Temuan abses pada sinus maksilaris paska pemasangan implan gigi melalui Cone Beam Computed Tomography  Abscess detection in the maxillary sinus after dental implant placement through the means of Cone Beam Computed Tomography

Noor Rachmawati; Ria Noerianingsih Firman; Deddy Firman; Sandy P; Krisna Krisna; Lusi Epsilawati

doi:10.24198/jkg.v31i1.21420

Temuan abses pada sinus maksilaris paska pemasangan implan gigi melalui Cone Beam Computed Tomography
Abscess detection in the maxillary sinus after dental implant placement through the means of Cone Beam Computed Tomography

Noor Rachmawati, Ria Noerianingsih Firman, Deddy Firman, Sandy P, Krisna Krisna, Lusi Epsilawati

Abstract

Pendahuluan: Tindakan implan merupakan salah satu upaya untuk mengganti gigi yang hilang. Pemasangan implan yang baik, mampu memberikan kenyamanan dan aspek estetis yang baik. Pemasangan implan yang penuh dengan resiko dan ketidak hati-hatian pada pemasangan berakibat tidak baik bagi pasien. Tujuan dari penulisan laporan kasus ini adalah untuk melaporkan kasus ketidaknyamanan yang disebabkan timbulnya reaksi inflamasi disertai supurasi pada sinus maksilaris paska pemasangan implan, dan juga untuk melihat kemampuan dari Cone Beam Computed Tomography (CBCT) dalam menganalisa hal tersebut. Laporankasus: Perempuan berusia 40 tahun, mengeluhkan adanya rasa tidak nyaman berupa bau mulut dan hidung disertai hidung tersumbat dan pusing kepala. Anamnesa diketahui bahwa pasien telah melakukan pemasangan implan 3 bulan sebelumnya. Pemeriksaan intraoral menemukan adanya implan pada regio posterior, tanpa rasa sakit dan tanda peradangan. Manajemen kasus dilakukan dengan meminta pasien melakukan pemeriksaan CBCT, karena dicurigai rasa tidak nyaman, pusing dan bau disebabkan oleh implan yang saat ini telah terpasang. Setelah dilakukan pemeriksaan CBCT ternyata ditemukan sinus aproksimasi pada ujung implan. Ujung implan masuk ke dalam sinus dengan panjang lebih dari 2 mm. Hal ini menyebabkan infeksi pada dinding sinus dan berkumpulnya nanah pada daerah sinus. Hal ini membuktikan bahwa implan menyebabkan infeksi pada sinus sehingga kasus ini terjadi. Pasien kemudian dirujuk ke bagian bedah untuk dilakukan perbaikan pada implan. Simpulan: Inflamasi sinus disertai supurasi pada sinus maksilaris paska pemasangan dapat terjadi, hal ini terjadi kemungkinan karena respon tubuh terhadap implan yang masuk ke rongga sinus. Analisa dapat dilakukan dengan memanfaatkan radiografi CBCT.

Kata kunci: Implan, CBCT, infeksi sinus maksilaris.

ABSTRACT

Introduction: Dental implant placement is an attempt to replace missing teeth. Installing the right implant can provide comfort and good aesthetic aspects. However, the installation of implants with full risks and caution will hurt the patient; thus proper planning is needed for implant placement. The purpose of this case report was to report cases of discomfort caused by an inflammatory reaction accompanied by suppuration in the maxillary sinus after implant placement and also to see the ability of Cone Beam Computed Tomography (CBCT) in analysing this. Case report: A 40-years-old woman complains of discomfort in the form of bad breath, nasal congestion, and headache. Anamnesa found that the patient had implant placement 3 months earlier. An intraoral examination found an implant in the posterior region, with no signs of pain and inflammation. Case management was performed by asking the patient to do a CBCT examination due to suspected discomfort, dizziness and bad breath caused by implants that are currently installed. After a CBCT examination found a sinus approximation at the tip of the implant. The tip of the implant goes into the sinus with a length of more than 2 mm. This caused an infection of the sinus wall and the gathering of pus in the sinus area. This proves that the implant caused an infection of the sinuses. The patient was then referred to the surgical section for the implant repairment. Conclusion: Sinus inflammation accompanied by suppuration of the maxillary sinus after installation can be occurred likely due to the body’s response towards the implants entering the sinus cavity. Analysis can be performed using CBCT radiography.

