上顎に埋入したインプラント撤去後に上顎洞炎を生じた2例

抄録

Explantation of failing or unfavorable implants is indicated in some patients. Here, we report the experience of two cases of surgical treatment required after extraction of implants by other dentists.
　In the first case, which was a 56-year-old male, another dentist had accidentally introduced a fixture into the left maxillary sinus during its explantation. Because we estimated the size of the perforation was too small to pull the fixture through, we performed endoscopic surgery to remove it another day after provisional closing of the perforation.
　The second case was a 58-year-old female. She had an oroantral fistula at the maxillary right molar region, resulting from the removal of implants. The fistula had been left untreated for about three months and the patient had chronic sinusitis and pustulosis palmaris et plantaris at the time she visited our hospital. Her uncontrolled diabetes required treatment to bring her diabetic status under control by the internist before surgery. Then, we repaired the oroantral fistula. In addition, ethmoidectomy and enlargement of the semilunar hiatus were simultaneously performed with an endoscope in cooperation with an otolaryngologist. The patient showed satisfactory progress, and recovered from pustulosis palmaxis et plantaris about one month later.
　Besides careful preoperative planning for implant therapy, primary management of surgical complications is also important.