Small sinus tract on 3 yr old implant: any input?

Last Updated March 15, 2019

I placed this implant in #9 site [maxillary left cental incisor; 21] 3 years ago in a 32 year old healthy male. I did an onlay graft prior to the surgical installation of the implant. The patient returned for stage 2 uncovery. Radiographically everything looks fine as you can see. I noticed a small sinus tract on the labial aspect of the cortical plate in the attached gingiva a few millimeters below the occlusal aspect. He has had no symptoms and did not notice this. I did milk a small amount of exudate from the sinus tract. My initial thought is to send this off to my periodontist and cover any costs to have this managed whatever that may be. Any input as to why this would be occuring and what I may be able to do? Any advice would be greatly appreciated.

implant with fistulaimplant with fistula

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