Keywords: Implant, CBCT, maxillary sinus infection.

Keywords

Implan, CBCT, infeksi sinus maksilaris, implant, CBCT, maxillary sinus infection.

Full Text:

PDF

References

Drysdale C, Feran K, Friel P, Henderson S, Parker C, Speechley D, et al. A Dentist’s Guide to Implantology. London: The Association of Dental Implantology; 2012. h. 4-6.

Daouahi N, Hadyaoui D, Khlifa MB, Cherif M. Management of missing second premolar with single-tooth implant using flapless surgery. Dent Open J. 2015; 2(4): 121-4. DOI: 10.17140/DOJ-2-122

Brodala N. Flapless surgery and its effect on dental implant outcomes. Int J Oral Maxillofac Implants. 2009; 24(Supp l): 118-25.

El-Anwar MI, Tamam RA, Fawzy UM, Yousief SA. The effect of luting cement type and thickness on stress distribution in upper premolar implant restored with metal ceramic crowns. Tanta Dent J. 2015; 12(1): 48-55. DOI: 10.1016/j.tdj.2015.01.004

Nissan J, Narobai D, Gross O, Ghelfan O, Chaushu G. Long term outcome of cemented versus screw-retained implant supported partial restorations. Int J Oral Maxillofac Implants. 2011; 26(5): 1102-7.

Tonetti MS, Hämmerle CHF. Advances in bone augmentation to enable dental implant placement: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol. 2008; 35(8 Suppl): 168-72. DOI: 10.1111/j.1600-051X.2008.01268.x

Valentini P, Abensur DJ. Maxillary sinus grafting with anorganic bovine bone: a clinical report of long-term results. Int J Oral Maxillofac Implants. 2003; 18(4): 556-60.

Rodoni LR, Glauser R, Feloutzis A, Hammerle CH. Implants in the posterior maxilla: a comparative clinical and radiologic study. Int J Oral Maxillofac Implants. 2005; 20(2): 231-7.

Wallace SS, Froum SJ. Effect of maxillary sinus augmentation on the survival of endosseous dental implants. A systematic review. Ann Periodontol. 2003; 8(1): 328-43. DOI: 10.1902/annals.2003.8.1.328

Brugnami F, Caleffi C. Prosthetically driven implant placement. How to achieve the appropriate implant site development. Keio J Med. 2005; 54(4): 172-8. DOI: 10.2302/kjm.54.172

Branemark PI, Adell R, Albrektsson T, Lekholm U, Lindstrom J, Rockler B. An experimental and clinical study of osseointegrated implants penetrating the nasal cavity and maxillary sinus. J Oral Maxillofac Surg. 1984; 42(8): 497-505. DOI: 10.1016/0278-2391(84)90008-9

Whaites E. Essentials dental radiography and radiology. 4th ed. London: Churchill Livingstone; 2006. h. 289-97.

Cevidanes LH, Bailey LJ, Tucker SF, Styner MA, Mol A, Phillips CL, et al. Three-dimensional cone-beam computed tomography for assessment of mandibular changes after orthognathic surgery. Am J Orthod Dentofacial. Orthop 2007; 131(1): 44–50. DOI: 10.1016/j.ajodo.2005.03.029

Rumah Sakit Gigi dan Mulut Universitas Padjadjaran. CBCT data [radiograph CBCT image]. Bandung: Universitas Padjadjaran; 2017.

