title: The characteristics and new treatment paradigm of dental implant-related chronic rhinosinusitis.
abstract: BACKGROUND
  Because dental implantation and sinus augmentation are widely performed in recent years, one of their possible complications, maxillary sinusitis, has become a major concern for both dentists and otolaryngologists. This study evaluates the characteristics of dental implant-related chronic rhinosinusitis (DIrCRS) and the outcome of endoscopic sinus surgery (ESS) for these patients.
  
  
  METHODS
  Eighteen patients diagnosed with DIrCRS from 2007 to 2012 and who were recommended for operation were included. ESS served as the first surgical choice. Dental implants were not routinely removed unless there was severe periimplantitis. All data, including CT and surgical findings, were collected and analyzed.
  
  
  RESULTS
  All 18 patients had findings of maxillary sinus floor perforation or penetration by dental implants on CT. Fifteen of the 18 patients underwent ESS. Two patients had the dental implants removed before ESS and did not experience recurrence. Four patients had recurrence and the dental implants were removed before revised ESS. They did not experience recurrence again after the revised operation. The other nine patients had their dental implants preserved and did not experience recurrence during follow-up. None of the 15 patients required a Caldwell-Luc operation.
  
  
  CONCLUSIONS
  In patients with DIrCRS, ESS can be used as the first surgical choice with good prognosis and low morbidity. Although most cases of DIrCRS are caused by dental implants penetrating into the maxillary sinus, the dental implants can be preserved unless there is severe periimplantitis or recurrence of sinusitis. Nonetheless, the sinus mucosa above the dental implants must be kept intact during ESS.
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan. yiwei0819@gmail.com
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Chen
authors.forename: Chi-Che
authors.initials: CC
authors.lastname: Huang
authors.forename: Po-Hung
authors.initials: PH
authors.lastname: Chang
authors.forename: Chiang-Wen
authors.initials: CW
authors.lastname: Chen
authors.forename: Chia-Chen
authors.initials: CC
authors.lastname: Wu
authors.forename: Chia-Hsiang
authors.initials: CH
authors.lastname: Fu
authors.forename: Ta-Jen
authors.initials: TJ
authors.lastname: Lee
mesh_terms: D002908:Chronic Disease; D003757:Dental Implantation / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D059747:Nasal Surgical Procedures / Q000379:methods*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D012220:Rhinitis / Q000209:etiology / Q000601:surgery*; D059546:Sinus Floor Augmentation / Q000009:adverse effects; D012852:Sinusitis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants