I have a couple of questions about a sinus perforation that happened during my dental implant placement. First, should it have happened? My dentist said this is fairly common. It went a few millimeters into the sinus cavity. Second, did my dentist handle this correctly once it happened? About six months into my procedure, the dentist realized that the area was not filling in correctly and he suspected bone loss. He removed the implant. He said there was no infection because there was no bone there. Because of that he said I would not need an antibiotic. He told me he did not repair it but cleaned and stitched the area and told me it should heal on its own. Then in a year we can start again. He also told me to take Flonase and not blow my nose. The week or two following, I had a problem with crackling and some mild pain. I felt like it was getting infected. He reluctantly agreed to give me an antibiotic. Thank you for any guidance you can give.
There are a few issues here. I think following the perforation was handled okay. However, the perforation itself and the fact that there was no bone integration are serious issues. While there are some occassions that a sinus would be perforated, it is certainly not common and definitely not by several millimeters. In dental terms, that is a HUGE amount. This should not have happened. I’m curious as to what type of diagnostics he did before your dental implants procedure. A CT scan would have shown him the complete layout of the area and prevented the perforation. It also would have told him if there was enough bone structure to support the dental implant.
Before you allow your dentist to start over, I think you should find out exactly why the first one failed. Be aware that you will also need some bone grafting done before you procede with the procedure a second time. Aside from the missing bone you already had, the area where the dental implant was will need bone to be filled in to the area.
Make sure, if you stick with this dentist, that he does adequate diagnostics to prevent these problems a second time.
This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.