I have had a tough experience with the placement of my dental implant. It was removed last week, only six weeks after the surgery because he didn’t think the bone was fusing properly and the gum wasn’t healing properly either. The dental implant also went through my sinus. So, there were many issues from the start.
Anyway, when it was removed, the surgeon said they didn’t see any sign of infection. It sounds like it came out really easily, which means it didn’t start fusing with my bone at all. I was supposed to be on an antibiotic to prevent infection, but since everything came out okay, they weren’t needed. He did put my on Flonase for my sinuses and told me not to blow my nose or sneeze with an open mouth. The sinus perforation was not repaired because he thinks it will heal on its own over time. The gums were repaired and stitches were placed. So, now I just wait. He wants to see how the sinus heals and if the sinus tissue and bone fill in. Then, he said we would try again.
In less than a week I felt congested, mostly at night. Also, my ear was starting to bother me, it sounded crackly at times when I opened and closed my mouth. When I went in for a follow-up appointment, he said it all looked fine. But, I didn’t like the symptoms I was having and requested an antibiotic. He was reluctant because he felt everything was OK. But, I just got started on it and my congestion cleared quickly. Do you think I should have taken antibiotics right away? Also, how do I know if the sinus is healing properly? I’m worried that there was an infection and it may interfere with the bone and sinus healing process.
Any input you have would be much appreciated.
-Josephine in California
Thank you for your question and sorry you are having complications after your dental implant surgery. There would have been no issues if you would have taken the antibiotics right away. This would have helped prevent any infection during or after the surgery. However, many physicians avoid prescribing antibiotics as a preventive measure because it is becoming a public health issue where bacteria are becoming resistant. So, it is not uncommon for patients to be monitored without antibiotics. In cases where an antibiotics aren’t required right away, many physicians will avoid prescribing them, “just in case of infection”. Flonase was a legitimate option to help in your recovery too. So, the choice of not giving antibiotics was fine, as long as the surgeon provided monitoring, which it sound like he has done.
The bigger issue from your story is the fact that the dental implant failed in the first place and that it perforated your sinus. That shouldn’t be overlooked. Also, the fact that your bone didn’t begin the integration process after six months is also concerning. Hopefully, there is a legitimate explanation for both of these problems from the initial dental implant surgery.
Many oral surgeons would say that this is an indication of poor surgery techniques. Others feel it’s not as big of a deal because it should heal fine. But, now you have had to go through six months of waiting for the bone to to fuse with the implant and now need to wait another year to see how things look. It sounds like it may be time to seek a second opinion. Clearly, we don’t have all the details and it is unclear what motivated the surgeon to remove the implant in the first place. But, the good news for your case is that the integration had not begun. Sometimes sinus perforations can cause lasting nasal and sinus problems that last years. Many times the end result is bone grafting due to the failure of the sinuses and bone to heal properly.
An excellent implant dentist and oral surgeon should take three-dimensional x-rays to make sure there is enough bone present at the surgery site to support the implant. Did your surgeon take 3D x-rays? It sounds like your surgeon plants to evaluate things in another year to see how the healing has gone. But, how do you have any guarantee this same situation will not happen again? We aren’t trying to discount or undermine your surgeon. But, you have been through a lot and it is time to get a couple other opinions from reputable implant dentists in your area. You need to be prepared that you may require bone grafting if your bone density isn’t sufficient to support the implant. There is also the possibility of a sinus lift procedure due to what has taken place the first time around.
Again, we don’t have all the details regarding your case and we understand your initial question was regarding the administration of antibiotics. We just want you to be aware that what you have experienced shouldn’t be brushed off like it was no big deal.
Donald H. Currie, DMD is an implant dentist located in York, PA that performs preventative care, cosmetic dentistry and implant dentistry services.