Management of maxillary sinus aspergillosis followed by implant-prosthetic rehabilitation: A retrospective study of 11 consecutively treated patients with a follow-up period of 3 to 10 years.

Abstract

Purpose: Aspergillosis is a common cause of fungal maxillary sinusitis that is often asymptomatic and detected only incidentally on imaging. It may be triggered by spores entering the maxillary sinus through the natural ostium, often following the dislocation of foreign bodies, for example root canal filling or augmentation materials. This retrospective study aimed to evaluate a standardised treatment for maxillary sinus aspergillosis followed by implant-prosthetic rehabilitation.

Materials and methods: Eleven immunocompetent patients with maxillary sinus aspergillosis were included in the present study. Maxillary sinus surgery was performed via a bone lid under local anaesthesia and intravenous sedation. The aspergilloma was removed completely and the diagnosis was confirmed by histopathology. Sinus disinfection consisted of irrigation with hydrogen peroxide (3%) and saline solution, followed by photodynamic decontamination. Three months postoperatively, a new CBCT scan was taken to confirm the absence of any pathology in the sinus. Sinus floor elevation and bone augmentation were then performed following a clear protocol. Implants were placed, whenever possible, simultaneously or after 3 months and exposed after another 3 months. The definitive prosthetic restoration followed 6 to 8 weeks postoperatively.

Results: The surgical procedures went without complications, and all patients were successfully restored. After 3 to 10 years (mean 6.8 ± 1.7 years), all inserted implants were still in place and presented with no inflammation, and with pocket depths below 5 mm (3.1 ± 0.9 mm). Postoperative radiographs showed no recurrence of any sinus pathology.

Conclusion: The present treatment protocol proved to be efficient in managing infection and defect reconstruction. Throughout the 3- to 10-year follow-up period, neither recurrences nor complications presented, affirming the reliability of the protocol.