I had a dental implant for a missing upper tooth. About six months after it was placed, my dentist suspected there was some bone loss and wanted to remove it and we could try again. When he removed it, there was no bone integration so the removal process was simple. The dental implant had perforated the sinus cavity by a few millimeters. He said that is pretty normal, but I am wondering if that is what caused the infection I had afterward. He didn’t give me antibiotics after the procedure because he said it was unnecessary. Then, I came down with a pretty good infection a week or so later. I’m nervous about doing this again. He said all of this was normal, but it doesn’t feel that way to me. Should I be doing anything different than just antibiotics? Am I safe to try and get this implant again?
There isn’t anything specifically wrong about not prescribing antibiotics until there is a sign of infection, but that is probably the only positive thing I’m going to say about how your dentist has handled this situation. First, let’s start with the sinus perforation. While some oral surgeons don’t think it is a big deal to occasionally perforate the sinus cavity, most (if not all) would think a few millimeters is excessive. That is a huge amount for the situation. It’s definitely not normal.
A second issue is the fact that there was no bone integration after six months, though honestly, you’re fortunate. If it had, you could have developed a serious infection because of the incursion into the sinus area. A basic standard is that your dentist does enough diagnostic x-rays to ensure there is enough bone support there to begin with. That should include a CT scan. Placing dental implants is a 3 Dimensional procedure and it requires 3 Dimensional images for proper placement. If there isn’t, then the patient would need some bone grafting done first to make sure their is enough bone to retain the dental implant. Your dentist obviously didn’t do that.
Personally, if I had a dentist who perforated my sinus and there was no osseointegration, I wouldn’t let that dentist anywhere near me to do dental implants again. What you need, because of all that has happened in your case, is first to secure a refund. That shouldn’t be too hard. Then, you will want to find a qualified dentist to do this. There are two specifics I want you to look for. First, is a dentist who is a Fellow with the International Congress of Oral Implantologists. These are the dentists with the highest qualifications and skill for implant procedures. Second, is a dentist who has the surgical training and experience to do the implant placement and the restoration. Look at Dr. Thomas’ bio to get an idea of the type of dentist you need for this.
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