In patients receiving dialysis for chronic renal failure, various biochemical abnormalities are often associated with kidney dysfunction. Such abnormalities can promote degradation and deformation of bones. The use of dental implants in such patients therefore requires careful consideration. A patient receiving chronic dialysis in whom maxillary sinusitis developed after a fixture was accidentally inserted into the sinus is reported. The patient was a 65-year-old man with a 21-year history of chronic dialysis. Before surgery, antibiotics were administered at decreased dosage, and dialysis was performed with an anticoagulant, nafamostat mesilate, which has a short halflife. After the patient was anesthetized with isofluorane, which is not nephrotoxic, the aberrant fixture in the sinus as well as two other loose fixtures were removed, and radical surgery was performed on the right maxillary sinus. The postoperative course was good, and the patient has not had any further problems during a 3-month follow-up. This case emphasizes the importance of preoperative bone evaluation when dental implants are placed in patients receiving chronic dialysis.
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