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Ask UsSinus Augmentation Complication: What to Do?
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Priscilla, a dental patient from Tennessee, asks:
I had a sinus augmentation on both sides and the right side took but the left side didn’t. I got an infection and had to have it cleaned out. The oral surgeon said that the sinus membrane had been torn and that is why the area became infected and the graft did not take. The surgeon does not want to go back into the left sinus. My dentist does not want to do the overdenture unless some implants can be placed on my left side. What am I supposed to do now?
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8 Responses to “ Sinus Augmentation Complication: What to Do? ”
Dear Priscilla:
If you have 4 or 5mm of bone below your sinus you can have endopore implants placed and solve your problem without much trouble.
hope that helps
I would use another OS. The sinus will heal and probably have a thicker membrane. Use a Piesosurgical diamond and this will help avoid a perforation.
Dear Lady, any damage to the schneiderian membrane will be completely healed after three months provided that the infection prcess and its causative factors are totally eradicated.If everything is cleared, then it is the oral and maxillofacial surgeon who can make the re-entry into your maxillary sinus and re-graft it with autogenous viable bone blocks, fixed by titanium mini-screws.For heaven’s sake, avoid receiving any type of short implants at the posterior maxilla.Most of them end up in disastrous failures.
Once the left Maxillary Sinus is healed, you stand a good chance of a new sinus graft working fine. A torn membrane in not a big deal, before, during or after. The way the torn membrane is handled does make a difference. Infection is probably why you lost the graft. You probably had some bugs in the left side that caused the graft to fail. Make sure you have been covered with antibiotics to clean out the infection potential and try it again. Find another surgeon that is comfortable in redoing the augmentation graft. There are several successful types of graft materials that work fine. If your surgeon has done a lot of successful sinus grafts, you can be comfortable giving it another chance. It will be worth it when you are finished.
I heartly second what Dr. Ben stated. Sinus augmentation is a very predictable procedure for patients unless there is a pre-existing condition where the sinus has pathology e.g. chronic sinusitis, polyps, or retention cysts. Another surgeon will guide you to a successful outcome.
Most sinus grafting is quite easy for generalist. The key factor I have found to prevent finding pathology in the sinus is to do a ct scan prior to the sinus lift proceedure. Tears in the sinus are easy to patch, and they are rarly a cause of the failure of bone grafts in the sinus. However sinus pathology is a big problem and should be resolved prior to any grafting. Not every patient is a candidate for sinus grafts, remember your license and peace of mind are worth more than the proceedure.
I agree with Dr. Jafari, avoid short implants when ever possible, especially in the posterior maxilla. Failure of a sinus graft is always a risk. I am sure you read that in your informed consent document. This can happen no matter how technically efficient the surgeon was during the procedure. These grafts do work however, so do not give up on the procedure. A second attempt will most likely work well for you and give you the final result that you set out for in the first place. Do not comprimise your prosthsis because of the failed first attempt. Sinus grafting is predictable. I have many patient’s in my practice who are going strong for 10+ years now following sinus grafting and implant treatment. Give it another try. The left side went well for you. There is no reason the right side will not be successful as well. Good luck.
Dr. Jafari
I would like to exchange photos and
discuss our procedures.
Dnourishad@aol.com
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