[Surgery]  Infection

I performed lateral sinus augmentation 9 months ago on the right side. No post op issues.

A new CT was obtained before placing the implants 15 and 16 and there was plenty of bone.

I placed 15 and 16 in September and did a 10 day post op check and removed sutures at this time. Everything looked great.

The patient came into the office at the end of this week concerned with the swollen gums and she felt like the swelling was going up onto the cheek although clinically it did not appear this way.

The two radiographs and 3 intra oral photos were all taken that day. It seems the fluctuant area is approximating the 16 more even though the 15 also looks involved.

Do I have a fractured implant here?


Dr. Chad Denomme

by Chad Denomme at Fri, Dec 1, 2017 6:54 PM

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Chad Denomme Replied at Thu, Dec 21, 2017 9:04 AM

I did exploratory flap and I found some shards of titanium on the corner of the flap.

I forgot when we did that lateral sinus augmentation that we denuded the threads of the implant #14 site as the apical portion perforated the cortex. Apparently I didnt get all of the shrapnel.   This took 4-5 months to manifest and had noting to do with #15,16 placement.

Everything else looked great. 

Thanks everyone


Likes : 1

Chad Denomme Replied at Sun, Dec 3, 2017 9:11 AM

Will flap it Monday and take some pictures, should be interesting.

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Chad Denomme Replied at Sun, Dec 3, 2017 9:11 AM

Thanks Ho Young,

Will do.

Madeson not that I know of. She has 2 other implants placed over the last 2 years without complications.



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Madeson Basie Replied at Sun, Dec 3, 2017 8:49 AM

Does this person have any allergies/immunological issues ?

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Ho-Young Chung Replied at Sat, Dec 2, 2017 11:46 AM

Chad, bring in patient and perform exploratory surgery.  you need to remove healing abutments and place cover screws.  LA and flap open.  Based on information provided, I can't determine what has happened.  Tx plan will depend on what you see after flapping.  be prepared to remove implants, however.  

Ho-Young Chung