Intrasinus Decontamination for Maxillary Sinus Infection Related to the Apically Exposed Implant in the Sinus: A Report of Two Cases

The apically exposed implant in the maxillary sinus may contribute to sinus inflammation during the early healing phase or afterward. The exposed surface of the implant can act as a reservoir for infectious agents. This case report presents 2 cases in which an intraoral approach was used to manage maxillary sinus infections related to exposed implants within the sinus. In both cases, bony access windows were created on the lateral wall of the sinus to reach the apically exposed portion of the implant. In case 1, mechanical (titanium curettes and a rotating titanium brush) and chemical decontamination (tetracycline HCl solution-soaked cotton pellets) were performed. In contrast, case 2 involved chemical decontamination performed only after removing inflammatory tissues and fluids. Following treatment, the patient's sinonasal symptoms completely resolved. Radiographic evaluations showed a significant reduction in mucosal thickening and bone formation around the exposed portion of the implant. Intrasinus decontamination may be viable for treating infected maxillary sinuses related to apically exposed implants. The current protocol should be verified in more cases with longer term follow-up.