Fungal infection as a complication of sinus bone grafting and implants: a case report

Sohn, Dong-Seok; Lee, Jung-Kwang; Shin, Hong‐In; Choi, Byung Jin; An, Kyung-Mi

doi:10.1016/j.tripleo.2008.08.002

Cited by 32 publications

(32 citation statements)

References 21 publications

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“…11,15 Thus far, only one case of FB following sinus bone graftingdwith irradiated cancellous bone as filling materialdhas been reported in the literature. 26 Although the exact etiopathogenesis of FB still remains obscure, there are two main coexisting theories: aerogenic and odontogenic theories. [1][2][3] The aerogenic theory is almost exclusively related to the endemic maxillary sinusitis found in the Sudan associated with the inhalation of high quantities of Apergillus flavus spores over a very long period.…”

Section: Discussionmentioning

confidence: 99%

“…[22][23][24][25] Although only one study has reported on the development of FB of the maxillary sinus following sinus bone grafting, in recent years, we have observed a resurgence of cases presenting with such a calamitous association. 26 Thus, the present case-control study was undertaken to assess the possible association between sinus bone graft material and subsequent development of FB of the maxillary sinus. To the best of our knowledge, this is the first comprehensive study that evaluates such a relationship.…”

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confidence: 99%

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Association between maxillary sinus fungus ball and sinus bone grafting with deproteinized bovine bone substitutes: a case-control study

Scolozzi

Perez

Verdeja

et al. 2016

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Objective. To evaluate the association between sinus bone graft and the development of fungus ball (FB) of the maxillary sinus. Study Design. The charts of all patients seen for surgical treatment of maxillary sinus FB following sinus bone grafting between 2006 and 2014 were reviewed. The charts of 49 participants were selected from our internal registry for comparison as controls. The association between FB and age, gender, smoking habits, associated co-morbidities, and bone grafting material was evaluated. FB of the maxillary sinus was estimated by using an odds ratio with a Yates' correction. P values were computed using Fisher's exact test, and the statistical significance was set at a P value < .05. Results. All 13 cases (100%) with FB of the maxillary sinus had received anorganic bovine bone as the bone substitute (P ¼ .0001). There were significantly more women in the case group than in the control group (84.6% in the cases vs 40.8% in the controls; P ¼ .01).Conclusions. This study demonstrated a significant association between a specific deproteinized bovine bone substitute use as sinus bone graft material and subsequent development of FB of the maxillary sinus. (Oral Surg Oral Med Oral Pathol Oral Radiol 2016;121:e143-e147) Fungus ball (FB) represents the most common form of noninvasive extramucosal fungal infection involving the paranasal sinuses and is encountered in almost 28.5% of patients suffering from chronic maxillary sinusitis. 1-3 Aspergillus fumigatus is, by far, the most frequent causative agent found in Europe, and the root canal overfilling with the passage of zinc oxide endodontic sealers into the maxillary sinus is the most commonly recognized risk factor for the development of FB in up to 84% of patients. [1][2][3][4][5][6] Although this form of sinusitis typically affects healthy adults and has a striking female predominance, several pathologic conditions, such as diabetes, immunodeficiency diseases, and immunosuppressive and chronic corticosteroid and antibiotic treatments have been pointed out as potential predisposing factors favoring the colonization and subsequent overgrowth of the fungal hyphae. [1][2][3] Since its first report in 1980 by Boyne and James, grafting of the maxillary sinus floor has rapidly become the most common surgical procedure used to increase the subantral alveolar bone height of the posterior maxilla for subsequent dental implant placement. 7 Although reported as a predictable and reliable procedure, sinus bone graft has, nevertheless, been associated with several intra-and postoperative complications, such as sinus membrane perforation, maxillary sinusitis, wound dehiscence with graft exposure, and graft infection. In most cases, complications resolve with no need for further surgery and with no substantial impact on implant survival; however, in some cases, complications may lead to complete loss of the graft material, thus compromising the subsequent implant-supported dental restoration. [8][9][10][11][12][13][14][15][16][17] Although the literature co...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Association between maxillary sinus fungus ball and sinus bone grafting with deproteinized bovine bone substitutes: a case-control study

Scolozzi

Perez

Verdeja

et al. 2016

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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“…Fungus balls in the sphenoid sinus are much rarer (4%–8%), suggesting an additional causative factor in maxillary sinuses apart from the aerogenic theory, which suggests that inhaled spores are trapped in the sinuses if the ostium is blocked, so that the spores can develop into fungus balls. Many case reports in the literature describe the relationship between fungus balls and root canal treatment, overfilling, and oroantral fistulae if the sinus floor is penetrated during the intervention …”

Section: Discussionmentioning

confidence: 99%

“…Though there are many case reports, there are only a few larger studies correlating dentogenic factors to maxillary sinus mycosis …”

Section: Introductionmentioning

confidence: 99%

“…The iatrogenic theory says that the maxillary sinus is colonized by fungus via oroantral communications after odontogenic treatment. 1 Though there are many case reports, [3][4][5][6][7][8][9][10] there are only a few larger studies correlating dentogenic factors to maxillary sinus mycosis. [11][12][13] We analyzed the records of patients treated for a fungus ball at the Department of General Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, to see whether there is a correlation between the presence of dentogenic factors and fungus balls.…”

Section: Introductionmentioning

confidence: 99%

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Potential correlations of dentogenic factors to the development of clinically verified fungus balls: A retrospective computed tomography–based analysis

Tomazic¹,

Dostal

Magyar

et al. 2015

The Laryngoscope

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Objectives/Hypothesis Fungus balls are a common disease of the paranasal sinuses, usually involving the maxillary sinus. To clarify the pathology, we analyzed patients treated for maxillary sinus fungus balls to see whether the latter correlated with dentogenic factors. Study Design Retrospective case analysis. Methods Cases of maxillary sinus fungus balls diagnosed between January 2000 and December 2013 were analyzed retrospectively. Patients' charts were reviewed for diagnosis, gender, and age. Paranasal sinus computed tomography (CT) scans were reviewed according to the side of the fungus ball, calcifications/opacifications, and dentogenic factors. Results In 98/102 patients (96.1%), 157 dentogenic factors could be identified on the side affected by a fungus ball. On the contralateral healthy side, there were 125 dentogenic factors. In four (3.9%) of the patients, no dentogenic pathology was identified on the CT scan. The presence of dentogenic factors (regardless of number) was significantly associated with a fungus ball compared to the healthy side (P = .024, χ2 test, odds ratio: 2.72 [95% confidence interval: 1.02–7.23]). Conclusions Dentogenic factors regardless of type potentially correlate with the presence of maxillary sinus fungus ball. Unlike the overall presence of dentogenic factors, the particular dentogenic factors in an individual patient do not significantly influence the development of fungus balls. After diagnosis of dentogenic pathology in penetrated maxillary sinus floors, patients should be closely monitored and informed about their higher risk of developing a fungus ball. Level of Evidence 4. Laryngoscope, 126:39–43, 2016

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Risk Assessment and Avoiding Complications

Yarmand¹,

Deporter

Cullum

2015

Minimally Invasive Dental Implant Surgery

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Fungal infection as a complication of sinus bone grafting and implants: a case report

Cited by 32 publications

References 21 publications

Association between maxillary sinus fungus ball and sinus bone grafting with deproteinized bovine bone substitutes: a case-control study

Association between maxillary sinus fungus ball and sinus bone grafting with deproteinized bovine bone substitutes: a case-control study

Potential correlations of dentogenic factors to the development of clinically verified fungus balls: A retrospective computed tomography–based analysis

Risk Assessment and Avoiding Complications

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