Maxillary sinusitis resulting from ostium plugging by dislodged bone graft: case report

J Oral Maxillofac Surg. 2009 Jul;67(7):1495-8. doi: 10.1016/j.joms.2009.03.033.

Abstract

Purpose: To report an unusual case of severe maxillary sinusitis resulting from ostial plugging by dislodged bone graft material used for sinus elevation procedure.

Patients and methods: A 49-year-old female presented to the oral surgery clinic with severe right maxillary sinusitis after a sinus elevation procedure and placement of a dental implant. She had completed an extended course of multiple antibiotics without culture and sensitivity studies or resolution of sinusitis.

Results: A CT scan was obtained which showed a dental implant protruding into the right maxillary sinus, sinusitis of the right ethmoid and maxillary sinuses, and dislodged bone graft material obstructing the ostium into the middle nasal meatus. The dental implant was removed, the patient was referred for functional endoscopic sinus surgery, and her sinusitis subsequently rapidly resolved.

Conclusions: Surgeons performing this or similar procedures should be aware of the possible complications that can arise from foreign debris introduced into the maxillary sinuses. Also, the avoidance of empirically changing antibiotic regimens and the early use of CT scans should be considered.

Publication types

  • Case Reports

MeSH terms

  • Bone Transplantation / adverse effects*
  • Bone Transplantation / diagnostic imaging
  • Dental Implantation, Endosseous / adverse effects
  • Dental Implants, Single-Tooth / adverse effects*
  • Ethmoid Sinus / injuries
  • Female
  • Foreign Bodies / complications*
  • Humans
  • Maxillary Sinus / diagnostic imaging
  • Maxillary Sinus / injuries*
  • Maxillary Sinus / surgery
  • Maxillary Sinusitis / etiology*
  • Maxillary Sinusitis / surgery
  • Middle Aged
  • Nasal Polyps / etiology
  • Tomography, X-Ray Computed