Impact of Maxillary Sinus Pathosis on Implant Success Following Augmentation

Maxillary sinus augmentation is routinely performed to permit the placement of dental implants, with overall high success rates. Although surgical and prosthetic factors have been examined in relation to implant survival, little evidence is available on the potential impact of pre-existing sinus pathosis on implant survival in the augmented sinus. Objective: The purpose of this study was to examine the impact of sinus pathosis on implant success in the augmented maxillary sinus. Methods: A retrospective analysis was performed on 36 (19 men; 17 women; mean age 58.3) consecutively treated patients that had undergone computed tomography imaging and evaluation by a radiologist prior to sinus augmentation (lateral window approach) and implant placement. The study was approved by the Institutional Review Board. Results: Fifty-three sinuses had undergone lateral window augmentation with placement of one or more implants. The radiology reports revealed that 40 out of 53 cases (75.5%) had pathosis present prior to sinus augmentation, including mucous retention cyst, chronic sinusitis, mild inflammation, mucosal thickening, acute sinusitis, and polyp. Only one subject received treatment for a sinus condition. Men were more likely than women to have radiographic findings consistent with pathosis (65.7% and 34.3%, respectively). Five implant failures were documented in the 35 sinuses with findings of pathosis. No implant failures were documented in the 13 sinuses without radiographic evidence of pathosis. Of the successful cases, 35 out of 48 cases (72.9%) had pathosis present. Overall, a 90.56% implant survival rate was found in the augmented maxillary sinus. Conclusion: The overall high implant success rate suggests that the relative impact of pre-existing sinus conditions on treatment outcome is modest, if present, given that the majority of maxillary sinuses exhibited evidence of pre-existing pathosis.