Perforating dental implants and maxillary sinus pathology

Tom Brandstaetter, Oren Ziv*, Iftach Sagy, Nili Segal, Shy Schneider, Navot Givol, Liran Levin, Yehuda Zadik, Sofia Kordeluk

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: To study the association between perforation dental implants into the maxillary sinus cavity and the development of sinus pathology. Methods: We retrospectively examined 3732 computerized tomography (CT) scans to detect maxillary implants. The detected scans were grouped based on apparent or lack of perforated dental implants in the maxillary sinus (study and control group, respectively). Clinical data was gathered including the CT indication, patients’ demographics, comorbidities and medications, implant features, and the radiographic appearance of the maxillary sinuses. We conducted a logistic regression to identify risk factors to develop radiopaque thickening in the sinuses. Results: Included in the study were 198 patients with 719 maxillary implants; of these, 236 and 483 implants were in the study and control groups, respectively. Sinus opacification was associated with implants’ perforations (p < 0.001), diameter, and side and place (p < 0.05). Implants’ perforation (OR = 3.679; 95% CI = 1.891–7.157) and diameter (OR = 1.608; 95% CI = 1.067–2.424), sinus floor augmentation (OR = 2.341; 95% CI = 1.087–5.042), male gender (OR = 2.703; 95% CI = 1.407–5.192), and smoking (OR = 6.073; 95% CI = 2.911–12.667) were associated with ipsilateral sinus fullness. Conclusions: A first large study on the association between maxillary dental implant and sinus pathology. Dental implant perforation is associated with sinus opacification. Considering dental implant diameter, rather than vertical depth of penetration into the sinus, as an important criterion when examining perforated dental implants necessitates a new approach to clinical decision-making.

Original languageEnglish
Pages (from-to)715-721
Number of pages7
JournalOral and Maxillofacial Surgery
Issue number2
StatePublished - Jun 2024

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023.


  • Dental implant
  • Maxillary sinus
  • Odontogenic sinusitis
  • Paranasal sinuses
  • Sinus pathology
  • Sinusitis


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