Sinus Infection from Dental Implant

Q: I had a full upper dental implant reconstruction in 2005.

I am experiencing a bad odor coming from my nose when inhaling through the nose. This has been going on for over a year.

I visited ENT specialist and found through CT scans that the odor was due to the sinus being punctured during implantation and creating an infection.  Prednisone was prescribed for sinus infection but the odor remains.

Is this something you have experienced and treated in the past?

A: The roots of the upper back molars often are separated from the floor of the sinuses by only a couple of millimeters, about a thickness of a thumbnail. There fore if we are removing diseased teeth that cannot be saved, it means our implants will be placed a couple of millimeters short of penetrating the sinus floor.

I also would like to know if antibiotics were prescribed such as Augmentin.

Should an implant actually traverse the floor of the sinus, this rarely causes a sinus infection as long as the implant has not failed, meaning it has not lost all its surrounding bone and has become loose. I believe many implants puncture the floor of the sinus inadvertently, but the hole is immediately sealed by the implant itself as it engages the surrounding bone, like a cork in a bottle.

I am also a bit puzzled as to why you would have an odor upon inhaling through your nose since the inhaled air passes over the olfactory (smell sensing) nerves independent of the sinuses.

I would recommend that the ENT doctor visually inspects your sinuses with a fiberoptic scope to truly verify if this is the cause of your sinus infection. If it is, the implant can be removed, followed by the possible need for placement of some bone graft material to permanently seal the opening stopping any communication of the sinus with the oral cavity.

If you need a second opinion for this issue, I recommend you see the ENT doctors Dittolo and Olsen in West Palm and the oral maxillofacial surgeon, Richard Kaplan DDS, MD.

I have no financial relationship with any of these doctors, other than an occasional fruitcake sent during the holidays which I used to prop up my bed a few inches to tame my acid reflux!