Retrieval of Displaced Implant Attributable to an Ill‐Fitting Denture From the Maxillary Sinus Six Months After Transcrestal Sinus Floor Augmentation and Implant Placement
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Introduction: Asymptomatic displacement of dental implants into the maxillary sinus after a transcrestal sinus augmentation is a rare complication that can occur when there is poor bone quality and minimal residual bone height. Patient compliance with postoperative appointments and failure to comply with denture‐wearing instructions are critical contributing factors. To the best of the authors’ knowledge, no cases of implant dislodgement attributable to a removable prosthesis have been reported in the literature, although some studies have suggested that improper occlusal forces can cause a long‐standing implant to develop peri‐implantitis and subsequent displacement of an implant into the sinus cavity. Case Presentation: A 71‐year‐old female presented 6 months after undergoing transcrestal sinus lift and implant surgery that involved a modified Summers technique using mineralized solvent‐dehydrated cancellous bone allograft and placement of six maxillary implants. A displaced dental implant was retrieved from the right maxillary sinus, which had an intact Schneiderian membrane. The patient was asymptomatic and infection free. The displaced implant was accessed and retrieved via a lateral window sinus technique. No clinical signs of sinus infection were evident, and there were no additional complications during the 2‐year follow‐up period. Conclusion: This case report demonstrates a technique for the retrieval of implants that have been dislodged and migrated into the maxillary sinus cavity caused by an ill‐fitting denture and improper masticatory forces.Keywords:
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Dental implants are the most preferred treatment option for the rehabilitation of the edentulous patients. However, implant placement to the posterior maxilla can be problematic due to bone atrophy and hyperpneumatization of the maxillary sinus. Bone augmentation procedures such as, internal or external sinus lift can be necessary. Implant placement without bone augmentation procedures can increase the migration risk of the dental implant to the maxillary sinus. The aim of this report is to present the diagnosis and the treatment of migrated dental implant to the maxillary sinus. A 52 -year- old male patient was referred by his dentist for the removal of a dental implant migrated to the maxillary sinus. A migrated dental implant was seen on panoramic radiography and CBCT imaging was performed. CBCT images showed that a dental implant staying under the orbital floor and lateral side of the upper nasal concha in maxillary sinus. Endoscopic approach via nasal ostium was failed due to improper position of the dental implant. A Caldwell–Luc operation was performed and migrated implant extracted from the maxillary sinus.
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A minimum subantral bone height in the posterior maxilla may require a bone augmentation where a sinus lift procedure is the most commonly used technique, either preceding or simultaneously with the implant installation. While elevating the Schneiderian membrane ruptures are common, possibly resulting in less bone formation. In this paper, we propose the surgical pneumatization of the Schneiderian membrane as a new technique to minimize the risk of such complications. This can be achieved mainly by creating a hole for the immediate and increased passage of air through the Schneiderian membrane and the maxillary sinus wall above the region of augmentation.
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Maxillary sinus lift without grafting is an alternative procedure that is used to lower the risk of infection and facilitate the surgical procedure. The objective of this study was to evaluate the tenting effect of the dental implant by measuring the amount and morphology of bone formation around it.49 implants were placed in 26 patients by maxillary sinus lift without grafting. Radiographic images were taken preoperatively and at 6 months postoperatively and used to evaluate the height of the residual bone, the width of the maxillary sinus, the amount of bone formation, and the adjacent tooth.The most common type of bone formed around the implant, as seen in 23 cases, was the same height as the apex of the implant; in 11 cases, it was 0-2 mm above the apex of the implant, and in 7 cases, 2 mm or more. Meanwhile, 5 cases showed defects. The tent type of bone formation, which showed more bone formation at the implant apex than in the surrounding bone, was overwhelmingly the most common. (80.4%) The amount of bone formation increased in proportion to the difference between the residual bone height and the implant length. (P < .001).The amount of bone formation in the sinus lift without grafting increased in proportion to the length of the implants in the maxillary sinus due to the tenting effect of the implant in the maxillary sinus membrane.
