I need some advice. I had a dental implant placed and the oral surgeon perforated the sinus cavity by a few millimeters. He thought that would be no big deal and then prescribed Flonase. He also instructed me to not blow my nose and to only sneeze with my mouth open. Then, it turned out about six months later that the bone wasn’t filling in so he decided to remove the implant. He felt everything was fine and didn’t prescribe any antibiotics. But, two weeks later I was having a lot of pain and a popping sound in my nose. I went back to see him and he said everything was fine, but I pretty much insisted he prescribe me some antibiotics. After a couple of days on the antibiotics, that made a huge difference. I have a couple of questions. Is it normal for this type of thing to happen with the sinus perforation and should he have prescribed antibiotics from the beginning?
Lexie
Dear Lexie,
As to whether or not it is normal to perforate the sinus cavity, that depends on your definition of normal. It is more common than it should be. However, a few millimeters is a big deal and too far. This often happens when dentists or oral surgeons skimp on the CT scan. Too often, they try to do a 3-Dimensional procedure with 2-Dimensional x-rays. Some dentists try to get away with this by using shorter implants. However, this is more likely to fail later. The patient will never know why it failed.
The steps he took after the perforation were correct, including the precautions he gave you. It is fine not to prescribe an antibiotic from the beginning. You want to wait until there are signs of infection. That being said, once you had those signs he should have been more willing to prescribe them.
Now there is another question as to why you didn’t have any osseointegration with your implant. As you can see from the image above, it is imperative for bone to form around the dental implants so that it will remain secure. Without that bone, the implant will come loose and end up failing.
In a way you are lucky the bone didn’t develop. Those who’ve had perforated sinuses where the bone did integrate the way it was supposed to often ended up with lifetime nasal problems.
Getting Your Dental Implant
Because of the issues you’ve faced with this oral surgeon, I’m not sure you will want to use him to do the repeat procedure. It’s likely you will also need a bone grafting procedure done in order to even have enough bone structure to place another implant.
If you want to give him another chance, make sure he can tell you what he’s going to do to prevent the same errors. If he’s not going to do a CT scan, move on quickly.
This blog is brought to you by Baton Rouge Dentist Dr. Steven Collins.