Did My Dentist Handle My Sinus Perforation Correctly?

I had a dental implant placed. During the procedure, the dentist perforated the sinus cavity by a few millimeters, which he explained is quite common. The bone never quite filled in so he eventually ended up removing the implant. I was sedated during the procedure and no antibiotics were administered. A few days later I started having congestion in the nose and a crackling sound. I wasn’t feeling well and thought I might be getting an infection. When I went in for my follow up, he told me everything looked fine. He also said that there was no need to repair the perforation and that it would heal on its own. I told him I thought I was getting an infection and insisted he prescribe me an antibiotic, to which he reluctantly agreed. Since then, I have not had any problem with the congestion. Now I am wondering if I should have had antibiotics to begin with. He said we can try again after everything is healed up. Do you know what the time period for that typically is?


Dear Kathey,

illustration of a dental implant

Not providing you antibiotics at the beginning, when there was no sign of infection, is not a problem. However, there are a couple of other issues here that I am concerned about.

First, the sinus perforation. While they do sometimes happen, I would not exactly call it common. Even more disturbing was the amount of the perforation. In dental terms, a few millimeters is HUGE. How did this happen? Did he do the appropriate diagnostics, which would include a CT scan? This is important because dental implants are a 3 dimensional procedure, so you need 3 dimensional images. Without that, you not only risk a sinus perforation, but damaging nearby nerves.

A second thing that concerns me is that the bone never integrated with the dental implant. Did he tell you why? Was there even enough bone there to begin with? Again, I’m curious about the diagnostics which would have given an idea about the bone support.

A Second Dental Implant Procedure

Getting your implant redone is not as simple as just waiting for things to heal. Even if you had enough bone to begin with, when the implant was removed, it would have taken some bone with it.

That bone will have to be replaced in order to even attempt a second procedure. You will need to have some bone grafting done. Then, after that has had time to heal you can get the implant done.

He also needs to answer why the implant failed. If he doesn’t know, how can he assure you it won’t happen the second time. In your place, I’d ask for a copy of the original diagnostics and then take them to another dentist for a second opinion on the reason for dental implant failure.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.