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Case 135327

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Dental implants

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Canaray 135327

1. Implant in left maxillary sinus + possible sinusitis

The left maxillary sinus is partially captured in this imaging volume. A displaced dental implant is present within the left antral space, superior to site 26. The visible portions of the left maxillary sinus appear completely opacified, and its posterolateral wall appears slightly thickened and sclerotic. This could infer the possibility of sinusitis, but clinical examination is necessary to substantiate this interpretation. Removal of this displaced implant is indicated, and continued radiographic monitoring is recommended to assess for the resolution of antral inflammation. The presence of sinusitis is a relative contraindication to a sinus lift procedure.

2. Oro-antral defect at site 26

A large osseous defect is evident at site 26, which extends from the alveolar crest to the overlying sinus floor. These findings suggest the presence of oro-antral communication. This defect is presently filled with soft tissue, and is consistent with the reported history of implant displacement into the left maxillary sinus.

3. History of bone grafting + sinus lift procedures

Dense granular bone is observed along the floor of the maxillary sinus apical to site 26, and the sinus floor demonstrates an irregularly elevated contour in this region. These findings suggest a history of bone graft and sinus lift procedures. The density of the bone graft material appears greater than that of the adjacent trabecular bone.

Orthogonal measurements of the oro-antral defect at site 26

These orthogonal cross-sectional images demonstrate the approximate mesiodistal and buccolingual dimensions of the oro-antral defect at site 26, at various levels.

5. Crestal bone loss around implant 24

Crestal bone loss may be present around the circumference of the implant 24, and the coronal thirds of its threads may be exposed. Due to the presence of beam hardening artifacts, periapical radiography is recommended as a supplement to this imaging examination.

4. Apex of implant 24 through left maxillary sinus

The apical half of the implant 24 extends beyond the floor of the left maxillary sinus, and its threads in these regions may not be embedded in bone. In addition to the displaced implant from site 26, it may be possible that this implant could also be a contributing source of antral inflammation.

6. History of bone grafting at site 27

Dense granular bone is evident along the crestal aspect of the alveolar process at site 27, which suggests a history of bone grafting in this region. The density of the bone graft material appears greater than that of the adjacent trabecular bone.

7. Dense bone island at site 28

A dense bone island is present in the alveolar bone at the edentulous site 28. This dense bone island demonstrates no effects on its surrounding structures. This is a non-significant incidental finding.