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The purpose of this paper is to present radiological findings of a short‐term (8 to 10 months) computerized tomography (CT) follow‐up study on 1‐stage maxillary sinus lift cases. Pre‐ and postoperative dental CT scans of 21 patients (24 sinuses) after sinus lift procedures were compared. CT scans were used to assess newly formed bone and its interface with the implants, condition of the sinus membrane, evidence of buccal window cortication, and presence of any sinus pathology. Of the 57 implants placed, 28 had bone fully covering the implant on all sides which did not extend above the apical portion; 20 had bone fully covering the implant which did extend above the apex; and 9 exhibited incomplete bone coverage. All implants supported a fixed ceramo‐metal prosthesis, and no implant failures were recorded after 3 years follow‐up. There was evidence of cortication of the buccal window in 10 sinuses; in the 14 remaining sinuses, bone consolidation on the buccal aspect was evident, but no evidence of cortication was seen. All sinuses healed without complications or clinical signs of sinusitis. In 11 sinuses, no changes in membrane thickness were noted. Membrane thickness decreased postoperatively in 12 sinuses, and in one, there was evidence of membrane thickening. Bone cortication the anterior wall window may serve as an indicator for the remodeling status of the entire graft. Postoperative findings showed a significant improvement in overall membrane thickness. No clinical symptoms of sinusitis were evident, indicating that sinus lift procedures can be considered safe and not predispose the sinus to acute or chronic sinusitis. J Periodontol 1999;70:1564‐1573.
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To evaluate the success rate of dental implants and the changes of sinus membrane thickness after sinus lift in cases of thickened sinus membrane.Sixteen patients without maxillary sinusitis and with 5-8 mm residual alveolar bone heights were included in this study. The sinus membrane thickeness of these patients were more than 2 mm. All patients received sinus lift surgery and dental implants insertion. The changes of sinus membrane was evaluated by cone-beam CT (CBCT) pre-surgery and 6 months after sinus lift surgery, and the short term success rate of dental implants was also evaluated.A total of 18 implants from 16 subjects were inserted. The thickness of membrane was decreased in 14 cases after sinus lift and increased in 2 cases. All the orifice of maxillary sinus was unobstructed before surgery, one case was obstructed after surgery without inflammation. All the dental implants succeeded.Sinus augmentation with thickened sinus membrane is not contraindication of sinus lift.
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This review analyzes articles published on the presence of septa in maxillary sinuses.An automated search was conducted on PubMed using different key words.This search resulted in 11 papers in which the presence of antral septa was assessed.These septa are barriers of cortical bone that arise from the floor or from the walls of the sinus and may even divide the sinus into two or more cavities.They may originate during maxillary development and tooth growth, in which case they are known as primary septa; or they may be acquired structures resulting from the pneumatization of maxillary sinus after tooth loss, in which case they are called secondary septa.Several methods have been used in their study, direct observation on dried skulls or during sinus lift procedures; and radiographic observation using panoramic radiographs or computed tomographs.Between 13 and 35.3% of maxillary sinuses have septa.They can be located in any region of the maxillary sinus and their size can vary between 2.5 and 12.7 mm in mean length.Some authors have reported a higher prevalence of septa in atrophic edentulous areas than in non-atrophic ones.If a sinus lift is conducted in the presence of maxillary sinus septa, it may be necessary to modify the design of the lateral window in order to avoid fracturing the septa.
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Maxillary sinus augmentation is an effective procedure to gain bone height for implant placement in an atrophic posterior maxilla. But maxillary sinus diseases are prevalent in patients scheduled for sinus lift procedures. The presence of these diseases may increase the difficulties in performing the surgery and the risk of developing postoperative complications. This paper summarizes and introduces the common maxillary sinus mucosa diseases related to maxillary sinus augmentation.上颌窦底提升术可以为垂直高度不足的上颌后牙区开辟有效的种植空间。但由于部分患者存在上颌窦黏膜疾病，增加了手术的难度及术后并发症。本文就此对与上颌窦底提升术有关的常见上颌窦黏膜疾病进行分类总结与阐述。.
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Sinus lift procedure is a procedure used to augment bone thickness of the maxillary sinus for bettersurvivability of dental implants. The maxillary sinus floor augmentation was 1st done by Oscar Hilt TatumJr, in 1974. Since then the procedure has been refined and revised over the years. Yet it has a few adverseeffects such as perforation, tearing of the antral lining and haemosinus. In this article we see that sinus liftsurgery is as versatile as the surgeon is and in some cases if not done properly, can result in severe morbidity
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