Post sinus augmentation chronic sinusitis –
Pinpointing the etiology, optimizing the treatment
2Department of Otolaryngology Head and Neck Surgery, Sackler Faculty of Medicine, Tel Aviv University
Introduction: Dental implants placed within an augmented sinus have been documented as a predictable and safe treatment option for edentulous patients. Nevertheless, the treatment does have several complications associated with it, sinusitis being one of them. Treating these patients is straightforward when an acute infection is diagnosed immediately postoperatively, often necessitating removal of the implanted material. However, cases where the sinus infection is diagnosed after the implants have integrated and were restored are more challenging, being that treating the cause of the infection may not suffice.
Objective: To present our experience in treating chronic sinusitis following sinus augmentation for dental implants.
Method: A retrospective chart review was performed on 258 patients treated in a combined Maxillofacial and Rhinology clinic between 2014 and 2018 for sinus infections following sinus augmentations. Inclusion criteria included patients who had a sinus augmentation at least 6 months before their initial visit and were diagnosed with maxillary sinus infection on the same side of the procedure. Of the reviewed charts, 32 were found fit for inclusion. The patients were divided into two groups – those who had infections in the bone graft area, however the implants perfectly intact, and those who had suboptimal implant integrity.
Results: Functional endoscopic sinus surgery (FESS) was sufficient to resolve the sinus infections in all cases where the implants were intact, however additional surgery was necessary for patients where the implants were compromised, namely implant removal and closure of the oral antral communication.
Conclusion: Sinus augmentations with dental implants can result in chronic sinusitis. Careful evaluation of implant integrity separately from the bone graft region can facilitate in planning a more conservative treatment approach, shorted healing times, and preservation of the dental restorations.
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