Aspergillosis associated with migration of a dental implant into the maxillary sinus: A case report

Migration of dental implants into the maxillary sinus and related sinusitis are serious complications of dental implant placement. Inadequate implant preparation in an atrophic maxilla can easily lead to these complications. We report an unusual case of aspergillosis associated with migration of a dental implant into the maxillary sinus. Four years after placement of the dental implant, the symptoms of sinusitis appeared. Panoramic radiograph showed the migration of the dental implant into the left maxillary sinus. The migrated dental implant, which was surrounded by a friable brownish-yellow mass, was removed from the left maxillary sinus. Histopathological examination of the brownish-yellow mass revealed hyphae of Aspergillus . We preserved the function of the natural ostium and sinus membrane by artificial oroantral fenestration, and avoided its progression to invasive and fulminant fungal sinusitis. Finally, we closed the oroantral fistula by a new method with two layers of the oral and sinus sides. Despite high success rates of dental implant placement, placement failures and complications still occur in some cases. The failure to achieve sufficient primary stability, especially, causes the migration of dental implants into the maxillary sinus and related sinusitis. Therefore implants that fail to osseointegrate should be removed immediately, in order to prevent the development of invasive and fulminant fungal sinusitis.