Intraoral Approach for Sinus Graft Infection Following Lateral Sinus Floor Augmentation With Simultaneous Implant Placement: A Clinical Case Series

Introduction Since the introduction of lateral sinus floor augmentation into the field of dental implantology, several concepts have been proposed regarding the etiologic factors and treatment of postoperative maxillary sinusitis after a lateral sinus floor augmentation procedure.1–8 Mucosal thickening, caused by surgical trauma or sinus membrane perforation, adversely affects the mucociliary clearance and ostium patency and, thus, increases the probability of developing postoperative maxillary sinusitis.9–11 It was also reported that problems of the ostiomeatal complex can affect outcomes of maxillary sinus augmentation.6 There have been a few reports of postoperative maxillary sinusitis caused by infections in the sinus bone graft.12,13 A sinus graft infection occurs in the grafted bone beneath the elevated sinus membrane. Postoperative maxillary sinusitis is an infection that occurs in the elevated sinus mucosa or the maxillary sinus. [...]the characteristics and treatment of these 2 diseases may be considered different12; however, distinguishing between them by means of clinical symptoms alone, without the assistance of radiographic examinations like cone-beam computerized tomography (CBCT), can be challenging. Surface Texture Type of Bone Graft Membrane Perforation Complications Group I 1 Male 54 No 12i, 13i, 14i, 15i SLA HA No swelling, fistula, mucoid rhinorrhea, pain, postnasal dripping 2 Male 46 Yes 2i, 3i HA DBBM, HA No swelling, fluctuation, fistula, pain, nasal obstruction, mucoid rhinorrhea, headache 3 Male 43 No 13i, 14i, 15i HA DBBM Yes swelling, fistula, mucoid rhinorrhea, pain Group II 4 Male 35 Yes 13i, 15i HA DBBM, HA Yes swelling, fluctuation, fistula, pus, pain 5 Male 46 No 14i, 15i TPS DBBM, HA Yes swelling, fluctuation, infraorbital tenderness, mucoid rhinorrhea, pain Group III 6 Male 36 No 2i, 4i MS DFDB No swelling, fluctuation, pus, foul odor, mucoid rhinorrhea, pain, headache 7 Male 55 Yes 13i, 14i, 15i TPS DBBM, HA No swelling, fluctuation, pain, headache * SLA indicates sandblasted, large grit, acid-etched; HA, hydroxyapatite; DBBM, deproteinized bovine bone mineral; TPS, titanium plasma spray; MS, machined surface; DFDB, demineralized freeze-dried bone. † Group I: In group II (n = 2), the patients received systemic antibiotics therapy (amoxicillin clavulanate potassium 375mg, 3 times a day) for 1 week before I&D. In group III (n = 2), patients received systemic antibiotic therapy (amoxicillin clavulanate potassium 375mg, 3 tim