the nasal fossae and in the right maxillary sinus, causing chronic purulent sinusitis. CT scan without contrast showed signs of right maxillary sinusitis and confirmed the misplacement of four dental implants that surfaced into the nasal cavities. The imaging also revealed the presence of another implant that emerged inside the maxillary sinus. The patient underwent functional endoscopic sinus surgery with complete symptom remission at the long-term follow-up. We propose that sinusitis caused by protrusion of implants and by sinus floor lift procedures could share common physiopathological patterns and predisposing factors.

Clinical features and treatment outcomes of dental implant‐related paranasal sinusitis: A 2‐year prospective observational study

“…; Biglioli & Chiapasco ; Biafora et al. ). As it is present between the floor of the maxillary sinus and the dental root of the maxilla, a thin cortical bone can trigger infection in the mucoperiosteum to cause if the cortical bone is damaged by implant surgery sinusitis (Lin et al.…”

“…; Lee & Lee ; Biafora et al. ). Paranasal sinusitis related to implant surgery is expected to continuously increase, and furthermore inappropriate treatment of sinusitis may lead to implant failure or severe complications, such as orbital cellulitis, optic neuritis, extradural and subdural infections, encephalitis, osteomyelitis, and, in rare cases, brain abscess (Longhini et al.…”

“…Although it helps partial or complete edentulous patients restore oral function, implant surgery causes infectious diseases involving the oral and sinonasal cavities (Zimbler et al 1998;Raghoebar et al 2004;Mehra & Jeong 2009;Ridaura-Ruiz et al 2009;Lee & Lee 2010;Biafora et al 2014). Paranasal sinusitis related to implant surgery is expected to continuously increase, and furthermore inappropriate treatment of sinusitis may lead to implant failure or severe complications, such as orbital cellulitis, optic neuritis, extradural and subdural infections, encephalitis, osteomyelitis, and, in rare cases, brain abscess (Longhini et al 2010).…”

“…Paranasal sinusitis related to implant surgery is expected to continuously increase, and furthermore inappropriate treatment of sinusitis may lead to implant failure or severe complications, such as orbital cellulitis, optic neuritis, extradural and subdural infections, encephalitis, osteomyelitis, and, in rare cases, brain abscess (Longhini et al 2010). Therefore, appropriate treatment of sinusitis is crucial (Legert et al 2004;Brook 2006a,b;Biafora et al 2014). There are several considerations in medical treatment.…”

Long‐term outcomes of the implants accidentally protruding into nasal cavity extended to posterior maxilla due to inferior meatus pneumatization

“…Infection was addressed by performing functional nasal endoscopy, without removal of the implants, in one study. 23 In another study, the protruded apex of the implant was surgically resected. 24 Notably, in both studies, the apical portion of the implants was breached the mucosal integrity, which is different compared to the endoscopic finding of the present study.…”