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Sinus Perforation During Dental Implants

I had a dental implant placed and things did not go as expected. The bone never integrated with the dental implant so he had to remove it. He did tell me that the sinus cavity had been perforated by a few millimeters, but that it was a common thing to happen. The one thing I don’t understand is why he didn’t give me an antibiotic until I developed an infection, which happened a few weeks later. Couldn’t we have prevented that from happening if he would have given me the antibiotic after he had to take the implant out? One other question. He wants to try again next year if the hole closes. Is there anything we can do to make sure this doesn’t happen again?


Dear Carol,

An illustration of a dental implant next to a natural tooth.

There are a few problems I see here with your treatment. However, the antibiotic isn’t one of them. Antibiotics are for the treatment of an infection. If there isn’t an infection the antibiotic will be detrimental to you instead of helpful. However, that is one of the only things I agree with so far.

One of the things that concern me is the fact that he perforated your sinus by several millimeters. That is a huge amount by dental standards. Additionally, it is not normal. While there are some oral surgeons and dentists who will perforate the occasional sinus cavity, it is far from being a normal thing. It is also quite preventable.

By doing sufficient diagnostics beforehand this wouldn’t have occurred. Placing dental implants is a 3-dimensional procedure. Because of that, your dentist really needs to do 3-dimensional x-rays such as a CT scan. My guess is he skipped that.

Another issue that bothers me is that the bone didn’t integrate with your implant. Why not? Was there not enough bone to begin with? Again, correct diagnostics would have determined that ahead of time. There is a procedure that could have been done before your implant procedure to ensure there was enough bone there, called a bone graft.  You are going to need to have bone grafting done either way at this point if you still want a dental implant.

As for how to prevent this from happening again, your best bet is to find a different dentist to do your procedure. You should be able to get a refund from this dentist. After all, you paid for a dental implant and didn’t get one. Look for a dentist with post-doctoral training in dental restorations, including dental implants.

This blog is brought to you by Naperville Dentist Dr. David Newkirk.