-
Dragos posted an update
Hey, guys! Dragos from Romania here! I’ve made a bit of courage to start posting and asking about some of my cases (since i started doing them more frequently). Please don’t judge mistakes since I don’ t pretend to be a guru of surgery of some sort. Actually I still consider myself a begginer in that matter. Anyway, here’s a case I did this month. I decided to place 3 implants on the left and I will follow with 3 on the right. Patient did not want all at once. She is a light smoker, no general pathology except a history of clostridium difficilae from antibiotics(she surpassed it 8 years ago). Surgery went fine, I know i could have placed 2.4 more palatally and 2.5 with a bit more vestibular inclination, but I did it freehand and as I said, I am still learning. I decided to keep the wisdom tooth there since it did not bother her at all and I had to do a bit of troughing to extract it. Second cbct is 5 days post surgery. She accused a sensation of fullness in the sinus and a bit of pressure. As you can see, there is a sinus reaction. She was on augmentin antibiotics after surgery and I also gave her some sinus meds(for drainage). 3 weeks later she is fine, no more symptoms. Question is: why did she develop so quickly this sinusitis. Could’ve been because of a possible bacterial colonization tru the wisdom tooth parh after i did the flap? (Yes i did go a bit distal with the incision, but no vertical releasing ones where necessary). I will prolly post another x ray to see if there is cronicization. The time between first and 2nd cbct is about 5 weeks.
Esther, Rod and 2 others10 Comments-
Thank you for your question! This is a JUDGEMENT FREE ZONE 🙂
I have a follow up question: So she experienced her sinus symptoms 5 days after the procedure?
-
Yes! I did the ct to see if there is a trouble with an implant. I was scared of maybe going to deep in the sinus, bur apparently that was not the case. I
-
And the first ct was 5 weeks prior to the 2nd one. She was supposed to come earlier for surgery but she was busy. That’s why there is a time gap of 1 month.
-
-
-
Before:
1 -
After:
1-
Interesting case indeed. I do not believe the third molar would’ve cause this unless you mobilized the third molar, whic does not seem the case. It’s relatively common for the sinus membrane to get bit irritated after implants, especially if it was near the floor like these. Not a drainage problem, but more inflammatory issue. You did all the right things and calmed the inflammation down. Great case
1-
Thanks for your expertise on this @rodk !
-
-
-
This is a very interesting case, Dragos, your implants did not even enter the sinus, so I imagine you did not drill into the sinus, correct?
So I don’t think you could have caused this with your implant procedure. Your guess might be right, — possible bacterial colonization tru the wisdom tooth path–but I honestly have never seen that before.
I would expect that this would cleared and not be an issue in the future. Definitely keep us posted on this case!
Thoughts on this @restoredsmiles
1 -
You are correct regarding the order of the cbcts. She s totally fine now, no symptoms whatsoever. I was thinking if I should remove that molar when I do uncovering to avoid another story like this. I will post another x ray. Another guess was maybe a coincidence of a rhinitis going into some sort of acute sinusitis at the same time with the procedure, but that would be kinda rare 😂
-
Hey Dragos! Nice to hear from you. Very interesting case period. Looking at some of your updates, and everything has cleared and improved. It looks like potentially the one implant that was the closest to the sinus. You may have drilled slightly deeper in one area that potentially enter the sinus, which allowed a little bit more fluid to enter the sinus cavity, causing a little bit of irritation. But it looks like that was short-lived and everything is better now. Thanks so much for sharing.
1
-