An JH, Park SH, Han JJ, Jung S, Kook MS, Park HJ, et al. Treatment of dental implant displacement into the maxillary sinus. Maxillofac Plast Reconstr Surg. 2017; 39(1): 35. DOI: 10.1186/s40902-017-0133-1

Gosau M, Rink D, Driemel O, Draenert FG. Maxillary sinus anatomy: a cadaveric study with clinical implications. Anat Rec (Hoboken). 2009; 292(3): 352–4. DOI: 10.1002/ar.20859

van den Bergh JPA, ten Bruggenkate CM, Disch FJM, Tuinzing DB. Anatomical aspects of sinus floor elevations. Clin Oral Implants Res. 2000; 11(3): 256–65. DOI: 10.1034/j.1600-0501.2000.011003256.x

Zijderveld SA, van den Bergh JP, Schulten EA, ten Bruggenkate CM. Anatomical and surgical findings and complications in 100 consecutive maxillary sinus floor elevation procedures. J Oral Maxillofac Surg. 2008; 66(7): 1426–38. DOI: 10.1016/j.joms.2008.01.027

Nolan PJ, Freeman K, Kraut RA. Correlation between Schneiderian membrane perforation and sinus lift graft outcome: a retrospective evaluation of 359 augmented sinus. J Oral Maxillofac Surg. 2014; 72(1): 47–52. DOI: 10.1016/j.joms.2013.07.020

Gonzalez-Garcia A, Gonzalez-Garcia J, Diniz-Freitas M, Garcia-Garcia A, Bullon P. Accidental displacement and migration of endosseous implants into adjacent craniofacial structures: a review and update. Med Oral Patol Oral Cir Bucal. 2012; 17(5): e769–e774. DOI: 10.4317/medoral.18032

Papaspyridakos P, Ostuni A, Han C, Lal K. Posterior maxillary segmental osteotomy for the implant reconstruction of a vertically deficient ridge: a 3-year clinical report. J Prosthet Dent. 2013; 110(2): 69–75. DOI: 10.1016/S0022-3913(13)00137-6

Li J, Lee K, Chen H, Ou G. Piezoelectric surgery in maxillary sinus floor elevation with hydraulic pressure for xenograft and simultaneous implant placement. J Prosthet Dent. 2013; 110(5): 344–348.

Galindo-Moreno P, Padial-Molina M, Sanchez-Fernandez E, Hernandez-Cortes P, Wang HL, O’Valle F. Dental implant migration in grafted maxillary sinus. Implant Dent. 2011; 20(6): 400–5. DOI: 10.1097/ID.0b013e31822b9d2d

Jenny N, Naorem S, Naorem K, Singh PD. Know About Biocompatibility of Dental Materials: A Review. Pyrex J Med Med Sci. 2017; 4(5): 33-43.

Murray PE, Garcia Godoy C, Garcia Godoy F. How is the biocompatibilty of dental biomaterials evaluated? Med Oral Patol Oral Cir Bucal. 2007; 12(3): E258-66.

Mahalaxmi S. Materials Used in Dentistry. 1st ed. New Delhi: Wolters Kluwer India Pvt. Ltd.; 2003. h. 129-32.

Göçmen G, Özkan Y. Maxillary Sinus Augmentation for Dental Implants. In: Singh Gendeh B. Paranasal Sinuses. London: Intech Open Ltd.; 2017 h. 40-54.

Anzalone JV, Vastardis S. Oroantral communication as an osteotome sinus elevation complication. J Oral Implantol. 2010; 36(3): 231–7. DOI: 10.1563/AAID-JOI-D-09-00026

Regev E, Smith R, Perrott DH, Pogrel MA. Maxillary sinus complications related to endosseous implants. Int J Oral Maxillofac Implants. 1995; 10(4): 451-61.

Raghoebar GM, Stellingsma K, Meijer HJ, Vissink A. Vertical distraction of the severely resorbed edentulous mandible: An assessment of the treatment outcome. Int J Oral Maxillofac Implants. 2008; 23(2): 299-307.

Macbeth R. Caldwell, Luc, and their operation. Laryngoscope. 1971; 81(10): 1652–7. DOI: 10.1288/00005537-197110000-00011

Mohan N, Wolf J, Dym H. Maxillary sinus augmentation. Dent Clin North Am. 2015; 59(2): 375–88. DOI: 10.1016/j.cden.2014.10.001

Drage NA, Palmer RM, Blake G, Wilson R, Crane F, Fogelman I. A comparison of bone mineral density in the spine, hip and jaws of edentulous subjects. Clin Oral Implants Res. 2007; 18(4): 496–500. DOI: 10.1111/j.1600-0501.2007.01379.x.

DOI: https://doi.org/10.24198/jkg.v31i1.21420