Sinus Augmentation Complication: What to Do?

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?

15 thoughts on “Sinus Augmentation Complication: What to Do?

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. I hear that there is a remarkablenew and predictable technique called ISM where you manually can lift the membrane through the Osteotomy up to any length and it is totally atraumatic to the patient and fast and predictable for the dentist. This guy is teaching this course to specialists all over the world currently and some implant company is supporting him.

  8. Had sinus lift (left side) and 2 implants 10 yrs. ago. Within 6 months began to have pain. Pain continues to increase as well as fatigue, sinus problems, general unwell, immune system attack. Pieces of bone came through gum. Had implants removed. That took away the “pressure” pain but not the “bone type” pain and I continue to go downhill dramatically. Had ENT surgically look into sinusus for infection. None. Had contrast MRI and Tagged White Blood Cell scan. No infection. I am confident (have had close association with medical situations throughout life) my symptoms of jaw pain, sinus pain (no sinus problem prior) and fatigue are due to procedure and a chronic low grade infection. Know the difference between infection fatigue and other types of fatigue. Can any one tell me of a medical center that would have dental expertise in this field?

    Thank you.

  9. I had a sinus augmentation with bone graph done 2 months ago. I had severe infections for weeks. 3 different meds didn’t clear up the infection. my surgeon took the graph out that we infected. now I am having severe sinus dryness. if I use a mouth wash and bend over the sink the mouth wash comes out of my nose(the side of the surgery) my cheek bones still pain from time to time(never had any sinus trouble on that side before)
    today I was chewing gum and tried to blow a bubble but I couldn’t and it felt like air was coming out of my nose and I can hear a weird sound in my mouth.
    I have been thinking of going to a ENT doctor to see why I am having so many problems. I am suppose to have the bone graph redone in august and I am afraid to have it done. 2 months of nothing but problems!
    any suggestions
    teresa

  10. Dear Teresa,
    From your symptoms it appears you have what is referred to as an Oro-antral communication. This requires drainage and closure after all purulent matter is drained either with or without an antrostomy.
    The sinus can be grafted after a wait of 4-6 mths when the membrane regenerates. A good xray at that time is a WATER’S view which would show the fluid levels if any in the sinus.
    These complications are very irritating but not without solution.
    See an OMFS guy insted of an ENT, he’ll help you out.
    The dryness maybe due to antihistaminics given with the antibiotics or due to the nasal decongestants.

  11. It’s most obvious that you have an opening between your mouth and sinus. Any good dentist can close this. Do not perform the sinus graft till your site has been closed and is free of pain and infection.

  12. I had a sinus augmentation with bone graph 1 1/2 month ago. I had severe three times infections ever since the first procedure they did.when I wash my mouth water goes through my nose. And my face and my cheek is puffy and red. So I decided to see ENT next week just a second opinion. I just want to feel better. I never have a problem with mu sinus before. What do I do?

  13. I had a sinus augmentation in February, 2011…Have been on antibiotics twice for swelling. Had CT showing infection within graft and after consulting with an ENT and Oral surgeon will need debridment of site. I have never had sinus issues and now have had a headache and sharp shooting pains in my head. Still have 2 weeks left before the Debridment takes place. Don’t if I will opt for a repeat and will probably go w/o moloar implants. Did find out that a bioglide membranes was not placed over graft implant so this would explain the bone granules seeping through suture line. Definately a questionable procedure for some resulting in sinus issues never before a problem.

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