I had a dental implant placed six months ago. At a check-up we realized there was a problem. He ended up doing a procedure to remove the implant. He said it had perforated the sinus by just a few millimeters and the bone didn’t integrate at all which made the removal easy. He seemed to indicate it was no big deal and figured we can do it again in a few months after everything has healed up. I’m hesitant to repeat it until I know if the perforation is normal. What are your thoughts?
There are a few issues going on here that I would address before moving forward. Let’s start with the perforation. While some oral surgeons will say it is normal and no big deal, it is preventable. You want whoever is doing your dental implant procedure to take all the diagnostics necessary including a CT scan. Some dentists or oral surgeons try to cheat on this part but dental implants are a 3-dimensional procedure and therefore it is important to have a visual that adequately represents the landscape. Some dentists try to get around this by using a shorter implant near the sinus cavity but these are more likely to fail down the line and you’d never know it was because your dentist cut corners.
A second issue regarding this particular perforation is your surgeon perforated it by a few millimeters. In dentistry, that is huge. Even dentists who think perforations are acceptable would think that amount unacceptable.
Thirdly, the lack of bone integration is concerning. Did he give a reason for this? While it did make your surgery easier and likely helped prevent a massive sinus infection, I’d like to know why. Osseointegration is imperative for a successful procedure.
Finally, you will need some bone grafting done too because you now will definitely not have enough bone for a second procedure. When you need bone around the sinus cavity that requires it be done through a procedure known as a sinus lift.
Bottom line, if someone perforated my sinus and there was no integration for the bone, I wouldn’t want that surgeon anywhere near me next time. At the very least, I think you need to get a second opinion.
This blog is brought to you by Des Moines Dentist Dr. Phelan Thomas.