Pt is completely healthy and sinus is clear no radiological opacity seen.
it has been seen that if any foreign body is present in the sinus it develops complications. If the lining of sinus is not intact then now or then it may develop complications. Right now if procedure has been completed then keep patient under close follow up.
if foreign body such as implant or tooth is removed at same sitting or next day at the most what are chances of pt developing sinusitis? the sinus lining is broken because of foreign body but the removal is as aseptic as possible and done by competent person such as oral surgeon. in this case are there any studies or any protocol to follow?
its given if implant or tooth is kept in sinus for more time chances of getting it infected or at least developing sinusitis increases. what i am asking is about immediate removal with aseptic procedure after which what is prognosis of sinus.
i have not come across any study, but the wise thing to do is to observe the patient provided the OAF (oroantral fistula) is closed. periodic radiograph would be better diagnostic tool to asses the condition even if the symptoms seize to persist. removing the sinus lining might just complicate matters. removal would be the last resort in my opinion
keep close follow up rather than relying on the literature statistic. I also agree with Dr. Bhushan.
As per the literature sinus lining should be removed. I think patient should be monitored regularly.
Dear colleague- my understanding here is that you have pushed a tooth which you were extracting into the sinus? OK, here are some important points for consideration:
1) The tooth is likely to be carrying infection if it was being extracted. This infection can potentially spread to tissues within the sinus
2) The sinus schniderian membrane has already been breached by the tooth invading the sinus
3) The tooth cannot be left in the sinus - ideally remove via a caldwell-luc approach pending position of tooth in sinus
4) A sinusitis (acute) may present symptoms but a chronic sinusitis may develop which can take considerable amount of time
5) Inform the patient of the occurence - present the remedial options and gain consent for the approach you will take
Final point: If you would like an answer regarding an implant please post and I will happily advise
Kind Regards
AP
Very easily, if tooth or implant is pushed in the maxillary sinus if there is oromaxillary fistula you have to deal with it by fistlectomy and use of buccal or palatal flap to close the defect. Using the endoscope , a wide middle meatal antrostony is performed allowing removal of pathology from the sinus including the displaced teeth or implant. No need to strip the remaining sinus mucosa as this is the concept of endoscopic sinus surgery
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